Oral (p.o.) administration has a delayed onset time of several weeks and moderate efficacy in obsessive-compulsive disorder (OCD), therefore a more rapidly effective treatment is required. The aim of this paper was to review available data detailing the clinical outcome of intravenously (i.v.) administered antiobsessional drug in OCD patients. Review of the research indicates that i.v. administration exhibits a faster onset and greater improvement than p.o. administration. I.v. pulse administration showed clinically significantly faster onset than i.v. gradual administration. I.v. administration was safe and rapidly effective in treatment resistant OCD patients and might be a valuable new treatment.
Administration, Intravenous ; Citalopram ; Clomipramine ; Humans ; Obsessive-Compulsive Disorder

No abstract available.
Animals ; Clomipramine* ; Preoptic Area* ; Rats* ; Serotonin Uptake Inhibitors* ; Serotonin*

We report two patients with frequent isolated sleep paralysis (SP). They have neither cataplexy nor daytime sleepiness, and there was no HLA DR2 or DQ1 association. We elicited one episode of sleep paralysis from a patient by a sleep interruption schedule. The polysomnographic recording during SP showed abundant alpha rhythm with persistent atonia, which indicate a concurrence of REM-atonia and wakefulness. The frequency of SP was markedly reduced by a use of clomipramine
Alpha Rhythm ; Appointments and Schedules ; Cataplexy ; Clomipramine ; Humans ; Polysomnography ; Sleep Paralysis* ; Sleep, REM ; Wakefulness

A 5-year-old, castrated male, Maltese was presented with history of acute flaccid paralysis. The dog was presented with sudden loss of muscle tone and involuntary movements of hind limbs. Neurologic examination revealed reduced postural reaction in the bilateral hind limbs. MRI of brain showed moderate hydrocephalus, but other examination results were normal. Based on the characteristic episodes and examination results, canine cataplexy was suspected. Treatment was initiated with clomipramine as cataplexy control. Clinical signs resolved with 3-month medication. This case demonstrates therapeutic diagnosis of cataplexy. To the author's knowledge, this is the first report of cataplexy treating with clomipramine.
Animals ; Brain ; Cataplexy ; Clomipramine ; Dogs ; Dyskinesias ; Extremities ; Humans ; Hydrocephalus ; Male ; Muscles ; Narcolepsy ; Neurologic Examination ; Paralysis

In spite of the long history of notice, research on the pharmacotherapy of body dysmorphic disorder is limited. No placebo-controlled, continuation, maintenance, or discontinuation studies have been published. But accumulated data and experiences in recent days enable us even roughly to set up a pharmacological treatment step for body dysmorphic disorder. In addition to the clinical aspect of body dysmorphic disorder and its relation to obsessive-compulsive disorder, this article reviewed recent researches and clinical experiences about the pharmacotheray issues like SRI treatment, augmented treatment strategy using buspirone or neuroleptics or others, clomipramine pulse-loaded intravenous therapy, and other treatment methods including ECT and brain surgery, mainly for the purpose of making helpful guidelines for the clinicians. Some tips about cognitive-behavior therapy and future research directions were also added.
Antipsychotic Agents ; Body Dysmorphic Disorders* ; Brain ; Buspirone ; Clomipramine ; Drug Therapy ; Obsessive-Compulsive Disorder

Dilated cardiomyopathy is a primary myocardial disease characterized by ventricular dilatation and impaired ventricular contractility. The etiology of dilated cardiomyopathy has not been known yet, but toxin such as alcohol, thiamine deficiency, endocrine disorder, viral or bacterial infection, hereditary disorder, and muscular dystrophy may be related to dilated cardiomyopathy. Cocaine abuse and anticancer drugs (especially doxorubicin) were reported as the causes of drugs of dilated cardiomyopathy also. Recently we experinced a case of dilated cardiomyopathy in 30 years old man who developed dilated cardiomyopathy on chronic clomipramine (one of trcyclic antidepressant drugs) treatment for a obsessive-compulsive disorder. He became asymptomatic and normalization of left ventricular diameters and function was evidenced echocardiographically after withdrawal of the drug. The possible association of cardiomyopathy and tricyclic antidepressant drugs and possibility of functional improvement after tricyclic antidepressant drugs withdrawal should be kept in mind.
Adult ; Antidepressive Agents, Tricyclic ; Bacterial Infections ; Cardiomyopathies ; Cardiomyopathy, Dilated* ; Clomipramine ; Cocaine-Related Disorders ; Dilatation ; Humans ; Obsessive-Compulsive Disorder ; Thiamine Deficiency

An 11-year-old, toy poodle dog was presented with dermatologic lesions and mammary gland tumor (MGT) evaluation. A solitary, lobulated MGT (size 2.5 x 3.5 cm) was affecting the 5th left mammary gland. Firm, oval plaque skin lesions were present on the left dorsal carpal area. The skin lesions were alopecic and salivary staining. The dog had historical separation anxiety and excessive licking of skin lesions were observed. Based on the clinical and histopathologic examinations, MGT was diagnosed with mammary complex adenoma and the skin lesions were diagnosed with acral lick dermatitis. Behavior modification treatment using oral clomipramine was effective.
Adenoma ; Animals ; Anxiety, Separation ; Behavior Therapy ; Child ; Clomipramine* ; Dermatitis* ; Dogs* ; Humans ; Mammary Glands, Human ; Play and Playthings ; Skin

PURPOSE: To compare the inhibitory effects of various tricyclic antidepressants (TCAs) on contractile response of the rat vas deferens to electrical stimulation of hypogastric nerve. MATERIALS AND METHODS: A total of forty Spraque Dawley rats (weight 300-350gm) were divided into 8 groups (n=5 in each): doxepine, amitriptyline, trimipramine, desipramine, imipramine, clomipramine, protriptyline, and prazosin treated groups. Before (baseline pressure) and 20 minutes after intravenous injection of each agent (0.1-, 1-, 10-, and 20-fold of therapeutic doses for human in each agent), the hypogastric nerves, iden tified under operative microscope, were electrically stimulated with rectangular pulses of 0.5 mseconds duration, 10 Hz, and 10 V for 10 seconds. Dose of drug administered was gradually increased in order of 0.1- to 20-fold dose. RESULTS: All drugs tested in this study caused dose-dependent inhibition of the rat intravasal pressure induced by the electrical stimulation of hypogastric nerve. Inhibitory potency of each drug was doxepine (88.5% and 96.5% at 10- and 20-fold dose)> OR = amitriptyline (76.8% and 91.8%)>clomipramine (66.7% and 74.4%)> OR =imipramine (48.2% and 67.0%)=prazosin (45.6% and 63.5%)=trimipramine (52.7% and 65.4%)> OR =desi pramine (45.3% and 49.0%)> protriptyline (18.9% and 19.9%). CONCLUSIONS: Inhibitory effects of TCAs on contractile response of the rat vas deferens to electrical stimulation of hypogastric nerve would increase in proportion to their potency of alpha1-adrenoceptor blocking actions.
Amitriptyline ; Animals ; Antidepressive Agents, Tricyclic* ; Clomipramine ; Desipramine ; Doxepin ; Electric Stimulation* ; Humans ; Imipramine ; Injections, Intravenous ; Prazosin ; Protriptyline ; Rats* ; Trimipramine ; Vas Deferens*

PURPOSE: To compare the effects of various serotonergic drugs on the inhibition of intraluminal pressure rise in the rat vas deferens induced by electrical stimulation of the hypogastric nerve. MATERIAL AND METHODS: Twenty-five Sprague Dawley rats (250-300 gm) were randomly divided into five groups of five animals each, which received intravenous injection of normal saline, clomipramine, sertraline, paroxetine, or fluoxetine. Before (baseline pressure) and 30 minutes after intravenous injection of four different doses (0.1 to 20 the therapeutic dose) of each agent, the hypogastric nerve, identified using microsurgical technique, was electrically stimulated, and the intraluminal pressure of the vas deferens was measured (central effect group). To evaluate the peripheral effects of clomipramine and sertraline, intraluminal vasal pressure was also measured after transection of all proximal sympathetic nerves projecting to the hypogastric nerve and the commissural branches between the right and left major and accessory pelvic ganglia. The adrenal veins were ligated bilaterally. RESULTS: Repeated stimulation of the hypogastric nerves, anesthesia of long duration (3hours), and repeated intravenous injection of normal saline did not result in significant changes in the intraluminal pressure of the vas deferens in a dose-dependent manner (p<0.05). The extent of inhibition by 20-fold therapeutic doses of clomipramine, sertraline, paroxetine, and fluoxetin were 74.4 1.8%, 34.1 8.3%, 24.8 7.8%, and 8.1 3.5%, respectively. At doses 10- and 20-fold the therapeutic dose, clomipramine had the strongest inhibitory effect, followed by sertraline and paroxetin, then fluoxetine (p<0.05). Definite inhibition was noted in all rats receiving clomipramine at 10- and 20-fold the therapeutic dose; the degree of inhibition was 80% in the sertraline-, 60% in the paroxetine-, and 20% in the fluoxetin-treated group. The inhibitory effect of sertraline on the elevation of the intraluminal vasal pressure in the peripheral-effect group was significantly (p<0.01) less than that in the central-effect group. However, there was no difference in the inhibitory effect of clomipramine in the two groups. CONCLUSIONS: Clomipramine was the most potent inhibitor of the elevation of the intraluminal pressure of the rat vas after electrical stimulation of the hypogastric nerve. The greater effect might be attributable to an additional peripheral effect of this drug on the vas deferens.
Anesthesia ; Animals ; Clomipramine ; Electric Stimulation* ; Fluoxetine ; Ganglia ; Injections, Intravenous ; Paroxetine ; Rats* ; Rats, Sprague-Dawley ; Serotonin Agents* ; Sertraline ; Vas Deferens* ; Veins

Premature ejaculation(PE) is the most prevalent male sexual complaint, yet it remains underdiagnosed and undertreated. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin(5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation and pharmacologic manipulation of the serotonergic system has been performed in rats, with the antidepressant selective serotonin reuptake inhibitors(SSRIs) exhibiting the greatest efficacy in delaying ejaculation. Over the last decade, an increasing number of studies of drug treatment of PE have been published. A meta-analysis of those studies demonstrated similar efficacies for daily treatment with the serotonergic antidepressants paroxetine hemihydrate, clomipramine, sertraline and fluoxetine, with paroxetine(hydrochloride) hemihydrate exerting the strongest effect on ejaculation. On the basis of fundamental insights into serotonergic neurotransmission, it has been suggested that on-demand selective serotonin reuptake inhibitor(SSRI) treatment will not lead to similarly impressive delays in ejaculation as has been observed with daily SSRI treatment. Apart from daily treatment with SSRIs, PE can be delayed by on-demand use of topical anaesthetics. Treatment with phosphodiesterase type 5 inhibitors may be used if PE is accompanied by erectile difficulties.
Animals ; Antidepressive Agents ; Brain ; Clomipramine ; Ejaculation ; Fluoxetine ; Humans ; Male ; Neurophysiology ; Paroxetine ; Phosphodiesterase 5 Inhibitors ; Premature Ejaculation ; Rats ; Serotonin ; Sertraline ; Spinal Cord ; Synaptic Transmission