Comparative Pharmacology
Head-to-head clinical analysis: ANAFRANIL versus NORTRIPTYLINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANAFRANIL versus NORTRIPTYLINE HYDROCHLORIDE.
ANAFRANIL vs NORTRIPTYLINE HYDROCHLORIDE
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.
Nortriptyline is a tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin at the presynaptic neuronal membrane, increasing their concentrations in the synaptic cleft. It also has anticholinergic, antihistaminic, and alpha-adrenergic blocking properties.
Initial: 25 mg PO tid; increase gradually to 100-150 mg/day. Maximum: 250 mg/day. Maintenance: lowest effective dose.
25 mg orally three times daily or 75 mg orally once daily at bedtime; initial dose 25 mg at bedtime, titrate up to 75-150 mg/day.
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 18-56 hours (mean 28 hours); steady-state reached in 5-7 days.
Renal (primarily as conjugated metabolites, ~60-70% over 72 hours); fecal (biliary excretion of ~10-20%); <2% excreted unchanged in urine.
Primarily renal (70% as metabolites, <5% unchanged) and fecal (30% via biliary elimination).
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant