fluoxetine + clomipramine

Fluoxetine + clomipramine is a combination of two antidepressant medications used primarily in the management of severe obsessive-compulsive disorder (OCD) and treatment-resistant depression. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI), while clomipramine is a tricyclic antidepressant with strong serotonin reuptake inhibition properties. The combination may be considered when monotherapy with either agent fails to achieve adequate symptom control, particularly in OCD[2][3][8]. Mechanistically, fluoxetine increases synaptic serotonin by inhibiting its reuptake, while clomipramine inhibits both serotonin and norepinephrine reuptake and also has antagonistic effects on several serotonergic receptors[6]. This combination can increase the risk of adverse effects due to pharmacokinetic interactions—fluoxetine inhibits cytochrome P450 enzymes that metabolize clomipramine, leading to increased plasma concentrations of the latter and heightened risk for side effects such as sedation, anticholinergic symptoms, cardiac arrhythmias, and potential toxicity[1][4][5][8]. Careful dose adjustment and monitoring are recommended when these drugs are used together.

Brand names

Prozac + Anafranil

Other names

fluoxetine hydrochloride + clomipramine hydrochloride