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Latest Drugs
Central Nervous System Drug Data - A-Z (English)
Drug Class Description
Tricyclic antidepressants (TCADs) .Generic Name
GenericDrug Description
Capsules.Presentation
Capsules, clomipramine 10mg , 25mg , 50mg . Available from APS, Cox, Generics UK, Hillcross, Norton.Indications
Depression, obsessional and phobic states, adjunctive treatment of cataplexy associated with narcolepsy.Adult Dosage
Depression, initially 10 mg daily increasing gradually to 30 - 150 mg daily in divided doses or as a single dose at night; maximum 250 mg daily. Obsessional and phobic states, initially 25 mg daily increasing gradually to 100 - 150 mg daily. Cataplexy, initially 10 mg daily increasing gradually to optimal response; maximum 75 mg daily.
Child Dosage
Not recommended.Elderly Dosage
Depression, initially 10 mg daily increasing gradually to 30 - 50 mg daily. Obsessional and phobic states, initially 10 mg daily increasing gradually according to severity. gradually according to severity.Contra Indications
Acute myocardial infarction, arrhythmias and heart block, disorders of cardiac rhythm, coronary insufficiency, severe liver disease, mania. Pregnancy and lactation.
Special Precautions
Cardiovascular disease, liver disorders, hyperthyroidism, tumours of adrenal medulla, epilepsy, diabetes, glaucoma, urinary retention, constipation, renal disease. Monitor cardiac and hepatic function during long term therapy.Hypotension. Psychoses, patients with suicidal tendencies. Reduce doses for the elderly. Closed angle glaucoma, history of urinary retention.
Interactions
With or within 21 days of MAOIs. Carbamazepine, phenytoin, neuroleptics. Barbiturates, other antidepressants, SSRIs alcohol, anticholinergics, local anaesthetics containing adrenaline (epinephrine) or noradrenaline (norepinephrine), cimetidine, oestrogens, quinidine, antihypertensives. Coumarin drugs. Methylphenidate.
Adverse Reactions
Anticholinergic effects such as dry mouth, constipation, urinary retention, blurred vision and changes in accommodation, palpitations and tachycardia. Tinnitus, drowsiness, nervousness or insomnia. Tremor, orthostatic hypotension, dizziness, sweating, weakness and fatigue, ataxia, epileptiform seizures, occasional extrapyramidal symptoms and gastric irritation. Weight loss or gain. Allergic skin reactions, jaundice and blood disorders (test blood regularly). Conduction defects and cardiac arrhythmias. Endocrine effects such as changes in libido, impotence, gynaecomastia and galactorrhoea. Some patients may switch over into mania and schizophrenic symptoms activated, especially in the elderly. Withdrawal symptoms.Confusion, mania, hypomania, aggressiveness, impaired memory, depersonalisation, headache
Drug Availability
(POM)Updated
27 April 2009Advert for Healthcare Professionals Only
Related News
TEMSO study for Aubagio in Multiple Sclerosis is published in NEJM Central Nervous System Page
The pivotal Phase III TEMSO study with investigational once-daily oral medication Aubagio (teriflunomide) from Sanofi/Genzyme is published in The New England Journal of Medicine (NEJM). Results showed that teriflunomide at the 14mg dosage significantly reduced the annual relapse rate, reduced disability progressions and improved several magnetic resonance imaging (MRI) measures of disease activity, including new or worsening brain lesions in relapsing, remitting Multiple Sclerosis. Teriflunomide has a well-characterized safety profile, with a similar proportion of trial participants reporting adverse events compared to placebo. Teriflunomide has been filed with the FDA in August of 2011 and the EMA filing is expected in the first quarter of 2012. see Randomized Trial of Oral Teriflunomide for Relapsing Multiple Sclerosis Paul O'Connor, M.D., et al for the TEMSO Trial Group N Engl J Med 2011; 365:1293-1303 October 6, 2011.
Tysabri shows benefits in Multiple Sclerosis patients Central Nervous System Page
Patients with Multiple Sclerosis who take anti-inflammatory Tysabri (natalizumab), from Biogen and Elan, for two years showed a reduced risk of experiencing at least one relapse (at 2 years this was reduced by 40%). The study also showed that the number of patients whose disability progressed in the time interval was reduced by 25%. In addition, MRI scans showed evidence that treatment with Tysabri reduced disease activity. Treatment also created some side effects including limb swelling, rigors, vaginal inflammation and menstrual disorders and 2 patients treated with Tysabri for more than 2 years developed Progressive Multifocal Leukoencephalopathy, a rare and often fatal viral disease. In light of this, the researchers recommend further studies. The review was published in The Cochrane Database of Systematic Reviews: "Natalizumab for relapsing remitting multiple sclerosis" by Eugenio Pucci et al. Issue 105 OCT 2011.Tysabri is approved in the USA and EU.
Lemtrada and Aubagio trials to report at ECTRIMS/ACTRIMS congress Central Nervous System Page
Genzyme/Sanofi will report more than 20 abstracts at ECTRIMS/ACTRIMS congress. Data will include Phase III results of Lemtrada(alemutuzumab) and Aubagio ( oral teriflunomide) in relapsing remitting Multiple Sclerosis (MS) including CARE-MS 1 study comparing Lemtrada and Rebif (interferon beta 1-a) in relapsing remitting MS and five year extension of TEMSO study of oral Aubagio (Poster 924) and efficacy of Aubagio (Poster 438) and long term results for Lemtrada CARE-MS Phase II trial (Poster 928) and four year efficacy of Lemtrada in MS (Poster 931). Lemtrada is being developed by Genzyme/Sanofi in the USA and Bayer HealthCare in the EU.
