Comparative Pharmacology
Head-to-head clinical analysis: ANAFRANIL versus SURMONTIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ANAFRANIL versus SURMONTIL.
ANAFRANIL vs SURMONTIL
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.
Tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin, with anticholinergic, antihistaminergic, 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.
50-75 mg/day orally in divided doses, increase gradually to 150-300 mg/day. Maximum 300 mg/day. Single bedtime dose may be used for maintenance (50-150 mg).
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.
11-27 hours (mean approximately 20 hours) for the parent drug; the active metabolite desmethyltrimipramine has a half-life of 15-30 hours. Steady-state is achieved within 5-7 days.
Renal (primarily as conjugated metabolites, ~60-70% over 72 hours); fecal (biliary excretion of ~10-20%); <2% excreted unchanged in urine.
Renal excretion of metabolites accounts for approximately 70-80% of elimination, with about 20-30% excreted in feces via biliary elimination. Unchanged drug in urine is less than 5%.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant