In the past decade, various investigators have attempted to find new pharmacological agents for the treatment of obsessive disorders. Of these, the drug which has attracted attention and has been most promising is clomipramine. This paper attempts to review the usefulness of clomipramine in the treatment of obsessive disorder. Accidentally, it was discovered that clomipramine was effective in alleviating obsessive symptoms in depressed patients by a Spanish psychiatrist, Lopez-Ibor. Initial studies carried out mainly on patients with major depression reported that obsessive symptomatology benefited with clomipramine therapy. A number of uncontrolled and controlled studies confirmed the efficacy of this drug in obsessive neurosis. The drug improves the obsessive symptoms. Discontinuation of the drug is followed by a relapse. The efficacy, dosage, duration and side effects of treatment with clomipramine are discussed in this paper.
References
1.
Lopez-IborJ.J.Ensayo clinico de la monochlorimipramina. Read at the Fourth World Congress of Psychiatry, Madrid, 1966.
2.
RackP.H.The chemotherapy of obsessive compulsive disorders: a review of the literature on the use of clomipramine.Pharmaceutical Medicine1980; 1: 22–38.
3.
LaboucarieJ., RascolA., JordaP.New prospects in the treatment of melancholic states. Therapeutic study of a major antidepressant chlorimipramine.Rev Med Toulouse1967; 3: 863–872.
4.
EscobarJ., TeeterR.R., TuasonV.B., SchieleB.C.Intravenous chlorimipramine and depressive subtypes.Dis Nerv Syst1976; 37: 325–328.
5.
CampbellB., GomezL., AnanthJ.V., BronheimL.A., KlingnerA., BanT.A.An uncontrolled clinical trial with clomipramine in the treatment of depressed patients.Current Therapeutic Research1973; 15: 223–231.
6.
MarshallW.K., MicevV.Clomipramine in the treatment of obsessional illness and phobic anxiety states.Journal of International Medical Research1973; 1: 403–412.
7.
MarshallW.K.Treatment of obsessional illness and phobic anxiety state with clomipramine.Br J Psychiatry1971; 119: 467–468.
8.
WaxmanD.A general practice investigation on the use of clomipramine in obsessional and phobic disorders.J Int Med Research1973; 1: 417–420.
9.
WaxmanD.A general practitioner trial of clomipramine in obsessions and phobias.J Int Med Research1975; 3; (Suppl. 1), 94–100.
10.
WaxmanD.An investigation into the use of anafranil in phobic and obsessional disorders.Scott Med J1975; 20: 61–66.
11.
Renynghe de VoxrieG.V.L'Anafranil dans l'obsession.Acta Neurol Belg1968; 68: 787–792.
12.
RackP.H.Clomipramine in the treatment of obsessional states with special reference to the Leyton Obsessive Inventory.J Int Med Res1973; 1: 397.
WeissmanM., BethwellS.Assessment of social adjustment by patient self-report.Arch Gen Psychiatry1976; 33: 1111–1115.
17.
EysenckH.The manual of the Maudsley Personality Inventory.London, University of London Press, 1959.
18.
AnanthJ., Van Der SteenN.Systematic studies in the treatment of obsessive compulsive neurosis with tricyclic antidepressants.Curr Ther Res1977; 21: 495–501.
19.
AnanthJ., SolyomL., SolyomC., SookmanD.Doxepin in the treatment of obsessive compulsive neurosis.Psychosomatics1975; 16: 185–187.
20.
KarabanowO.Double-blind controlled study in phobias and obsessions complicated by depression.Int J Med Research1977; 5; (Suppl. 5), 42–48.
21.
Yaryura-TobiasJ.A., NezirogluF., BergmanL.Clomipramine for obsessive compulsive neurosis: an organic approach.Curr Ther Res1976; 20: 541–547.
22.
AnanthJ., PecknoldJ., Van Den SteenN., EngelsmannF.Double-blind comparative study of clomipramine and amitriptyline in obsessive neurosis.Progress in Neuro Psychopharmacology1981; 5: 257–262.
23.
ThorenP., AsbergM., CronholmB., JorenstedtL.Clomipramine for obsessive compulsive neurosis: an organic approach.Curr Ther Res1976; 20: 541–547.
24.
CassanoG.B., CastrogiovanniP., MauriM.A multicenter controlled trial in phobic-obsessive psychoneurosis. The effect of clorimipramine and its combinations with haloperidol and diazepam.Prog Neuro-Psychopharmacol1981; 5: 129–138.
25.
MavisswkalianM.R., MichelsonL.Tricyclic antidepressants in obsessive-compulsive disorder: antiobsessional or antidepressant agents?J Nerv Ment Dis1983; 171: 301–306.
TurnerS.M., HersenM., BelleckA.S., AndrasikF., CapparellH.V.Behavioral and pharmacological treatment of obsessive-compulsive disorders.J Nerv Ment Dis1980; 168: 651–657.
28.
MarksI.M., SternR.S., MawsonD., CobbJ., McDonaldR.Clomipramine and exposure for obsessive-compulsive rituals.Br J Psychiatry1980; 136: 1–25.
29.
RachmanS., CobbJ., GreyS., McDonaldR., MawsonD., SartoryG., SternR.Behavioral treatment of obsessive compulsive disorders with and without clomipramine.Behav Res Ther1979; 17: 467–468.
30.
AminM.M., BanT.A., PecknoldJ.C., KlingnerA.Clomipramine (Anafranil) and behavior therapy in obsessive-compulsive and phobic disorders.J Int Med Res1977; (suppl. 5): 33–37.
31.
SolyomL., SookmanD.A comparison of clomipramine hydrochloride (Anafranil) and behavioral therapy in the treatment of obsessive neurosis.J Int Med Res1977; (Suppl. 5): 49–61.
32.
AnanthJ., AssalianP.Intolerable side effects of clomipramine. Letter to Editor.J Clin Psychopharm1982; 2: 215–216.
33.
SternR.S., MarksI.M., MawsonD., LuscombeD.K.Clomipramine and exposure for compulsive rituals: II Plasma levels, side effects and outcome.Br J Psychiatry1980; 136: 161–166.
34.
KleinD.F.Anxiety reconceptualized. In: KleinD.F., RabkinJ.G., eds. Anxiety: new research and changing concepts.New York: Raven Press, 1981: 235–263.
