Drug interactions
Clomipramine + Lithium
Severity: Major
Clomipramine and Lithium: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining lithium with clomipramine may increase serotonergic effects, causing tremor, agitation, hyperreflexia or serotonin toxicity. Both drugs can also affect cardiac conduction, and lithium toxicity may produce neurotoxicity and seizures. The combination is sometimes used deliberately for resistant depression under supervision.
What this interaction means in plain words
Clomipramine and Lithium can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Clomipramine belongs to Central Nervous System; Lithium belongs to Central Nervous System.
Why it happens
Additive serotonergic enhancement and additive effects on cardiac conduction and seizure threshold.
What to do
Monitor for serotonin toxicity symptoms, check serum lithium levels, and obtain an ECG in patients with cardiac risk. Start with low doses and increase gradually.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine Contraindicated
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Clomipramine with Lithium?
MediHelp rates the interaction as major. Clomipramine and Lithium can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining lithium with clomipramine may increase serotonergic effects, causing tremor, agitation, hyperreflexia or serotonin toxicity. Both drugs can also affect cardiac conduction, and lithium toxicity may produce neurotoxicity and seizures. The combination is sometimes used deliberately for resistant depression under supervision.
How serious is the interaction between Clomipramine and Lithium?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for serotonin toxicity symptoms, check serum lithium levels, and obtain an ECG in patients with cardiac risk. Start with low doses and increase gradually.
What other medicines interact with Clomipramine?
MediHelp also lists interactions of Clomipramine with, for example, Arsenic trioxide, Dofetilide, Droperidol. The full list is on the Clomipramine page.
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