The drug "Clomipramine": analogues, instructions for use, reviews
Quite often in the treatment of patients suffering from mental disorders, the drug "Clomipramine" is used. Analogues for sale are represented by several names. However, the alternative options are mostly much more expensive than the original "Clomipramine".What are the main advantages of this drug? When it is necessary to replace the analogues of "Clomipramine", and when should you choose it? At what violations will the tool help? Let's try to understand.
Considering the analogues of "Clomipramine", first of all, you need to pay attention to a number of medicines, in which a similar active substance - clomipramine. In Russia, antidepressants with such a composition are almost not manufactured, therefore, mostly imported goods are on sale. Analogues of Clomipramine:
In addition to the tablets, there is also a solution for sale.
"Clomipramine": what is it?
Under this name, in modern pharmacies, you can buy tablets covered with a thin film when you make a prescription. The price for the antidepressant Clomipramine varies about two or three hundred rubles for a package containing three dozen tablets. The length of the period for which one package is enough depends on the dosage prescribed by the doctor treating it.
The specificity of the drug in question is such that the application of "Clomipramine" is possible only under the supervision of the attending physician. It is unacceptable to prescribe it yourself, within the framework of self-medication. In addition, you can not replace the prescribed drug without the doctor's consent. If there is a desire to change "Clomipramine" for analogs, synonyms, you need to inform the doctor about it. The doctor will help you choose the best option, taking into account the wishes of the patient. Otherwise, the doctor will strongly advise to adhere to the initially chosen therapy and use "Clomipramine".
As can be seen from the instructions for the application of Clomipramine( analogues are mainly based on the same active substance), the effectiveness of the drug is due to the presence in its composition of clomipramine in the form of hydrochloride. In one tablet, the active ingredient is present in an amount of 25 mg.
In addition to the basic substance, the tablet contains a number of auxiliary components that enhance the effect of the active compound and simplify the process of digestion 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 the composition of the medicament in detail if the patient knows for himself an increased sensitivity to any substance used in the pharmaceutical industry. This makes it possible to understand at the stage of packing research whether Clomipramine will provoke an allergic reaction or whether the drug will be treated successfully. As can be seen from the patients' reviews, "Clomipramine" sometimes becomes a source of allergic reaction and other side effects, but this is very rare.
The described preparation is presented by tablets, convex on both sides. Visually, these are small pale yellow capsules covered with a thin film. One side is supplemented with an engraving indicating the concentration of the active component - 25 mg. As indicated in the instructions for use, "Clomipramine" on one side is perfectly smooth. Tablets are made in the form of a circle, packed in blisters. Blisters on sale are present in blocks, packed in paper boxes. In each such box there is an instruction for the application of Clomipramine. Reviews of analogues indicate that all modern manufacturers pack antidepressants in this way. Acquire the drug, in the packaging of which there is no instruction for use, it is impossible - it is probably a fake. In a reliable pharmacy, such a product does not occur.
The drug belongs to the group of antidepressants. This is a tricyclic preparation that affects the capture of monoamines. The inhibitor belongs to the category of non-selective. As can be seen from the instruction, "Clomipramine" has a strong thymoanaleptic effect, at the same time it is a balanced medication that is characterized by a stimulating effect 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 instruction, "Clomipramine" affects the concentration of norepinephrine in the brain tissues, and also increases the serotonin content, as the process of neuronal re-uptake of the compounds is blocked. In comparison with the majority of tricyclic antidepressants, when using the described preparation, the reverse capture of serotonin decreases more significantly. This makes Clomipramine more applicable, synonyms based on other active components have less positive effects.
Quickly and Effectively
Judging by the feedback, "Clomipramine" shows the first efficacy within a few days of the start of the therapeutic course. The drug has a good effect on patients with incontinence during sleep, and is also effective in bulimia and is a strong analgesic."Clomipramine" is an alpha-adrenoblocker, which also has the effect of choline blocker, H1-histaminoblocker.
When using "Clomipramine" a wide list of pharmacological effects is observed. The drug is able to block receptors of the 5-HT class, and it has a pronounced antihistaminic effect. The use of "Clomipramine" shows good results with a depressive syndrome, including in a number of specific situations."Clomipramine" also struggles with typical manifestations of depression( mental retardation, motor skills, depression), and it also helps to remove increased anxiety. A persistent clinical effect is usually achieved on the second or third week of the therapeutic course.
Diagnosis and use of
Often, "Clomipramine" is prescribed for OCD.The impact on the patient is somewhat different from that observed in depressive disorders."Clomipramine" is effective in chronic pain, provoked by somatic disorders. The use of medication allows to normalize the transmission of nerve signals, for which norepinephrine, serotonin, whose concentration in the brain tissues is increased under the action of the active component of the drug, are involved.
If we compare "Clomipramine" and preparations based on imipramine, then the first is characterized by a weaker psychostimulating effect. When conducting a comparative analysis of the use of "Clomipramine" and preparations on amitriptyline it was revealed that the first one has a weaker sedative effect.
What happens in the body?
"Clomipramine" is intended for ingestion. When the agent is in the body, almost one-hundred percent absorption occurs. Biological availability of the active ingredient varies about 50 percent, which in medicine is called the effect of primary liver treatment. If 50 mg is ingested once in a single meal, the highest level of active substance concentration in the blood is reached in four hours. Metabolites in the body are found 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 three meals a day to receive 25 mg of Clomipramine, then by the end of the first week, an equilibrium concentration can be achieved. To monitor the indicator, you need to take blood plasma for analysis. The drug is 97.6% bound by blood proteins. In the spinal fluid, the concentration varies in the amount of about two percent of the value characteristic for 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.
As can be seen from the clinical studies conducted, in certain groups of patients the perception of "Clomipramine" differs somewhat from the standard one. In particular, when choosing this drug for elderly patients, it should be remembered that their body is characterized by a lower level of metabolism. This leads to an increase in the concentration of the active substance in the blood plasma. At the same time, the use of "Clomipramine" for the treatment of patients diagnosed with kidney and liver function is of particular caution. Currently, there are no clinical official data on the therapy of such persons with Clomipramine.
When to use?
Usually, "Clomipramine" is prescribed for depressive states. You can use the drug in diseases of different etiologies. A good effect the remedy shows with a wide list of symptoms. It is possible to apply "Clomipramine" for depressions of disguised, organic and reactive ones. The drug shows an excellent result in the involutionary, endogenous and neurotic type of depressive disorder.
"Clomipramine" is effective in psychopathy, it is often used in the complex treatment of schizophrenia. The drug shows the effectiveness in the depressive syndromes accompanying the elderly, provoked by chronic pain, somatic disorders. You can apply "Clomipramine" for problems with mood, provoked by different causes( psychopathy, neurosis).The agent shows a good result in RCC therapy. Often, "Clomipramine" is prescribed to patients who have a phobia, cataplexy accompanying narcolepsy, panic attacks and panic disorders."Clomipramine" is effective in pain syndrome, manifested in chronic form. For patients aged 10 years and older, when carrying out additional studies to exclude the possibility of organic causes, Clomipramine can be used to eliminate urinary incontinence.
In some cases, it is not recommended or absolutely impossible to resort to Clomipramine. This applies, for example, to situations in which the patient has an increased sensitivity to any substance included in the composition of the medication. Do not use Clomipramine if the patient is aware of hypersensitivity to dibenzazepine derivatives. It is unacceptable to resort to such therapy if there is a history of acute poisoning by various groups of substances: sedatives, sleeping pills, and beverages containing alcohol. You can not use "Clomipramine" if you know that a person has experienced the administration of psychotropic or analgesics, medications developed for general anesthesia.
"Clomipramine" is not applicable for the decompensation stage of cardiac insufficiency. It can not be used for myocardial infarction: both in acute stages and during rehabilitation. If the problems of conduction of the heart muscle are revealed, increased pressure in the expressed form, as well as acute pathologies of the kidneys, liver, provoking a violation of the functionality of these organs, therapy with the use of "Clomipramine" becomes impossible, since it is associated with a risk of strong negative effects. The drug is inadmissible for the treatment of persons with blood diseases, gastrointestinal ulcers, hypertrophied prostate gland, and also in detecting atony of the bladder. You can not use "Clomipramine" at the same time with preparations of the IMAO group, as well as two weeks before taking such drugs. If MAOI was used, "Clomipramine" can be used only after two weeks, otherwise the probability of serotonin syndrome increases. A complete list of contraindications can be found in the instructions for use. In addition, the doctor must inform about it when writing out the medication.
In some cases, "Clomipramine" can be used, but only with the constant supervision of a physician. Typically, the frequency of testing is set, and the doctor constantly monitors blood counts to prevent negative side effects if the risk of manifestation of such risks increases. Specific situations requiring special care include patients who have epilepsy, and other factors that can cause seizures."Clomipramine" is very accurately used if the patient has experienced a brain trauma, and also undergoes a course with the use of neuroleptics.
If a person undergoes forced withdrawal from alcohol, use "Clomipramine" very carefully. 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: do not exceed the maximum dose for a 24-hour period in order not to provoke negative reactions of the body.
When still apply neatly?
As can be seen from the instructions, special attention of the doctor should be riveted to patients who have cardiac disorders. Specific attitude is required by those who have glaucoma( especially if it is a closed-type type).The drug is used carefully if there is a delay in urine, increased pressure in the eye system and with severe liver disorders. If a tumor of adrenal medulla is detected, "Clomipramine" can be used, but with constant monitoring of the situation. It is necessary to remember the increased risk of hypertensive crisis, associated with a number of pathologies.
Currently, official information on the use of "Clomipramine" during gestation is insufficient. Use the medication in this state should only be in a limited format. It is suggested that tricyclic antidepressants can provoke abnormalities in the development of the embryo. Proceeding from this, in general, doctors are advised to abandon the course of "Clomipramine" during gestation. At the same time, in each specific 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 decides how justified the therapy is.
If during the gestation period the patient drank "Clomipramine" or other tricyclic antidepressants, and the therapy lasted until the moment of the birth of the child, the probability of withdrawal syndrome in a baby in the first few hours after birth is high. This is manifested by shortness of breath, colic. The child sleeps a lot, it can be irritable, the pressure is higher or lower than normal. In addition, there is a possibility of spastic phenomena, tremors. To prevent such consequences, "Clomipramine" is stopped taking two months before the expected moment of delivery. It is also taken into account that the substance can penetrate into the milk during lactation, so that when taking the drug it is not necessary to breast-feed the baby or to refuse tricyclic depressants for the lactation period.