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Plasma clomipramine levels in adult patients with obsessive-compulsive disorder

Marazziti, Donatella; Baroni, Stefano; Faravelli, Luca; Giannaccini, Gino; Massimetti, Gabriele; Palego, Lionella; Catena-Dell’Osso, Mario

International Clinical Psychopharmacology: January 2012 - Volume 27 - Issue 1 - p 55–60
doi: 10.1097/YIC.0b013e32834cde39
Original Articles

The aim of this study was to explore the possible relationship between plasma clomipramine and its major metabolite (N-desmethylclomipramine) levels and related parameters, and clinical features in patients with obsessive-compulsive disorder (OCD). Twenty-six outpatients (13 men, 13 women), suffering from OCD were consecutively enrolled in this study. The severity of OCD was assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The measurements were taken after 4 weeks and 6 months from the beginning of the treatment. The drug levels were measured by a high-performance liquid chromatography method developed by us. The correlations between biological and clinical parameters were analyzed by means of Spearman’s correlation coefficient. The Mann–Whitney test was used for comparing biological and clinical variables between men and women. The results showed that clomipramine levels were related to the doses at the two assessment times. A significant and positive correlation was detected at the beginning between the N-desmethylclomipramine ratio and the Y-BOCS total score; however, this was true only for men, where the similar correlations were measured also with the Y-BOCS subscale. After 6 months of clomipramine, men showed a significant improvement of the compulsions. These findings would highlight the potential impact of assessing clomipramine plasma levels and their relationships with specific symptoms, as well as the influence of the sex on the drug response.

Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Pisa, Italy

Correspondence to Dr Donatella Marazziti, MD, Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Via Roma 67, Pisa 56100, Italy Tel +39 050 2219768; fax: +39 050 2219787; e-mail:

Received June 30, 2011

Accepted September 7, 2011

© 2012 Lippincott Williams & Wilkins, Inc.