Delirious episodes induced by intravenous administration of clomipramine associated with an acute increase in its plasma concentrations

Ueda, Nobuhisa; Yoshimura, Reiji; Eto, Seiji; Terao, Takeshi; Nakamura, Jun

doi:10.1046/j.1440-1819.2000.00775.x

Psychiatry Clin Neurosci

2000

DOI: 10.1046/j.1440-1819.2000.00775.x

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Delirious episodes induced by intravenous administration of clomipramine associated with an acute increase in its plasma concentrations

Nobuhisa Ueda¹,

Reiji Yoshimura²,

Seiji Eto

et al.

Abstract: The aim of this paper is to describe two cases of clomipramine-induced delirium. One 61-yearold and one 67-year-old female depressive patients became delirious after beginning intravenous clomipramine injections in addition to their oral clomipramine administrations. Their plasma levels of both clomipramine and its metabolite, desmethylclomipramine, were acutely increased about twofold during delirium. The intravenous clomipramine administrations were discontinued. Their delirious state was gradually improved … Show more

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Cited by 3 publications

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Intravenous antidepressants: A review

Moukaddam

Hirschfeld

2004

Depress. Anxiety

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Antidepressant medications have an onset of action of several weeks and have moderate efficacy. Their mode of administration is oral (p.o.). Some clinicians wondered whether intravenous (i.v.) administration would speed onset of action and increase efficacy. In this article we review controlled studies on i.v. administration of antidepressants. These include clomipramine, citalopram, and other antidepressants. Overall these studies do not support increased efficacy of i.v. over p.o.administration but there are suggestions of a faster onset of action. In one study i.v. citalopram showed superior response rates over p.o. citalopram (79% vs. 63%) in severely depressed patients at 8 weeks.

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Intravenous antidepressants: A review

Moukaddam

Hirschfeld

2004

Depress. Anxiety

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Current Awareness

2001

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 19 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Clomipramine

&NA;

2001

Reactions Weekly

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Clomipramine Delirium: 2 case reportsTwo women, aged 61 and 67 years, with major depressive disorder developed delirium after IV clomipramine was added to their regimen of oral clomipramine, and the plasma concentration of the agent became acutely elevated.Both women started oral clomipramine with the dosage increased over 3 and 6 weeks, respectively, to 150 mg/day [duration of therapy not stated]. Their plasma clomipramine concentrations were 150 and 148 ng/ml and their plasma desmethylclomipramine concentrations were 151 and 103 ng/ ml, respectively. Both patients subsequently started additional treatment with IV clomipramine 12.5mg [frequency of administration not stated] for worsening depressive symptoms.Both women developed symptoms of delirium 6 and 4 days after starting IV clomipramine, respectively. Both patients experienced disorientation, confusion and hallucinations. Their pupils were slightly dilated and they had mildly hyperactive deep tendon reflexes. Their delirium rating scale scores were 20 and 16, respectively (> 10 is considered delirious). Their plasma clomipramine concentrations were 252 and 248 ng/ml, and their plasma desmethylclomipramine concentrations were 295 and 194 ng/ml, respectively.Intravenous administration of clomipramine was discontinued in both of the patients, while their oral dosage was maintained. Their delirium improved 7 and 3 days later, respectively. After recovery from their delirium, the patients' plasma clomipramine concentrations were 110 and 176 ng/ml, and their desmethylclomipramine concentrations were 146 and 144 ng/ml, respectively.Ueda N, et al. Delirious episodes induced by intravenous administration of clomipramine associated with an acute increase in its plasma concentrations.

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Delirious episodes induced by intravenous administration of clomipramine associated with an acute increase in its plasma concentrations

Cited by 3 publications

References 15 publications

Intravenous antidepressants: A review

Intravenous antidepressants: A review

Current Awareness

Clomipramine

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