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Intravenous clomipramine and obsessive-compulsive disorder
A K Thakur1, A J Remillard, L H Meldrum
1Department of Psychiatry, University of Saskatchewan, Saskatoon.
Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|September 1, 1991
Summary
Intravenous clomipramine effectively controlled obsessive-compulsive disorder symptoms in a patient refractory to oral treatment. Long-term follow-up confirmed sustained symptom remission, highlighting a viable alternative therapy.
Area of Science:
- Pharmacology
- Neuroscience
- Psychiatry
Background:
- Obsessive-compulsive disorder (OCD) is a debilitating mental health condition.
- Treatment resistance is common in patients with severe OCD.
- Oral clomipramine is a first-line treatment but may be insufficient for some patients.
Observation:
- A 62-year-old woman with a history of treatment-refractory OCD was administered intravenous clomipramine.
- Blood levels of clomipramine and its metabolite, desmethylclomipramine, were monitored.
- Symptomatic control was achieved during hospitalization.
Findings:
- Intravenous clomipramine administration led to significant symptom improvement in the patient.
- Therapeutic drug monitoring of clomipramine and desmethylclomipramine levels was crucial.
- A three-year follow-up demonstrated sustained remission of OCD and depressive symptoms.
Implications:
- Intravenous clomipramine represents a potential therapeutic option for severe, treatment-resistant OCD.
- Careful monitoring of drug levels and administration is essential for safety and efficacy.
- Further research into IV clomipramine protocols for refractory OCD is warranted.