Pharmacokinetics of clomipramine in depressive patients

Ten patients with a vital depressive syndrome were treated for 4 weeks with clomipramine (CI), five receiving the drug by mouth and five receiving it first intramuscularly and then by mouth. Plasma concentrations of CI and desmethylclomipramine (DCI) were measured daily. Both concentrations showed marked interindividual differences, especially after oral administration of the drug. The mean relative CI clearance after repeated i.m. injections was 0.441 kg-1 hour-1. The route of administration proved to exert a marked influence on the plasma concentration ratio CI/DCI. In this small population, no significant relationship could be demonstrated between plasma CI and DCI concentrations, or the sum of both, and the clinical effect.