clomipramine vs paroxetine

According to this portal's Publishing Organization, this page was last reviewed in August 2026 against our methodology. Figures and extracts on this site, including tables above 1,000 rows when the corpus is that large, are the publisher's responsibility.

Side-by-side comparison of clomipramine and paroxetine. 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

While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, paroxetine, and fluvoxamine, inhibit P450 2D6, they may vary in the extent of inhibition.

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

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

paroxetine

Paroxetine (Paxil) is a medicine that can help treat depression and anxiety disorders. 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.

paroxetine

Paroxetine is used to treat several conditions in adults. These include major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder (PD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD). It helps to improve mood and reduce anxiety and panic feelings.

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.

paroxetine

Paroxetine works by increasing the amount of serotonin in your brain. Serotonin is a natural substance that helps regulate mood. By increasing serotonin levels, paroxetine can help improve symptoms of depression and anxiety.

Common Side Effects
clomipramine
  • Dry mouth
  • Constipation
  • Nausea
  • Upset stomach
  • Sleepiness
paroxetine
  • Abnormal ejaculation
  • Weakness or fatigue
  • Constipation
  • Decreased appetite
  • Diarrhea
FAERS Reports
clomipramine
  • Drug Interaction 225
  • Somnolence 203
  • Fall 202
  • Tremor 185
  • Nausea 173
paroxetine
  • Drug Interaction 1,825
  • Fatigue 1,821
  • Nausea 1,738
  • Toxicity To Various Agents 1,579
  • Anxiety 1,476
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.

paroxetine

Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults. Your doctor will monitor you closely for worsening depression or suicidal thoughts. Paroxetine is not approved for use in children.

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.

paroxetine

Paroxetine may cause harm to your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. Taking paroxetine later in pregnancy may cause problems for the newborn.

Also Compare, Nearby Drugs

How to Read This clomipramine vs paroxetine Comparison

clomipramine is classified in the Tricyclic Antidepressant (TCA) drug class, while paroxetine 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 paroxetine has 8,439. 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 paroxetine blocks the liver enzyme responsible for breaking down clomipramine. this makes clomipramine stay in your body longer and reach higher levels.. 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 paroxetine.

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