Clomipramine Long-Term Side Effects

Clomipramine is a tricyclic antidepressant (TCA) primarily used to treat obsessive-compulsive disorder (OCD). Like all medications, clomipramine can have side effects. While some side effects are transient and might diminish as the body adapts to the medication, others can be persistent when the drug is taken over a long period. Below, I’ll discuss the potential long-term side effects of clomipramine.

Clomipramine Long-Term Side Effects

1. Cardiovascular Effects:

  • Arrhythmias: Clomipramine can lead to changes in heart rhythm, which might become problematic especially in overdose.
  • Hypotension: The drug can lead to a drop in blood pressure, especially upon standing (orthostatic hypotension).

2. Central Nervous System Effects:

  • Memory Problems: Some patients might experience memory issues.
  • Confusion: Especially in the elderly, prolonged use can lead to confusion or a foggy brain.

3. Weight Gain:

Many people experience weight gain with TCAs, including clomipramine.

4. Sexual Side Effects:

  • Prolonged use can cause problems like reduced libido, erectile dysfunction, or difficulty achieving orgasm.

5. Anticholinergic Effects:

Clomipramine has anticholinergic properties. Over time, this can lead to:

  • Dry mouth
  • Constipation
  • Blurred vision
  • Difficulty urinating
  • Potential risk of glaucoma exacerbation

6. Bone Density:

Some research suggests that long-term use of antidepressants might be associated with decreased bone density, leading to a higher risk of fractures.

7. Withdrawal Symptoms:

If one stops taking clomipramine suddenly after prolonged use, they might experience withdrawal symptoms such as dizziness, nausea, headache, irritability, and insomnia.

8. Serotonin Syndrome:

While this is more acute than chronic, if clomipramine is taken with other serotonergic agents, there’s a risk of serotonin syndrome, a potentially life-threatening condition.

Monitoring and Considerations:

  • Regular Check-ups: Anyone on clomipramine should have regular check-ups, including monitoring of blood pressure and ECGs to check for any heart abnormalities.
  • Elderly patients: They are generally more susceptible to side effects, so they might need closer monitoring.
  • Pregnancy: If you’re pregnant or planning to become pregnant, discuss the risks and benefits with your doctor.


Clomipramine, like all medications, has its benefits and risks. It’s essential to work closely with a physician when on this medication. Regular monitoring and open communication about any emerging side effects can ensure that the drug is as safe and effective as possible. Always talk to a healthcare professional about any concerns.

by Abdullah Sam
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