Clomipramine Health Dictionary

A condition in which uncontrollable episodes of sleep occur two or three times a day. It starts at any age and persists for life. The attacks, which usually last for 10–15 minutes, come on suddenly at times normally conducive to sleep, such as after a meal, or sitting in a bus, but they may occur when walking in the street. In due course, usually after some years, they are associated with cataplectic attacks (see CATAPLEXY), when for a few seconds there is sudden muscular weakness affecting the whole body. The cataplectic attacks can be controlled by the TRICYCLIC ANTIDEPRESSANT DRUGS, imipramine or clomipramine.

Familial narcolepsy is well recognised, and recently a near-100-per-cent association between narcolepsy and the histocompatability antigen HLA-DR2 (see HLA SYSTEM) has been discovered, which suggests that narcolepsy is an immunorelated disease. The Narcolepsy Association (UK) has been founded to help patients with this strange disorder.... narcolepsy

Inadequate sexual response may be due to a lack of sexual desire (LIBIDO) or to an inadequate performance; or it may be that there is a lack of satisfaction or ORGASM. Lack of sexual desire may be due to any generalised illness or endocrine disorder, or to the taking of drugs that antagonise endocrine function (see ENDOCRINE GLANDS). Disorders of performance in men can occur during arousal, penetration and EJACULATION. In the female, DYSPAREUNIA and VAGINISMUS are the main disorders of performance. DIABETES MELLITUS can cause a neuropathy which results in loss of erection. IMPOTENCE can follow nerve damage from operations on the PROSTATE GLAND and lower bowel, and can be the result of neurological diseases affecting the autonomic system (see NERVOUS SYSTEM). Disorders of satisfaction include, in men, impotence, emission without forceful ejaculation and pleasureless ejaculation. In women such disorders range from the absence of the congestive genital response to absence of orgasm. Erectile dysfunction in men can sometimes be treated with SILDENAFIL CITRATE (Viagra®), a drug that recent research suggests may also be helpful to women with reduced libido and/or inability to achieve orgasm.

Sexual dysfunction may be due to physical or psychiatric disease, or it may be the result of the administration of drugs. The main group of drugs likely to cause sexual problems are the ANTICONVULSANTS, the ANTIHYPERTENSIVE DRUGS, and drugs such as metoclopramide that induce HYPERPROLACTINAEMIA. The benzodiazepine TRANQUILLISERS can reduce libido and cause failure of erection. Tricyclic ANTIDEPRESSANT DRUGS may cause failure of erection and clomipramine may delay or abolish ejaculation by blockade of alpha-adrenergic receptors. The MONOAMINE OXIDASE INHIBITORS (MAOIS) often inhibit ejaculation. The PHENOTHIAZINES reduce sexual desire and arousal and may cause di?culty in maintaining an erection. The antihypertensive drug, methyldopa, causes impotence in over 20 per cent of patients on large doses. The beta-adrenoceptorblockers and the DIURETICS can also cause impotence. The main psychiatric causes of sexual dysfunction include stress, depression and guilt.... sexual dysfunction

A type of antidepressant drug.

Tricyclic antidepressants prevent neurotransmitters in the brain from being reabsorbed, thereby increasing their level.

Examples are amitriptyline, clomipramine, and imipramine.... tricyclic antidepressants

n. a drug designed to alleviate the symptoms of *depression. Most antidepressants act by altering the availability of *serotonin and *noradrenaline in the brain; they are also likely to influence synaptic transmission regulation and postsynaptic conduction. There are four main classes of antidepressants. The selective serotonin reuptake inhibitors, such as fluoxetine, sertraline, escitalopram, and citalopram (see SSRI), are recommended as first-line treatment for depression and anxiety by current NICE guidelines. Their mode of action is entirely on serotonin. Side-effects include gastrointestinal problems and nausea. Tricyclic antidepressants, such as *imipramine, *doxepin, *lofepramine, *clomipramine, and *amitriptyline, are also widely used. They act on noradrenaline as well as serotonin, although most of them primarily have a noradrenergic action. They are also used in chronic pain management. Their side-effect profile varies from that of SSRIs; on the whole they have more *antimuscarinic effects and are more sedative. They are more dangerous in overdose than SSRIs and cause more weight gain. Other side-effects include postural hypotension. Serotonin and noradrenaline reuptake inhibitors), such as venlafaxine and duloxetine (see SNRI), are a common second-line choice in the treatment of depression and anxiety. Monoamine oxidase inhibitors (MAOIs), such as the reversible moclobemide and the irreversible phenelzine (see MAO inhibitor), are older antidepressants. They are now less used because of significant side-effects and interactions with other drugs. The irreversible MAOIs also require certain dietary restrictions. Antidepressants are not addictive, but depending on their half-life they show a varying prevalence of *discontinuation syndrome. Antidepressants have consistently been shown to be more effective than placebo. Their efficacy is lower in mild depression but moderate to good in moderate and severe depression. They are part of the gold-standard treatment for depression and anxiety.... antidepressant

(OCD) a mental illness prevalent in about 1% of the adult population but more common in children. Males are most commonly affected. The affected person has *obsessions or *compulsions he or she recognizes as senseless. Resisting the obsession causes anxiety, which is relieved by giving in to the compulsion. The obsession may, for example, be a vivid image, a fear (e.g. of contamination), or an impulse (e.g. to wash the hands repetitively). In severe cases obsessions and rituals can take over many hours of a person’s life each day. The condition can be treated with behaviour therapy and antidepressant medication, particularly clomipramine and SSRIs. *Psychosurgery is still a rare option in very severe and treatment-resistant cases.... obsessive–compulsive disorder