Quite often, the drug “Clomipramine” is used in the treatment of patients suffering from mental disorders. Its analogues for sale are represented by several items. However, alternatives predominantly cost much more than the original Clomipramine. What are the main benefits of this drug? When is it worth replacing Clomipramine with analogues, and when is it worth choosing it? What violations can help? Let's try to figure it out.
Similar drugs
Considering the analogues of "Clomipramine", first of all, you need to pay attention to a number of medications, which include a similar active substance - clomipramine. In Russia, antidepressants with such a composition are practically not made, therefore, imported goods are predominantly on sale. Analogs of Clomipramine:
In addition to tablets, a solution is also on sale.
Clomipramine: what is it?
Under this name, in modern pharmacies, upon presentation of the prescription, tablets coated with a thin film can be purchased. The price of the antidepressant "Clomipramine" varies about two to three hundred rubles for a package containing three dozen tablets. The duration of the period for which one package is enough depends on the dosage prescribed by the attending physician.
The specificity of the drug in question is such that the use of “Clomipramine” is possible only under the supervision of the attending physician. It is unacceptable to prescribe a remedy for yourself independently, as part of self-medication. In addition, you cannot replace the prescribed drug without the consent of the doctor. If you want to change “Clomipramine” for analogues, synonyms, you need to notify the doctor about this. The doctor will help you choose the best option, taking into account the wishes of the patient. Otherwise, the doctor will strongly advise you to adhere to the initially selected therapy and use “Clomipramine”.
What is made of?
As can be seen from the instructions for use of "Clomipramine" (analogues are mainly based on the same active substance), the effectiveness of the drug is due to the presence of clomipramine in the form of hydrochloride in its composition. In one tablet, the active ingredient is present in an amount of 25 mg.
In addition to the main substance, the tablet contains a number of auxiliary components that enhance the action of the active compound and simplify the process of assimilation by the body. As can be seen from the instructions for use, “Clomipramine” (analogues too) includes cellulose, lactose, carmellose, iron oxide and titanium dioxide, as well as macrogol and magnesium stearate. It is very important to study in detail the composition of the medication, if the patient knows for himself hypersensitivity to any substance used in the pharmaceutical industry. This allows one to understand already at the stage of studying the packaging whether Clomipramine will provoke an allergic reaction or whether the treatment with the drug will be successful. As can be seen from the patient reviews, “Clomipramine” sometimes becomes a source of an allergic reaction and other side effects, but this happens quite rarely.
Pharmaceutical Features
On sale, the described drug is represented by tablets convex on both sides. Visually, these are small capsules of a pale yellow hue, covered with a thin film. One of the sides is supplemented with an engraving indicating the concentration of the active component - 25 mg. As indicated in the instructions for use, "Clomipramine" on the one hand is completely smooth. The tablets are made in the shape of a circle, packaged in blisters. Blisters for sale are presented in blocks packed in paper boxes. In each box there is an instruction for the use of Clomipramine. Reviews of analogues indicate that all modern manufacturers pack antidepressants in this way. It is impossible to purchase a drug in the packaging of which there is no instruction for use - it is probably a fake. In a reliable pharmacy such a product is not found.
The tool belongs to the group of antidepressants. This is a tricyclic drug that affects the capture of monoamines. The inhibitor belongs to the category of non-selective. As can be seen from the instructions, “Clomipramine” has a strong thymoanaleptic effect, at the same time it is a balanced medication, which has a psychic stimulating result in combination with a sedative effect on the patient. In addition, Clomipramine has an anxiolytic effect on the patient. As can be seen from the instructions, "Clomipramine" affects the concentration of norepinephrine in the brain tissue, and also increases the content of serotonin, since the process of neural reuptake of compounds is blocked. Compared with most tricyclic antidepressants, the reuptake of serotonin is significantly less when using the described drug. This makes Clomipramine more applicable, while synonyms built on other active components have a less pronounced effect.
Fast and efficient
Judging by the reviews, “Clomipramine” shows the first effectiveness after a few days from the start of the therapeutic course. The drug has a good effect on patients suffering from urinary incontinence during sleep, and is also effective in bulimia and is a strong analgesic. “Clomipramine” is an alpha-blocker, which also has the effect of a cholinergic blocker, an H1-histamine blocker.
When using "Clomipramine" there is a wide list of pharmacological effects. The drug is capable of blocking class 5-HT receptors, and it also has a pronounced antihistamine effect. The use of Clomipramine shows good results in depressive syndrome, including in a number of specific situations. “Clomipramine” also fights with typical manifestations of depression (mental retardation, motor activity, depression), and also eliminates increased anxiety. A persistent clinical effect is usually achieved at the second or third week of a therapeutic course.
Diagnoses and Usage
Often, "Clomipramine" is prescribed for OCD. The impact on the patient is somewhat different from that observed with depressive disorders. “Clomipramine” is effective for chronic pain provoked by somatic disorders. The use of the medication allows normalizing the transmission of nerve signals, which involves the use of norepinephrine, serotonin, the concentration of which in the brain tissue increases under the action of the active component of the drug.
If we compare "Clomipramine" and drugs based on imipramine, then the former is characterized by a weaker psychostimulating effect. When conducting a comparative analysis of the use of Clomipramine and drugs on amitriptyline, it was revealed that the former has a weaker sedative effect.
What is going on in the body?
"Clomipramine" is intended for ingestion. When the drug is in the body, almost one hundred percent absorption occurs. The bioavailability of the active component varies about 50 percent, which in medicine is called the effect of the primary processing by the liver. If 50 mg is ingested once at a time, the highest level of active substance concentration in the blood is reached after four hours. Metabolites in the body are detected in the highest concentration a little later: the period varies from four hours to a day.
If a therapeutic course has been chosen that involves taking 25 mg of Clomipramine three times a day, then by the end of the first week you can achieve an equilibrium concentration. To control the indicator, it is necessary to take blood plasma for analysis. The drug is 97.6% bound to blood proteins. In spinal fluid, the concentration varies in the amount of about two percent of the value characteristic of blood plasma. But in the breast milk of a nursing woman, studies have shown that the concentration of clomipramine is exactly the same as in blood plasma.
Special occasions
As can be seen from the clinical trials, in certain patient groups, the perception of “Clomipramine” is somewhat different from the standard. In particular, when choosing this drug for elderly patients, it must be remembered that their body has a lower metabolic rate. This leads to an increase in the concentration of the active substance in blood plasma. At the same time, the use of “Clomipramine” for the treatment of patients with diagnosed problems of the functioning of the kidneys and liver requires special caution. Currently, there are no official clinical data on the treatment of such individuals with clomipramine.
When to use?
Typically, clomipramine is prescribed for depressive conditions. You can use the drug for diseases of various etiologies. The remedy shows a good effect with a wide list of symptoms. Clomipramine can be used for masked, organic, and reactive depression. The drug shows excellent results with the involutional, endogenous and neurotic type of depressive disorder.
"Clomipramine" is effective in psychopathy, often used as part of a comprehensive treatment for schizophrenia. The tool shows effectiveness in depressive syndromes accompanying the elderly, provoked by chronic pain, somatic disorders. “Clomipramine” can be used for mood problems triggered by various reasons (psychopathy, neurosis). The tool shows a good result in the treatment of OCD. Often, “Clomipramine” is prescribed for patients with defined phobia, cataplexy, accompanying narcolepsy, panic attacks and panic disorders. "Clomipramine" is effective in pain, manifested in a chronic form. For patients whose age is 10 years or older, with additional studies to eliminate the likelihood of organic causes, Clomipramine can be used to eliminate nightly urinary incontinence.
When is it impossible?
In some cases, resorting to Klomipramin is not recommended or categorically impossible. This applies, for example, to a situation where the patient has an increased sensitivity to any substance included in the medication. You can not use "clomipramine" if the patient is known to have an increased sensitivity to dibenzazepine derivatives. It is unacceptable to resort to such therapy if there is a history of acute poisoning by various groups of substances: sedative drugs, sleeping pills, and also drinks containing alcohol. You can not use "Clomipramine" if it is known that a person survived the administration of psychotropic or analgesics, medicines designed for general anesthesia.
"Clomipramine" is not applicable in the decompensation stage of failure of the functioning of the heart muscle. It can not be used for myocardial infarction: both in the acute stage and during the rehabilitation period. If problems of cardiac muscle conduction, increased pressure in a pronounced form, as well as acute pathologies of the kidneys, liver that provoke a violation of the functionality of these organs are detected, therapy with Clomipramine becomes impossible, as it is associated with a risk of severe negative effects. The drug is unacceptable for the treatment of persons with blood diseases, gastrointestinal ulcers, hypertrophied prostate glands, as well as the detection of atony of the bladder. You can not use "Clomipramine" simultaneously with drugs of the IMOA group, as well as two weeks before taking them. If IMAO has been used, Clomipramine can be used only after two weeks, otherwise the likelihood of serotonin syndrome increases . A complete list of contraindications can be found in the instructions for use. In addition, the doctor must report these when prescribing a medication.
Specific situations
In some cases, clomipramine can be used, but only with constant medical supervision. As a rule, the frequency of tests is set, and the doctor constantly monitors blood counts to prevent negative side effects if the risk of manifestation increases. Specific situations requiring special care include patients who have epilepsy, as well as other factors that can trigger seizures. “Clomipramine” is used very carefully if the patient has suffered a brain injury, and is also taking a course using antipsychotics.
If a person is experiencing a forced abandonment of alcohol, the use of "clomipramine" must be very careful. Constant monitoring of the patient's condition is also necessary in the case when drugs that prevent convulsive conditions have just been canceled. There is an opinion that the appearance of seizures may be associated with the dosage of Clomipramine, but at present this theory has no evidence base. In any case, the manufacturer pays special attention to both doctors and patients: you can not exceed the maximum dose set for 24 hours, so as not to provoke negative reactions of the body.
When else to apply gently?
As can be seen from the instructions, the doctor’s special attention should be focused on patients with cardiac abnormalities. A specific relationship is required by those who have glaucoma (especially if it is a closed-angle type). The drug is used carefully if urinary retention, increased pressure in the ocular system and in severe liver disorders are observed. If a tumor of the brain layers of the adrenal glands is detected, “Clomipramine” can be used, but with constant monitoring of the situation. It is necessary to remember the increased risk of a hypertensive crisis, associated with a number of pathologies.
During pregnancy
Currently, official information on the use of Clomipramine during gestation is insufficient. Apply the medication in this condition only in a limited format. It is suggested that tricyclic antidepressants can provoke disturbances in the development of the embryo. Based on this, in the general case, doctors recommend abandoning the course of Clomipramine during gestation. At the same time, in each case, the attending physician assesses the condition of the expectant mother, as well as the likelihood of risk for the child, and on the basis of a comparative analysis makes a decision on how reasonable the therapy is.
If the patient drank “Clomipramine” or other tricyclic antidepressants during the period of gestation, and the therapy lasted until the birth of the baby, the baby is likely to have withdrawal symptoms in the first few hours after birth. This is manifested by shortness of breath, colic. The child sleeps a lot, can be irritable, pressure is higher or lower than normal. In addition, there is the likelihood of spastic events, tremors. To prevent such consequences, "Clomipramine" stop taking two months before the expected time of delivery. It is also taken into account that the substance can penetrate into milk during lactation, which is why when taking the drug, you should not breast-feed a child or refuse tricyclic depressants for a lactation period.