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Re: Anyone on Anafranil (clomipramine)? » Jackster

Posted by sunnely on August 31, 2001, at 18:44:22

In reply to Anyone on Anafranil (clomipramine)?, posted by Jackster on August 29, 2001, at 5:56:43

> Just want to compare notes on side effects experienced and any good results.
>
> Jackie

Aside from the side effects mentioned in the previous posts, it is clinically advisable to obtain a heart tracing (usually called EKG or ECG) before clomipramine (Anafranil) is started, and then periodically thereafter for routine monitoring.

Like other tricyclic antidepressants (TCAs), Anafranil has been reported to induce heart dysfunction including prolonged QTc (EKG) leading to "torsades," AV block, and cardiac arrest. Clomipramine (the parent compound) is a potent serotonin reuptake inhibitor. However, the drug is demethylated in humans, and the resultant metabolite (desmethylclomipramine) is a potent norepinephrine reuptake inhibitor. Clomipramine is metabolized to desmethylclomipramine by at least 2 cytochrome enzymes, CYP1A2 and CYP3A4.

As a precautionary measure, someone who is on Anafranil should avoid taking other drugs known to prolong QTc. Some of the drugs reported to prolong QTc include the antibiotics belonging to the class of quinolones; antipsychotics such as thioridazine (Mellaril), mesoridazine (Serentil), pimozide (Orap), and ziprasidone (Geodon). Needless to say, if at all possible, avoid drinking grapefruit juice while on Anafranil. For more info on drugs and prolonged QTC/torsades, go to the following site:

http://www.torsades.org


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