Comparative Pharmacology
Head-to-head clinical analysis: ANAFRANIL versus SILENOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANAFRANIL versus SILENOR.
ANAFRANIL vs SILENOR
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.
Selective histamine H1 receptor antagonist; promotes sleep by antagonizing central histaminergic neurotransmission.
Initial: 25 mg PO tid; increase gradually to 100-150 mg/day. Maximum: 250 mg/day. Maintenance: lowest effective dose.
6 mg orally once daily at bedtime, not to exceed 6 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 is approximately 10 hours (range 8-15 hours) in healthy adults; prolonged in elderly and hepatic impairment.
Renal (primarily as conjugated metabolites, ~60-70% over 72 hours); fecal (biliary excretion of ~10-20%); <2% excreted unchanged in urine.
Primarily renal (approximately 60% as unchanged drug and metabolites), with 30% fecal elimination.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant