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      * Àý´ë ÀÓÀǺ¹¿ëÇÏÁö ¸¶½Ã°í ¹Ýµå½Ã ÀÇ»ç ¶Ç´Â ¾à»ç¿Í »ó´ãÇϽñ⠹ٶø´Ï´Ù. 
    
     
      
      
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      1. ¼ºÀÎ : ÃÊȸ·®À¸·Î ¿°»êŬ·Î¹ÌÇÁ¶ó¹ÎÀ¸·Î¼ 1ÀÏ 10§·À» °æ±¸Åõ¿©ÇÑ´Ù. Á¡Â÷ÀûÀ¸·Î 1ÀÏ 30-150§·±îÁö Áõ·®ÇÏ¸ç ºÐÇÒÅõ¿©Çϰųª ¶Ç´Â Ãëħ½Ã 1ȸ Åõ¿©ÇÑ´Ù. À¯Áö·®Àº 1ÀÏ 30-50§·ÀÌ´Ù. 
2. °í·ÉÀÚ : ÃÊȸ·®À¸·Î ÀÌ ¾àÀ¸·Î¼ 1ÀÏ 10§·À» Åõ¿©Çϸç ÁÖÀÇÇÏ¸é¼ 1ÀÏ 30-50§·±îÁö Áõ·®ÇÒ ¼ö ÀÖ´Ù. ¼ºÀÎ À¯Áö¿ë·®ÀÇ 1/2¸¸À¸·Îµµ ¸¸Á·ÇÒ ¸¸ÇÑ ÀÓ»ó¹ÝÀÀÀ» º¼ ¼ö ÀÖ´Ù. 
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    1) ÀÌ ¾à¿¡ °ú¹ÎÁõ ȯÀÚ 
2) »ïȯ°è Ç׿ì¿ï¾à(µðº¥ÀÚÁ¦Çɰè¿)¿¡ ±³Â÷°ú¹ÎÁõÀÌ Àִ ȯÀÚ 
3) ÀÌ ¾àÀÇ Åõ¿©ÀüÈÄ 14ÀÏ À̳»¿¡ MAOÀúÇØÁ¦(¸ðŬ·Îº£¹Ìµå¿Í °°Àº ¼±ÅÃÀû, °¡¿ªÀûÀÎ MAO-AÀúÇØÁ¦µµ Æ÷ÇÔ), ¼±ÅÃÀûÀÎ ¼¼·ÎÅä´Ñ ÀçÈí¼ö ÀúÇØÁ¦(SSRI), ¼¼·ÎÅä´Ñ-³ë¸£¿¡Çdz×ÇÁ¸° ÀçÈí¼ö ÀúÇØÁ¦(SNRI), ¼±ÅÃÀûÀÎ ¼¼·ÎÅä´Ñ È¿ÇöÁ¦(Æ®¸³Åº·ù)¸¦ Åõ¿©Çϰí Àִ ȯÀÚ 
4) ÃÖ±ÙÀÇ ½É±Ù°æ»ö ȯÀÚ 
5) ³ì³»Àå ȯÀÚ(Ç×Äݸ°ÀÛ¿ë¿¡ ÀÇÇØ Áõ»óÀÌ ¾Ç鵃 ¼ö ÀÖ´Ù.) 
6) ÀÌ ¾àÀº À¯´çÀ» ÇÔÀ¯Çϰí ÀÖÀ¸¹Ç·Î, °¥¶ôÅä¿À½º ºÒ³»¼º(galactose intolerance), Lapp À¯´çºÐÇØÈ¿¼Ò °áÇÌÁõ(Lapp lactase deficiency) ¶Ç´Â Æ÷µµ´ç-°¥¶ôÅä¿À½º Èí¼öÀå¾Ö(glucose-galactose malabsorption) µîÀÇ À¯ÀüÀûÀÎ ¹®Á¦°¡ Àִ ȯÀÚ¿¡°Ô´Â Åõ¿©ÇÏ¸é ¾È µÈ´Ù.  | 
   
  
  
  
  
   
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    1) ÀúÇ÷¾Ð ¶Ç´Â ¼øÈ¯±â°è ºÒ¾ÈÁ¤ ȯÀÚ(Ç÷¾ÐÀÌ ÀúÇ쵃 ¼ö ÀÖÀ¸¹Ç·Î Åõ¿©Àü¿¡ ¹Ýµå½Ã Ç÷¾ÐÀ» È®ÀÎÇÑ´Ù.) 
2) ½ÉÇ÷°üÀå¾Ö, ƯÈ÷ ½ÉÇ÷°üºÎÀü, ºÎÁ¤¸Æ ȯÀÚ(¹ßÀÛ¼º ºó¸Æ, ÀÚ±ØÀüµµÀå¾Ö µî)(½É±â´É ¹× EEG¸¦ °è¼Ó ¸ð´ÏÅ͸µÇÑ´Ù.) 
3) ½ÉºÎÀü, ½É±Ù°æ»ö, Çù½ÉÁõ µîÀÇ ½ÉÁúȯ ȯÀÚ(¼øÈ¯±â°è¿¡ ¿µÇâÀ» ¹ÌÄ¥ ¼ö ÀÖ´Ù.) 
4) °©»ó¼±±â´ÉÇ×ÁøÁõ ¶Ç´Â °©»ó¼±Á¦Á¦¸¦ Åõ¿©ÁßÀΠȯÀÚ(½Éµ¶¼ºÀÌ ÀϾ ¼ö ÀÖ´Ù.) 
5) ºÎ½Å¼öÁúÁ¾¾ç(Å©·Òģȼº¼¼Æ÷Á¾, ½Å°æ¾Æ¼¼Æ÷Á¾) ȯÀÚ(°íÇ÷¾ÐÀ§±â¸¦ À¯¹ßÇÒ ¼ö ÀÖ´Ù.) 
6) ¾È³»¾ÐÇ×Áø, Çù¿ì°¢Çü ³ì³»Àå ȯÀÚ(ÀÌ ¾àÀº Ç×Äݸ°ÀÛ¿ëÀÌ ÀÖ´Ù.) 
7) ¹è´¢°ï¶õ ¶Ç´Â ±× º´·ÂÀÌ Àִ ȯÀÚ(Ç×Äݸ°ÀÛ¿ë¿¡ ÀÇÇØ Áõ»óÀÌ ¾Ç鵃 ¼ö ÀÖ´Ù.) 
8) ÁßÁõÀÇ °£¤ý½ÅÀå¾Ö ȯÀÚ(´ë»ç¹è¼³Àå¾Ö¿¡ ÀÇÇØ ÀÌ»ó¹ÝÀÀÀÌ ³ªÅ¸³ª±â ½¬¿ì¸ç °£Áúȯ ȯÀÚ´Â Á¤±âÀûÀ¸·Î °£È¿¼ÒÄ¡°Ë»ç¸¦ ½Ç½ÃÇÑ´Ù.) 
9) Àü±â°æ·Ã¿ä¹ýÀ» ¹Þ´Â ȯÀÚ 
10) °í·ÉÀÚ ¶Ç´Â Á¤½Åº´ÀÇ ¼ÒÀÎÀÌ Àִ ȯÀÚ[ƯÈ÷ ¾ß°£¿¡ ¾à¹°¿ø¼º(Á¤½ÅÂø¶õ¼º) Á¤½Åº´À» À¯¹ßÇÒ ¼ö ÀÖÀ¸¹Ç·Î ÀÌ·¯ÇÑ °æ¿ì¿¡´Â Åõ¿©¸¦ ÁßÁöÇÑ´Ù.] 
11) ¸¸¼º º¯ºñ ȯÀÚ(ƯÈ÷ °í·ÉÀÚ, °Åµ¿ÀÌ ºÒÆíÇÑ È¯ÀÚ¿¡¼ ¸¶ºñ¼º ÀåÆó»öÀ» À¯¹ßÇÒ ¼ö ÀÖ´Ù.) 
12) ³úÀüÁõ µîÀÇ °æ·Ã¼º Áúȯ ¶Ç´Â ±× º´·ÂÀÌ Àִ ȯÀÚ(°æ·ÃÀ» ÀÏÀ¸Å³ ¼ö ÀÖ´Ù.) 
13) Á¶¿ïÁõ ȯÀÚ(Á¶Àü, ÀÚ»ì±âµµ µîÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù.) 
14) ³úÀÇ ±âÁúÀû Àå¾Ö ¶Ç´Â Á¶Çöº´ÀÇ ¼ÒÀÎÀÌ Àִ ȯÀÚ(Á¤½ÅÁõ»óÀÌ ¾Ç鵃 ¼ö ÀÖ´Ù.) 
15) ÀÌ ¾àÀº Ȳ»ö 4È£(Ÿ¸£Æ®¶óÁø)¸¦ ÇÔÀ¯Çϰí ÀÖÀ¸¹Ç·Î ÀÌ ¼ººÐ¿¡ °ú¹ÎÇϰųª ¾Ë·¹¸£±â º´·ÂÀÌ Àִ ȯÀÚ¿¡´Â ½ÅÁßÈ÷ Åõ¿©ÇÑ´Ù. (Ȳ»ö 4È£ ÇÔÀ¯Á¦Á¦¿¡ ÇÑÇÔ)  | 
   
  
    
  
  
  
  
  
   
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       ÀÌ»ó¹ÝÀÀÀº º¸Åë ¿ÏÈÇϰí ÀϽÃÀûÀ̸ç, Åõ¿©¸¦ °è¼ÓÇϰųª ¿ë·®À» °¨¼Ò½ÃŰ¸é »ç¶óÁø´Ù. ÀÌ»ó¹ÝÀÀÀÌ Ç×»ó Ç÷Àå³» ¾à¹°³óµµ³ª Åõ¿©¿ë·®°ú °ü°è°¡ ÀÖ´Â °ÍÀº ¾Æ´Ï¸ç ¶§¶§·Î ¿ì¿ïÁõ Áõ»ó(ÇÇ·Î, ¼ö¸éÀå¾Ö, °Ý¿ù, ºÒ¾È, º¯ºñ, ±¸°¥ µî)°ú ƯÁ¤ ÀÌ»ó¹ÝÀÀÀÇ ±¸º°ÀÌ ¾î·Á¿ï ¶§µµ ÀÖ´Ù. 
1) ¼ï : µå¹°°Ô ¼ïÀ» ÀÏÀ¸Å³ ¼ö ÀÖÀ¸¹Ç·Î °üÂûÀ» ÃæºÐÈ÷ Çϰí ÀÌ»óÀÌ ³ªÅ¸³ª´Â °æ¿ì¿¡´Â Åõ¿©¸¦ ÁßÁöÇϰí ÀûÀýÈ÷ óġ¸¦ ÇÑ´Ù. 
2) ½Å°æÀÌ¿ÏÁ¦¾Ç¼ºÁõÈıº(Neuroleptic Malignant Syndrome) : ¿îµ¿¸¶ºñ, ½ÉÇѱÙÀ°°Á÷, ¿¬Çϰï¶õ, ºó¸Æ, Ç÷¾Ðº¯È, ¹ßÇÑ µîÀÌ ³ªÅ¸³ª°í ÀÌ·¯ÇÑ Áõ»ó°ú ÇÔ²² ¹ß¿ÀÌ ³ªÅ¸³ª´Â °æ¿ì¿¡´Â Åõ¿©¸¦ ÁßÁöÇϰí ü³Ã°¢°ú ¼öºÐº¸±Þ µîÀÇ Àü½ÅÀû Ä¡·á¿Í ÇÔ²² ÀûÀýÇÑ Ã³Ä¡¸¦ ÇÑ´Ù. ÀÌ·¯ÇÑ Áõ»óÀÇ ¹ßÇö½Ã¿¡´Â ¹éÇ÷±¸ Áõ°¡, Ç÷û CPK»ó½ÂÀÌ ÀÚÁÖ ³ªÅ¸³ª°í ¹Ì¿À±Û·Îºó´¢ÁõÀ» ¼ö¹ÝÇÑ ½Å±â´ÉÀúÇϰ¡ ³ªÅ¸³¯ ¼ö ÀÖ´Ù. ¶ÇÇÑ ´Ù¸¥ »ïȯ°è Ç׿ì¿ï¾à¿¡¼ °í¿ÀÌ Áö¼ÓµÇ°í ÀǽÄÀå¾Ö, È£Èí°ï¶õ, ¼øÈ¯ÇãÅ»°ú Å»¼öÁõ»ó, ±Þ¼º ½ÅºÎÀüÀ¸·Î ¹ßÀüÇØ¼ »ç¸ÁÇß´Ù´Â º¸°í°¡ ÀÖ´Ù. 
3) Á¤½Å½Å°æ°è : ¼Ò¾Æ, û¼Ò³â ¹× ÀþÀº ¼ºÀÎ(18¢¦24¼¼)¿¡¼ÀÇ Àڻ켺ÇâÀÇ Áõ°¡, Á¹À½, ÇÇ·Î, µé¶°ÀÖ´Â »óÅÂ, ½Ä¿åÁõ°¡, ¾îÁö·¯¿ò, ÁøÀü µîÀÇ ÆÄŲ½¼ÁõÈıº, µÎÅë, °£´ë¼º °æ·Ã, ¶§¶§·Î È¥µ¿, ºÎÀ§°¨°¢»ó½Ç, ȯ°¢(ƯÈ÷ °í·ÉÀÚ ¹× ÆÄŲ½¼º´ ȯÀÚ), ºÒ¾È, °Ý¿ù, ¼ö¸éÀå¾Ö, Á¶Áõ, °æÁ¶Áõ, °ø°Ý¼º, ±â¾ï·ÂÀå¾Ö, ÀÌÀÎÁõ, ¿ì¿ïÁõ¾ÇÈ, ÁýÁß·ÂÀå¾Ö, ºÒ¸é, ¾Ç¸ù, ÇÏǰ, Çê¼Ò¸®, Á¤½ÅÂø¶õ, ¾ð¾îÀå¾Ö, ¸¶ºñ, ±Ù¾àÈ, ±Ù±äÀåÇ×Áø, µå¹°°Ô Á¤½Åº´Àû ÁõÈÄÀÇ È°¼ºÈ, °æ·Ã, ¿îµ¿½ÇÁ¶, ³úÀüÁõ¹ßÀÛ, ¸Å¿ì µå¹°°Ô EEGº¯È, ÀÌ»ó°í¿, ±Çۨ, ¹ßÇÑ µîÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù. 
4) Ç×Äݸ°ÀÛ¿ë : ±¸°¥, ¹ßÇÑ, º¯ºñ, ½ÃÁ¶ÀýÀå¾Ö, ½Ã°¢Àå¾Ö, ¹è´¢Àå¾Ö, ¶§¶§·Î È«Á¶, µ¿°ø»ê´ë, ¾È³»¾ÐÇ×Áø, ȫäÁ¶ÀýÀå¾Ö, ¸Å¿ì µå¹°°Ô ³ì³»Àå µîÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù. 
5) °ú¹ÎÁõ : ¶§¶§·Î ¹ßÁø, µå¹°°Ô ±¤°ú¹ÎÁõ, ¸Å¿ì µå¹°°Ô ¾Ë·¯Áö¼º ÆóÆ÷¿°(Æó·Å)(È£»ê±¸Áõ°¡¸¦ ¼ö¹ÝÇÏ´Â °æ¿ì¸¦ Æ÷ÇÔ), ÀúÇ÷¾ÐÀ» Æ÷ÇÔÇÑ Àü½ÅÀûÀÎ ¾Æ³ªÇʶô½Ã/¾Æ³ªÇʶô½Ã¾ç ¹ÝÀÀÀÌ ³ªÅ¸³¯ ¼ö ÀÖÀ¸¹Ç·Î ÀÌ·¯ÇÑ °æ¿ì¿¡´Â Åõ¿©¸¦ ÁßÁöÇÑ´Ù. 
6) ¼øÈ¯±â°è : ¶§¶§·Î µ¿¼º ºó¸Æ, ½É°èÇ×Áø, üÀ§¼º ÀúÇ÷¾Ð, ÀúÇ÷¾Ð, ½ÉÂ÷´Ü, Á¤»óÀûÀÎ ½É±â´ÉÀ» °¡Áø ȯÀÚ¿¡¼ ÀÓ»óÀûÀ¸·Î ¹«°üÇÑ ECGº¯È(ST, Tº¯È), µå¹°°Ô ºÎÁ¤¸Æ, Ç÷¾Ð»ó½Â, ¸Å¿ì µå¹°°Ô ½ÉÀüµµÀå¾Ö(QRSº¹ÇÕüÀÇ È®Àå, °¢ºí·Ï, PQº¯È) µîÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù. 
7) Ç÷¾× : ÀÚ¹Ý, ¹éÇ÷±¸°¨¼Ò, Ç÷¼ÒÆÇ°¨¼Ò, È£»ê±¸Áõ°¡, ¹«°ú¸³±¸Áõ µîÀÇ Ç÷¾×Àå¾Ö°¡ ³ªÅ¸³¯ ¼ö ÀÖÀ¸¹Ç·Î Á¤±âÀûÀ¸·Î Ç÷¾×°Ë»ç¸¦ ½Ç½ÃÇϰí ÀÌ»ó(ÀüÁ¶Áõ»óÀ¸·Î¼ ¹ß¿, ÀεÎÅë, ÀÎÇ÷翣ÀÚ¾çÁõ»óÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù.)ÀÌ ÀÎÁ¤µÇ´Â °æ¿ì¿¡´Â Åõ¿©¸¦ ÁßÁöÇÑ´Ù. 
8) °£Àå : µå¹°°Ô Ȳ´Þ, °£¿°, Æ®·£½º¾Æ¹Ì³ªÁ¦(ALT, AST µî) »ó½Â µîÀÇ °£Àå¾Ö°¡ ³ªÅ¸³¯ ¼ö ÀÖÀ¸¹Ç·Î °üÂûÀ» ÃæºÐÈ÷ Çϰí ÀÌ»óÀÌ ÀÎÁ¤µÇ´Â °æ¿ì¿¡´Â Åõ¿©¸¦ ÁßÁöÇÑ´Ù. 
9) ¼Òȱâ°è : µå¹°°Ô Àå°ü¸¶ºñ(½Ä¿åºÎÁø, ±¸¿ª, ±¸Åä, ÇöÀúÇÑ º¯ºñ, º¹ºÎÆØ¸¸ ¶Ç´Â ÀÌ¿Ï, Àå³»¿ë¹° ¿ïü µî)À» ÀÏÀ¸Å°°í, ¸¶ºñ¼º ÀåÆó»öÀ¸·Î ÀÌÇàµÉ ¼ö ÀÖÀ¸¹Ç·Î Àå°ü¸¶ºñ°¡ ³ªÅ¸³ª´Â °æ¿ì¿¡´Â Åõ¿©¸¦ ÁßÁöÇÑ´Ù. ¶ÇÇÑ ±¸¿ª, ±¸Åä, ½Ä¿åºÎÁø, ¼³»ç, ¹Ì°¢ÀÌ»ó µîÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù(ÀÌ ¾àÀÇ ÁøÅäÀÛ¿ë¿¡ ÀÇÇÏ¿© ±¸¿ª, ±¸Åä°¡ ÀºÆóµÉ ¼ö ÀÖÀ¸¹Ç·Î ÁÖÀÇÇÑ´Ù.). 
10) ³»ºÐºñ°è : µå¹°°Ô Àú³ªÆ®·ýÇ÷Áõ, ÀúħÅõ¾ÐÇ÷Áõ, ¿äÁß ³ªÆ®·ý ¹è¼³·® Áõ°¡, °íÀå´¢, °æ·Ã, ÀǽÄÀå¾Ö µîÀ» ¼ö¹ÝÇÑ Ç×ÀÌ´¢È£¸£¸óºÐºñÀÌ»çÁõÈıº(Syndrome of Inappropriate ADH)ÀÌ ³ªÅ¸³¯ ¼ö ÀÖÀ¸¹Ç·Î ÀÌ·¯ÇÑ °æ¿ì¿¡´Â Åõ¿©¸¦ ÁßÁöÇÏ°í ¼öºÐ¼·Ã븦 Á¦ÇÑÇÏ´Â µî ÀûÀýÈ÷ óġ¸¦ ÇÑ´Ù. ¶ÇÇÑ ÇÁ·Î¶ôƾÀÇ ºÐºñÃËÁø, ¶§¶§·Î üÁßÁõ°¡, ¼º¿å¤ý¼º±â´ÉÀÌ»ç, À¯·çÁõ, À¯¹æÈ®´ë µîÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù. 
11) Àå±âÅõ¿© : ¶§¶§·Î ÀÔÁÖÀ§ÀÇ ºÒ¼öÀǿÀÌ ³ªÅ¸³¯ ¼ö ÀÖ°í Åõ¿©ÁßÁö ÈÄ¿¡µµ ÀÌ·¯ÇÑ Áõ»óÀÌ Áö¼ÓµÉ ¼ö ÀÖ´Ù. 
12) °¨°¢±â°è : ¶§¶§·Î ¹Ì°¢ÀÌ»ó, ÀÌ¸í µîÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù. 
13) ±Ù°ñ°Ý°è : °ñÀý(ÁÖ·Î 50¼¼ ÀÌ»óÀÇ È¯ÀÚ¸¦ ´ë»óÀ¸·Î ÇÑ ¿Ü±¹ ¿ªÇבּ¸¿¡¼ ¼±ÅÃÀû ¼¼·ÎÅä´Ñ ÀçÈí¼ö ÀúÇØÁ¦(SSRI) ¹× »ïȯ°è Ç׿ì¿ïÁ¦(TCA)¸¦ Åõ¿©¹ÞÀº ȯÀÚ¿¡°Ô¼ °ñÀý À§ÇèÀÌ Áõ°¡ÇÏ¿´À½ÀÌ º¸°íµÇ¾ú°í, ÀÛ¿ë±âÀüÀº ¹àÇôÁöÁö ¾Ê¾Ò´Ù.) 
14) ±âŸ : ¿ë·®À» °¨¼Ò½ÃŰ°Å³ª °©ÀÚ±â Åõ¿©¸¦ ÁßÁöÇÑ °æ¿ì¿¡ ¶§¶§·Î ±¸¿ª, ±¸Åä, º¹Åë, ¼³»ç, ºÒ¸éÁõ, µÎÅë, ½Å°æ°ú¹ÎÁõ, ºÒ¾È µîÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù. 
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    | Mechanism of Action | 
    
       Clomipramine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Clomipramine is a strong, but not completely selective Serotonic-Reuptake-Inhibitor (SRI), as the active main metabolite desmethyclomipramine acts preferably as an inhibitor of Noradrenaline-Reuptake. Alpha-1-Receptor blockage and beta-down-regulation have been noted and most likely play a role in the short term effects of clomipramine. A blockade of sodium-channels and NDMA-receptors might, as with other tricyclics, account for its effect in chronic pain, in particular the neuropathic type. 
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    | Pharmacology | 
     
       Clomipramine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Clomipramine, a tricyclic antidepressant, is the 3-chloro derivative of Imipramine. It was thought that tricylic antidepressants work exclusively by inhibiting the re-uptake of the neurotransmitters norepinephrine and serotonin by nerve cells. However, this response occurs immediately, yet mood does not lift for around two weeks. It is now thought that changes occur in receptor sensitivity in the cerebral cortex and hippocampus. The hippocampus is part of the limbic system, a part of the brain involved in emotions. Presynaptic receptors are affected: alpha-1 and beta-1 receptors are sensitized, alpha-2 receptors are desensitized (leading to increased noradrenaline production). Tricyclics are also known as effective analgesics for different types of pain, especially neuropathic or neuralgic pain. 
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    | Metabolism | 
    
       Clomipramine¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Cytochrome P450 2C9 (CYP2C9)Cytochrome P450 1A2 (CYP1A2)Cytochrome P450 2D6 (CYP2D6)Cytochrome P450 2A13 (CYP2A13) 
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    | Protein Binding | 
    
       Clomipramine¿¡ ´ëÇÑ ´Ü¹é°áÇÕ Á¤º¸ 97% 
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    | Half-life | 
    
       Clomipramine¿¡ ´ëÇÑ ¹Ý°¨±â Á¤º¸ Approximately 35 hours. 
     | 
   
  
   
    | Absorption | 
    
       Clomipramine¿¡ ´ëÇÑ Absorption Á¤º¸ Bioavailability is approximately 50% orally. 
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    | Biotransformation | 
    
       Clomipramine¿¡ ´ëÇÑ Biotransformation Á¤º¸ Hepatic. The main active metabolite is desmethylclomipramine. 
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    | Toxicity | 
    
       Clomipramine¿¡ ´ëÇÑ Toxicity Á¤º¸ Signs and symptoms vary in severity depending upon factors such as the amount of drug absorbed, the age of the patient, and the time elapsed since drug ingestion. Critical manifestations of overdose include cardiac dysrhythmias, severe hypotension, convulsions, and CNS depression including coma. Changes in the electrocardiogram, particularly in QRS axis or width, are clinically significant indicators of tricyclic toxicity. In U.S. clinical trials, 2 deaths occurred in 12 reported cases of acute overdosage with Anafranil either alone or in combination with other drugs. One death involved a patient suspected of ingesting a dose of 7000 mg. The second death involved a patient suspected of ingesting a dose of 5750 mg. 
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    | Drug Interactions | 
    
       Clomipramine¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Altretamine	Risk of severe hypotensionAtazanavir	Atazanavir increases the effect and toxicity of tricyclicsCimetidine	Cimetidine increases the effect of tricyclic agentCisapride	Increased risk of cardiotoxicity and arrhythmiasClonidine	The tricycli decreases the effect of clonidineDihydroquinidine barbiturate	Quinidine increases the effect of tricyclic agentDobutamine	The tricyclic increases the sympathomimetic effectDonepezil	Possible antagonism of actionDopamine	The tricyclic increases the sympathomimetic effectEphedra	The tricyclic increases the sympathomimetic effectEphedrine	The tricyclic increases the sympathomimetic effectEpinephrine	The tricyclic increases the sympathomimetic effectFenoterol	The tricyclic increases the sympathomimetic effectFluoxetine	Fluoxetine increases the effect and toxicity of tricyclicsFluvoxamine	Fluvoxamine increases the effect and toxicity of tricyclicsGalantamine	Possible antagonism of actionGrepafloxacin	Increased risk of cardiotoxicity and arrhythmiasGuanethidine	The tricyclic decreases the effect of guanethidineIsoproterenol	The tricyclic increases the sympathomimetic effectIsocarboxazid	Possibility of severe adverse effectsMephentermine	The tricyclic increases the sympathomimetic effectMetaraminol	The tricyclic increases the sympathomimetic effectMethoxamine	The tricyclic increases the sympathomimetic effectMoclobemide	Possible severe adverse reaction with this combinationNorepinephrine	The tricyclic increases the sympathomimetic effectOrciprenaline	The tricyclic increases the sympathomimetic effectPhenylephrine	The tricyclic increases the sympathomimetic effectPhenelzine	Possibility of severe adverse effectsPhenylpropanolamine	The tricyclic increases the sympathomimetic effectPirbuterol	The tricyclic increases the sympathomimetic effectProcaterol	The tricyclic increases the sympathomimetic effectPseudoephedrine	The tricyclic increases the sympathomimetic effectQuinidine	Quinidine increases the effect of tricyclic agentQuinidine barbiturate	Quinidine increases the effect of tricyclic agentRasagiline	Possibility of severe adverse effectsRifabutin	The rifamycin decreases the effect of tricyclicsRifampin	The rifamycin decreases the effect of tricyclicsRitonavir	Ritonavir increases the effect and toxicity of tricyclicsRivastigmine	Possible antagonism of actionSalbutamol	The tricyclic increases the sympathomimetic effectSibutramine	Increased risk of CNS adverse effectsSparfloxacin	Increased risk of cardiotoxicity and arrhythmiasTerbutaline	The tricyclic increases the sympathomimetic effectTerfenadine	Increased risk of cardiotoxicity and arrhythmiasTranylcypromine	Possibility of severe adverse effects 
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    CYP450  Drug Interaction | 
    
      [CYP450 TableÁ÷Á¢Á¶È¸] Clomipramine¿¡ ´ëÇÑ P450 table
  SUBSTRATES 
CYP 2C19 
Proton Pump Inhibitors: 
omeprazole 
lansoprazole 
pantoprazole 
rabeprazole 
Anti-epileptics: 
diazepam 
phenytoin 
phenobarbitone 
amitriptyline 
**clomipramine** 
clopidogrel 
cyclophosphamide 
progesterone 
 INHIBITORS 
CYP 2C19 
fluoxetine 
fluvoxamine 
ketoconazole 
lansoprazole 
omeprazole 
ticlopidine 
 INDUCERS 
CYP 2C19 
N/A 
 
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    | Food Interaction | 
    
       Clomipramine¿¡ ´ëÇÑ Food Interaction Á¤º¸ Take with food to reduce irritation.Avoid alcohol.Grapefruit and grapefruit juice should be avoided throughout treatment, grapefruit can modify serum levels of clomipramine and its metabolite desmethyl-clomipramine. 
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    | Drug Target | 
    
      
      [Drug Target]
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    | SNP Á¤º¸ | 
    
      Name:Clomipramine (DB01242)
 Interacting Gene/Enzyme:Cytochrome P450 2D6 (Gene symbol = CYP2D6) Swissprot P10635
 SNP(s):CYP2D6*4 rs3892097 (A Allele)
 Effect:Poor drug metabolizer, lower dose requirements, higher risk for adverse side effects
 Reference(s):Bijl MJ, Visser LE, Hofman A, Vulto AG, van Gelder T, Stricker BH, van Schaik RH: Influence of the CYP2D6*4 polymorphism on dose, switching and discontinuation of antidepressants. Br J Clin Pharmacol. 2008 Apr;65(4):558-64. Epub 2007 Dec 7. [PubMed] 
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    | Description | 
    
       Clomipramine¿¡ ´ëÇÑ Description Á¤º¸ A tricyclic antidepressant similar to imipramine that selectively inhibits the uptake of serotonin in the brain. It is readily absorbed from the gastrointestinal tract and demethylated in the liver to form its primary active metabolite, desmethylclomipramine. [PubChem] 
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    | Drug Category | 
    
       Clomipramine¿¡ ´ëÇÑ Drug_Category Á¤º¸ Antidepressive Agents, TricyclicSerotonin Uptake Inhibitors 
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    | Smiles String Canonical | 
    
       Clomipramine¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ CN(C)CCCN1C2=CC=CC=C2CCC2=C1C=C(Cl)C=C2 
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    | Smiles String Isomeric | 
    
       Clomipramine¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ CN(C)CCCN1C2=CC=CC=C2CCC2=C1C=C(Cl)C=C2 
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    | InChI Identifier | 
    
       Clomipramine¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C19H23ClN2/c1-21(2)12-5-13-22-18-7-4-3-6-15(18)8-9-16-10-11-17(20)14-19(16)22/h3-4,6-7,10-11,14H,5,8-9,12-13H2,1-2H3 
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    | Chemical IUPAC Name | 
    
       Clomipramine¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ 3-(9-chloro-5,6-dihydrobenzo[b][1]benzazepin-11-yl)-N,N-dimethylpropan-1-amine 
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    | Drug-Induced Toxicity Related Proteins | 
    
      CLOMIPRAMINE ÀÇ Drug-Induced Toxicity Related ProteinÁ¤º¸ Replated Protein:serotonin transporter Drug:clomipramine Toxicity:5-Hydroxytryptamine neurotransmission,antidepressant response.  [¹Ù·Î°¡±â] Replated Protein:CYP2D6 Drug:Clomipramine  Toxicity:Toxicity and inefficacy.  [¹Ù·Î°¡±â] 
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                          ÀüÈ: 02-3486-1061 ¤Ó À̸ÞÀÏ: webmaster@druginfo.co.kr
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  The database contains the following fields: The generic name of each chemical For module A10 (liver enzyme composite module): Overall activity category for each compound (A for active, M for marginally active, or I for inactive) based on the number of active and marginally active scores for each compound at the five individual endpoints (see research article for full description of method) Number of endpoints at which each compound is marginally active (M) Number of endpoints at which each compound is active (A) For modules A11 to A15 (alkaline phosphatase increased, SGOT increased, SGPT increased, LDH increased, and GGT increased, respectively): Overall activity category for each compound (A for active, M for marginally active, or I for inactive) based on the RI and ADR values (see the research article for full description of method) Number of ADR reports for each compound, given as <4 or ¡Ã4 Reporting Index value for each compound, except where no shipping units were available (NSU) Group 1 comprises of compounds for which ADR data were available for the first five years of marketing, so when no ADR reports were listed during this period the compounds were evaluated as inactive. Group 2 comprises of compounds for which a 'steady state' period of ADR data were available (1992-1996). In cases where no ADR reports were filed during this period, the compounds were scored as 'NA' (data not available) since they may have had one or more ADR reports during their first five years of marketing which should not be negated by a lack of ADR reports during the steady-state period. CLOMIPRAMINE[GGT Increase][Composite Activity](Score)  I(Marginal)  0(Active)  0[Alkaline Phosphatase Increase](Activity Score)  I(Number of Rpts)  <4(Index value)  0[SGOT Increase](Activity Score)  I(Number of Rpts)  <4(Index value)  0[SGPT Increase](Activity Score)  I(Number of Rpts)  <4(Index value)  0[LDH Increase](Activity Score)  I(Number of Rpts)  <4(Index value)  0[GGT Increase](Activity Score)  I(Number of Rpts)  <4(Index value)  0
 
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