Clomipramine (Anafranil) in the Treatment of Obsessional States with Special Reference to the Leyton Obsessional Inventory

Intravenous Clomipramine for Obsessive-Compulsive Disorder Refractory to Oral Clomipramine

“…1998;55:918-924 A LTHOUGH controlled studies have demonstrated the superiority of serotonin reuptake inhibitors (SRIs) over placebo in reducing symptoms of obsessive-compulsive disorder (OCD), the response is often limited. [1][2][3] Uncontrolled clinical reports have suggested that clomipramine administered intravenously (IV) is effective for OCD [4][5][6] and that it may act more rapidly and be more effective, 7 even among patients who have not responded to oral clomipramine. [8][9][10] Summarizing his experience with 30 patients with OCD treated with IV clomipramine in an open setting, Warneke 10 noted that 14 consecutive weekday IV clomipramine infusions starting at 25 mg and building to 350 mg appeared to be safe, well tolerated, and effective for some oral clomipraminerefractory or oral clomipramine-intolerant patients.…”

Evidence for a Biological Hypothesis of Obsessive-Compulsive Disorder

“…amitriptyline and most importantly chlorimipramine [Angst and Theo bald, 1970;Beaumont. 1973;Marshall, 1971;Capstick, 1975;Rach. 1973;Walters, 1973;Snyder, 1980b;Hus sain and Ahad, 1970;Bauer and Nowak, 1969;Ananth et al, 1975;Lopez-lbor, 1969].…”

“…Anecdotal reports of improvement in 36 of 51 obsessional patients with CMI prompted more extensive clinical trials [Beaumont, 1973;Marshall, 1971;Capstick. 1975;Rach, 1973: Wal ters, 1973. Investigators using high-dose CMI adminis tered intravenously [Walters, 1973;Lopez-lbor, 1969] and orally [Ananth et al, 1979] demonstrated treatment efficacy in open studies.…”

The assessment of drugs in obsessional states.

“…Further studies of the inventory by Cooper & Kelleher (1973) (Capstick, 1973;Rack, 1973;Marshall & Micev, 1973;Walter, 1973). Other drugs merit inclusion in future trials.…”