Clomipramine is a type of medicine known as an anti-depressant. It has been used to treat depression for many years. It acts on the nerve cells in the brain to prolong the feel-good effect that certain brain chemicals, called serotonin and noradrenaline, normally give us.

There is some anecdotal evidence about clomipramine being effective in treating a group of brain tumours known as gliomas. There has also been some laboratory research into its effect on brain tumour cells. However, the use of clomipramine to treat brain tumours is debated.

What is the evidence for its use in treating brain tumours?

The reason why the use of clomipramine in brain tumour treatments is debated is that there has not been a randomised clinical trial showing if the drug is effective in treating brain tumours.

In a randomised clinical trial, some of the patients would receive clomipramine whilst others would receive a 'dummy drug', known as a placebo. This would allow a comparison of the outcomes for the two groups to be made, and is needed to establish scientifically whether clomipramine is an effective treatment for brain tumours.

In the case of the anecdotal claims, any positive result could be due to other factors. These factors may also not be the same from one person to another.

As a result, there is currently insufficient evidence to support the anecdotal claims. Without such evidence, clomipramine will not be licenced for use with brain tumours. There are no NICE guidelines at present for the use of clomipramine in the treatment of brain tumours.

Your doctor may therefore be unwilling to prescribe this drug.

How might clomipramine work in brain tumours?

Clomipramine is thought to block the ability of brain tumour cells to carry out respiration. Respiration is the way cells break down a type of sugar, called glucose, to use as energy. This energy is needed for the cell to be able to grow and divide. Without this energy, the cell will die.

Clomipramine, therefore, may be able to slow or stop the continued rapid cell production that occurs in tumours.

Laboratory research has found that clomipramine can cause cell death in a type of rat glioma that is resistant to chemotherapy. However, this was in combination with other drugs and it may not work, or be safe, in human brain tumours.

Common side-effects

Clomipramine's use as an anti-depressant has demonstrated that it has some common side-effects:

  • Dry mouth
  • Constipation
  • Headaches
  • Feeling faint or light headed
  • Feeling or being sick
  • Diarrhoea
  • Feeling as if you have a fast heartbeat or feeling panicky
  • Feeling shaky
  • Hot flushes
  • Confusion
  • Sleep disturbance
  • Skin rashes
  • Difficulty passing urine

It is important to read the literature that comes with all medication and talk to your doctor if you feel unwell, or if the side-effects do not improve.

Things you must consider before taking clomipramine

Some people must not take clomipramine. Talk to your doctor if you have::

  • Ever had an allergic reaction to any anti-depressants
  • Had a heart attack in the last three months
  • Heart or liver disease
  • Mental illness other than depression

Clomipramine also interferes with many other medicines, such as carbamazepine or phenytoin (used for epilepsy). If you decide to take clomipramine, you must discuss this with your medical team.

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