Clomipramine
Clomipramine is used for canine separation anxiety and compulsive disorders, and selected feline behavioral problems.
Group
Tricyclic antidepressant
Mechanism of Action
Inhibits serotonin reuptake; active metabolites contribute antimuscarinic effects.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Behavioral disorders | 2–4 mg/kg | PO | Every 24 h | Total daily oral regimen. An alternative is division into two daily doses; do not give the entire daily amount twice daily. |
| Behavioral disorders | 1–2 mg/kg | PO | Every 12 h | Arithmetic division of the stated 2–4 mg/kg total daily amount into two equal doses. |
| Higher-dose behavioral titration | Reference only | PO | Historical escalation: 1 mg/kg orally every 12 hours for two weeks, then 2 mg/kg every 12 hours for two weeks, then 3 mg/kg every 12 hours for four weeks and reassessment. This exceeds some routine label daily ranges and requires an individualized titration plan. | |
| Storm-phobia combination treatment | Reference only | PO | Historical combination: clomipramine 2 mg/kg orally every 12 hours for three months, then reduce through 1 mg/kg and 0.5 mg/kg every 12 hours, the latter for two weeks. Alprazolam 0.02 mg/kg orally one hour before a predicted storm and every four hours as needed is a separate adjunct; use behavior modification. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Behavioral disorders | 1–5 mg/animal | PO | Every 12–24 h | Start low and titrate. The source also describes approximately 0.5 mg/kg total daily as an alternative. |
| Behavioral disorders | 0.5 mg/kg | PO | Every 24 h | |
| Urine spraying | 5 mg/animal | PO | Every 24 h | Upper fixed dose described; lower doses may be selected during titration. |
| Behavioral disorders | 0.3–0.5 mg/kg | PO | Every 24 h | |
| Behavioral disorders | 0.5–1 mg/kg | PO | Every 24 h | |
| Urine spraying | 2.5–5 mg/animal | PO | Every 24 h |
Birds
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Feather-picking adjunct | 0.5–9 mg/kg | PO | Every 12–24 h | Very broad historical reported range; species, diagnosis and behavior management determine appropriateness. Not a routine starting range. |
Indications
- Separation anxiety
- Compulsive behavior
- Feline urine spraying
Contraindications
- Use cautiously in cardiac disease.
- Use cautiously with seizures, urinary retention, reduced gastrointestinal motility, glaucoma or thyroid disease/supplementation.
Interactions
- Do not combine with other serotonergic behavior medicines or MAO inhibitors, including selegiline and amitraz.
- Cisapride can add to QT-related arrhythmia risk; cimetidine can reduce tricyclic clearance.
- Serotonergic opioids, dextromethorphan and SSRIs increase serotonin-syndrome risk; avoid MAO inhibitors and maintain an appropriate drug-specific washout.
- Anticholinergics and CNS depressants add to adverse effects; sympathomimetics or quinidine can increase cardiac risk.
- Rifampin can reduce tricyclic exposure.
Adverse effects
- Sedation
- Reduced appetite and vomiting
- Dry mouth, tachycardia and urine retention
- Weight gain in cats
- Reduced total and free T4
Toxicity
Large overdoses can cause life-threatening cardiotoxicity.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Clomipramine 5 mg tablet | Tablet | 5 mg / tablet | PO |
| Clomipramine 20 mg tablet | Tablet | 20 mg / tablet | PO |
| Clomipramine 40 mg tablet | Tablet | 40 mg / tablet | PO |
| Clomipramine 80 mg tablet | Tablet | 80 mg / tablet | PO |
| Clomipramine 25 mg capsule | Capsule | 25 mg / capsule | PO |
| Clomipramine 50 mg capsule | Capsule | 50 mg / capsule | PO |
| Clomipramine 75 mg capsule | Capsule | 75 mg / capsule | PO |
Monitoring and Administration
Combine drug treatment with behavior management. Benefit can take 2–4 weeks; increase doses gradually, generally no more often than every 14 days.
Monitor heart rate and rhythm. A small amount of food may reduce vomiting. Protect from moisture.
Efficacy has not been shown for dominance aggression or feline psychogenic alopecia.
Obtain baseline hepatic tests and ECG when indicated; reassess liver function during long-term use. Broad behavioral response may require 4–6 weeks, and withdrawal or dose reduction should be gradual.