Active Ingredient: Clomipramine
In the management of endogenous depression including manic depression, periodic and involutional depression, reactive and neurotic depression.
For this indication, competent medicine agencies globally authorize below treatments:
For:
Intramuscular, between 25 milligrams clomipramine and 50 milligrams clomipramine, once daily. Afterwards, intramuscular, between 75 milligrams clomipramine and 150 milligrams clomipramine, once daily.
For:
Oral, in total between 10 milligrams clomipramine and 25 milligrams clomipramine, daily. Afterwards, oral, in total between 30 milligrams clomipramine and 250 milligrams clomipramine, daily. The maximum allowed total dose is 250 milligrams clomipramine daily.
The usual daily dosage is in the range of 30 to 75 mg in single or divided doses. Initial dosage should be 10 mg/day with gradual increments to 30-150 mg/day in divided doses or as a single dose at bedtime. Dosage may exceed the stated range if necessary up to a maximum of 250 mg.
The dosage should be adapted to the individual patient’s condition. The aim is to achieve an optimum effect while keeping the doses as low as possible and increasing them cautiously. After a response has been obtained, maintenance therapy should be continued at the optimum dose to avoid relapse. Patients with a history of recurrent depression require maintenance treatment for a longer duration. Duration of maintenance treatment and need for further treatment should be reviewed periodically.
Abrupt discontinuation of clomipramine therapy should be avoided because of possible withdrawal symptoms. Therefore, dosage should be stopped gradually after regular use for long duration and the patient should be monitored carefully when clomipramine therapy is discontinued.
Clomipramine can be administered with or without food.
For:
Intravenous, between 50 milligrams clomipramine and 75 milligrams clomipramine, once daily.
For:
Oral, in total between 10 milligrams clomipramine and 50 milligrams clomipramine, daily.
Elderly patients generally show a stronger response to clomipramine than patients of intermediate age groups. Clomipramine should be used with caution in elderly patients and doses should be increased cautiously. Daily dose should generally be low, initiated at the lowest level (10 mg) with very slow cautious increments to 30-75 mg daily.
The dosage should be adapted to the individual patient’s condition. The aim is to achieve an optimum effect while keeping the doses as low as possible and increasing them cautiously. After a response has been obtained, maintenance therapy should be continued at the optimum dose to avoid relapse. Patients with a history of recurrent depression require maintenance treatment for a longer duration. Duration of maintenance treatment and need for further treatment should be reviewed periodically.
Abrupt discontinuation of clomipramine therapy should be avoided because of possible withdrawal symptoms. Therefore, dosage should be stopped gradually after regular use for long duration and the patient should be monitored carefully when clomipramine therapy is discontinued.
Clomipramine can be administered with or without food.
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