Comparative Pharmacology
Head-to-head clinical analysis: ANAFRANIL versus ENDEP.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANAFRANIL versus ENDEP.
ANAFRANIL vs ENDEP
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Clomipramine is a tricyclic antidepressant (TCA) that inhibits the reuptake of serotonin and norepinephrine, with a higher potency for serotonin reuptake inhibition. It also has anticholinergic, antihistaminergic, and alpha-adrenergic blocking properties.
Increases synaptic concentrations of serotonin and norepinephrine by inhibiting their reuptake in the central nervous system.
Initial: 25 mg PO tid; increase gradually to 100-150 mg/day. Maximum: 250 mg/day. Maintenance: lowest effective dose.
Initial 75 mg/day orally in divided doses, increased gradually to 150-200 mg/day; maintenance 50-150 mg/day as single dose at bedtime or in divided doses.
None Documented
None Documented
Terminal elimination half-life of clomipramine is approximately 21-26 hours; its active metabolite, desmethylclomipramine, has a half-life of approximately 36-42 hours. Steady-state is achieved within 7-14 days.
Terminal elimination half-life: 15-40 hours (mean ~24 h); clinical context: steady-state achieved in 5-7 days; prolonged in elderly and CYP2D6 poor metabolizers.
Renal (primarily as conjugated metabolites, ~60-70% over 72 hours); fecal (biliary excretion of ~10-20%); <2% excreted unchanged in urine.
Renal: 70-80% as metabolites (including glucuronides, unchanged drug <5%); Biliary/Fecal: 20-30%.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant