amitriptyline vs clomipramine

PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.

Side-by-side comparison of amitriptyline and clomipramine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
amitriptyline Tricyclic Antidepressant (TCA)
clomipramine Tricyclic Antidepressant (TCA)
Type
amitriptyline Prescription
clomipramine Prescription
Summary
amitriptyline

Amitriptyline is a medicine used to treat depression. It may take up to 30 days to feel the full effect.

clomipramine

Clomipramine (Anafranil) is a medicine used to treat obsessive-compulsive disorder (OCD). It helps reduce unwanted thoughts and repetitive behaviors.

What It Treats
amitriptyline

Amitriptyline is used to relieve the symptoms of depression. It works best for a type of depression called endogenous depression. This is depression that comes from within, rather than being caused by outside events.

clomipramine

Clomipramine treats obsessive-compulsive disorder (OCD). OCD causes upsetting thoughts or images that keep coming back. It also causes the need to repeat actions over and over. Clomipramine can help control these symptoms.

How It Works
amitriptyline

Amitriptyline belongs to a class of drugs called tricyclic antidepressants (TCAs). It works by increasing the levels of certain chemicals in your brain. These chemicals help improve your mood.

clomipramine

Clomipramine is a type of antidepressant. It works by increasing the amount of certain chemicals in the brain. These chemicals help regulate mood and reduce OCD symptoms.

Common Side Effects
amitriptyline
  • Drowsiness
  • Dizziness
  • Weakness
  • Fatigue
  • Headache
clomipramine
  • Dry mouth
  • Constipation
  • Nausea
  • Upset stomach
  • Sleepiness
FAERS Reports
amitriptyline
  • Pain 1,565
  • Nausea 1,434
  • Headache 1,381
  • Fatigue 1,371
  • Dyspnoea 1,340
clomipramine
  • Drug Interaction 225
  • Somnolence 203
  • Fall 202
  • Tremor 185
  • Nausea 173
Serious Warnings
amitriptyline

Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults. Your doctor should closely monitor you for worsening depression or unusual changes in behavior. Amitriptyline is not approved for use in children.

clomipramine

Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults. Watch closely for worsening mood or unusual behavior. Clomipramine is only approved for OCD in children.

Pregnancy
amitriptyline

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if amitriptyline will harm your unborn baby. Amitriptyline can pass into breast milk.

clomipramine

Tell your doctor if you are pregnant or plan to become pregnant. Clomipramine may harm your unborn baby. It can also pass into breast milk, so talk to your doctor about breastfeeding.

Also Compare, Nearby Drugs

How to Read This amitriptyline vs clomipramine Comparison

amitriptyline is classified in the Tricyclic Antidepressant (TCA) drug class, while clomipramine sits within the Tricyclic Antidepressant (TCA) class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, amitriptyline has 7,091 submissions while clomipramine has 988. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for amitriptyline or clomipramine.

Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.