Clomipramine is a tricyclic antidepressant (TCA) primarily used for the treatment of obsessive-compulsive disorder (OCD), panic disorder, and major depressive disorder (MDD). It works by inhibiting the reuptake of serotonin and norepinephrine, increasing their levels in the brain and helping regulate mood, anxiety, and compulsive behaviors. Among TCAs, clomipramine is particularly effective for OCD due to its strong serotonin reuptake inhibition, making it comparable to selective serotonin reuptake inhibitors (SSRIs) in managing obsessive thoughts and compulsions. Additionally, it is prescribed for panic disorder, where it helps reduce the frequency and severity of panic attacks by stabilizing neurotransmitter activity in the brain. For patients with major depressive disorder, clomipramine improves mood, energy levels, and overall well-being, particularly in cases where other antidepressants have been ineffective.

Beyond its psychiatric applications, clomipramine is also used in the management of chronic pain conditions, including neuropathic pain, fibromyalgia, and migraine prophylaxis. Its ability to modulate pain perception through serotonin and norepinephrine pathways makes it a valuable option for patients with treatment-resistant pain syndromes. Additionally, clomipramine has been explored for its benefits in certain sleep disorders and cataplexy associated with narcolepsy. However, as a TCA, it carries potential side effects such as dry mouth, dizziness, weight gain, constipation, and drowsiness, along with a risk of cardiovascular complications in susceptible individuals. Due to these risks, careful dosage adjustments and medical supervision are required, especially in elderly patients or those with preexisting heart conditions. Despite these considerations, clomipramine remains an effective and versatile medication for both mental health and chronic pain management.