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Antidepressant medications are designed to alleviate symptoms of depression and various mental health disorders. They play a crucial role in reducing the risk of suicidal thoughts and attempts while offering significant therapeutic benefits. However, research indicates that a small fraction of users, particularly those under 25, may experience a deterioration in their mental health, including increased depression or emergent suicidal thoughts or behaviors.

• It is essential to discuss the potential risks and advantages of using antidepressants with a healthcare provider, particularly for those under 25, regardless of whether the treatment targets a mental health condition.
• Immediate medical consultation is advised if there is an exacerbation of depression, emergence of unusual behavioral changes, or other mental health alterations, such as new or worsening anxiety, panic attacks, sleep disturbances, irritability, aggressive feelings, impulsivity, extreme restlessness, or rapid speech.
• Vigilance is especially crucial when initiating a new antidepressant or adjusting the dosage.

This proactive approach ensures that any adverse effects are promptly addressed, allowing for necessary adjustments in treatment.

When taking this medication, you might experience dizziness, drowsiness, dry mouth, constipation, stomach upset, nausea, vomiting, changes in appetite or weight, flushing, sweating, tiredness, and blurred vision. These side effects are generally mild and often improve as your body adjusts to the medication. If they persist or worsen, it's important to seek advice.

It's not uncommon for anxiety symptoms to temporarily worsen when starting clomipramine. To manage dizziness, especially when standing up, rise slowly from sitting or lying down. For dry mouth relief, consider options like sugarless gum or candy, ice chips, or a saliva substitute. Prevent constipation by incorporating dietary fiber, staying hydrated, and exercising regularly; a pharmacist can recommend an appropriate laxative if needed.

However, some side effects require immediate medical attention. Contact a healthcare professional if you experience serious effects such as mental or mood changes, breast pain, unwanted breast milk production, irregular menstrual periods, muscle stiffness, tinnitus, sexual issues, tremors, numbness or tingling in extremities, difficulty urinating, easy bruising, unusual movements, severe abdominal pain, dark urine, or jaundice.

This medication can increase serotonin levels, rarely leading to a serious condition called serotonin syndrome. The risk heightens if combined with other serotonin-enhancing drugs. Symptoms needing urgent care include rapid heartbeat, hallucinations, coordination loss, severe dizziness, nausea, vomiting, diarrhea, muscle twitching, unexplained fever, and agitation.

Additionally, seek immediate help for very serious side effects such as black stools, chest pain, fainting, irregular heartbeat, seizures, vomit resembling coffee grounds, eye pain or redness, widened pupils, and vision changes. Although rare, severe allergic reactions can occur. Look out for fever, swollen lymph nodes, rash, itching, facial swelling, severe dizziness, and breathing difficulties, and seek immediate medical care if they occur. If you notice any other unusual effects, consult your healthcare provider.

Some medications that may interact with this drug include certain blood pressure medicines like Clonidine and guanethidine, Digoxin, thyroid supplements, and Valproic Acid. Additionally, medications that can lead to bleeding or bruising, such as antiplatelet drugs like Clopidogrel, NSAIDs like Ibuprofen or Naproxen, and blood thinners like Dabigatran or Warfarin, may also interact.

Taking this medication with MAO inhibitors can result in a dangerous or even fatal reaction. Avoid using MAO inhibitors such as isocarboxazid, Linezolid, Metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, and Tranylcypromine during treatment. Generally, MAO inhibitors should not be used two weeks before and after taking this medication. Consult your doctor for advice on starting or stopping this medication.

There is an increased risk of serotonin syndrome or toxicity if you also use drugs that raise serotonin levels. These include MDMA/"ecstasy," St. John's wort, and certain antidepressants like SSRIs (e.g., Fluoxetine, paroxetine) and SNRIs (e.g., Duloxetine, Venlafaxine). This risk may be higher when starting or increasing the dose of these drugs.

Various drugs, besides clomipramine, may affect heart rhythm (known as QT prolongation), including Amiodarone, Dofetilide, quinidine, Sotalol, Pimozide, procainamide, and macrolide antibiotics like Erythromycin. Before using clomipramine, inform your doctor or pharmacist about all medications you are taking.

Some medications can influence the elimination of clomipramine from your body, potentially altering its effectiveness. These include artemether/lumefantrine, barbiturates like Phenobarbital, Cimetidine, Haloperidol, certain heart rhythm drugs like Flecainide or Propafenone, certain HIV protease inhibitors like Fosamprenavir, phenothiazines like Thioridazine, and certain anti-seizure medications like Phenytoin.

Inform your doctor or pharmacist if you use other products that cause drowsiness, such as alcohol, marijuana (cannabis), antihistamines like Cetirizine or diphenhydramine, sleep or anxiety medications like Alprazolam, Diazepam, or Zolpidem, muscle relaxants like Carisoprodol or Cyclobenzaprine, and opioid pain relievers like codeine or hydrocodone.

Aspirin may increase bleeding risk with this drug. However, if your doctor has advised you to take low-dose aspirin (usually 81-162 milligrams daily) to prevent a heart attack or stroke, continue unless instructed otherwise by your doctor. Seek more information from your doctor or pharmacist.

Check all your medications, including allergy or cough-and-cold products, as they may contain ingredients causing drowsiness. Consult your pharmacist on using these products safely.

Lastly, smoking decreases the blood levels of this medication. Inform your doctor if you smoke or have recently quit.