clomipramine vs fluoxetine

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

minor Known Drug Interaction

The plasma concentration of CMI has been reported to be increased by the concomitant administration of haloperidol; plasma levels of several closely related tricyclic antidepressants have been reported to be increased by the concomitant administration of methylphenidate or hepatic enzyme inhibitors (e.g., cimetidine, fluoxetine) and decreased by the concomitant administration of hepatic enzyme inducers (e.g., barbiturates, phenytoin), and such an effect may be anticipated with CMI as well. While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline,...

Drug Class
clomipramine Tricyclic Antidepressant (TCA)
fluoxetine Selective Serotonin Reuptake Inhibitor (SSRI)
Type
clomipramine Prescription
fluoxetine Prescription
Summary
clomipramine

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

fluoxetine

Fluoxetine is a medicine that can help treat depression and other mental health conditions. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs).

What It Treats
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.

fluoxetine

Fluoxetine can treat major depressive disorder in adults and children. It also treats obsessive-compulsive disorder (OCD) in adults and children. Fluoxetine can help with bulimia nervosa (an eating disorder) and panic disorder. Sometimes, it is used with another medicine called olanzapine to treat depression related to bipolar disorder.

How It Works
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.

fluoxetine

Fluoxetine works by increasing the amount of serotonin in your brain. Serotonin is a chemical that helps regulate mood. By increasing serotonin, fluoxetine can help improve mood and reduce symptoms of depression, OCD, and other conditions.

Common Side Effects
clomipramine
  • Dry mouth
  • Constipation
  • Nausea
  • Upset stomach
  • Sleepiness
fluoxetine
  • Abnormal dreams
  • Problems ejaculating
  • Loss of appetite
  • Feeling anxious
  • Feeling weak
FAERS Reports
clomipramine
  • Drug Interaction 225
  • Somnolence 203
  • Fall 202
  • Tremor 185
  • Nausea 173
fluoxetine
  • Drug Interaction 3,335
  • Toxicity To Various Agents 3,316
  • Nausea 3,233
  • Fatigue 3,156
  • Completed Suicide 2,904
Serious Warnings
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.

fluoxetine

Antidepressants may increase the risk of suicidal thoughts and behaviors in children, teenagers, and young adults. Watch closely for worsening depression or suicidal thoughts. Tell your doctor right away if you notice any changes in mood or behavior. Fluoxetine is not approved for use in children younger than 7 years old.

Pregnancy
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.

fluoxetine

Talk to your doctor if you are pregnant or plan to become pregnant. Fluoxetine should only be used during pregnancy if the benefit outweighs the risk to the baby. Breastfeeding is not recommended while taking fluoxetine.

Also Compare, Nearby Drugs

How to Read This clomipramine vs fluoxetine Comparison

clomipramine is classified in the Tricyclic Antidepressant (TCA) drug class, while fluoxetine sits within the Selective Serotonin Reuptake Inhibitor (SSRI) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. 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, clomipramine has 988 submissions while fluoxetine has 15,944. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to fluoxetine slows down the liver's process for clearing clomipramine from your body. this can lead to higher and potentially unsafe levels of clomipramine.. 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 clomipramine or fluoxetine.

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