Biochemical changes during clomipramine treatment of childhood obsessive-compulsive disorder

Arch Gen Psychiatry. 1987 Mar;44(3):219-25. doi: 10.1001/archpsyc.1987.01800150025004.


Peripheral measures of serotonergic and noradrenergic function were obtained in 29 obsessive-compulsive adolescents and 31 age- and sex-matched controls, as well as in a subsample of 22 patients after five weeks of treatment with clomipramine hydrochloride (134 +/- 33 mg/d) (mean +/- SD) given in a double-blind placebo-controlled trial. Drug-free obsessive-compulsive subjects did not differ from controls on measures of platelet serotonin and monoamine oxidase (MAO) activity, nor on plasma epinephrine or norepinephrine concentrations at rest and after a standard orthostatic challenge procedure. Compared with placebo, treatment with clomipramine was clinically effective and produced a marked decrease in platelet serotonin concentration, a trend toward a reduction in platelet MAO activity, and a rise in standing plasma norepinephrine. Clinical improvement during drug therapy was closely correlated with pretreatment platelet serotonin concentration and MAO activity, as well as with the decrease in both measures during clomipramine administration. This suggests that the effects of clomipramine on serotonin uptake may be essential to the antiobsessional action observed.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Blood Platelets / drug effects
  • Blood Platelets / metabolism
  • Blood Pressure / drug effects
  • Clinical Trials as Topic
  • Clomipramine / blood
  • Clomipramine / pharmacology
  • Clomipramine / therapeutic use*
  • Double-Blind Method
  • Epinephrine / blood
  • Female
  • Humans
  • Male
  • Monoamine Oxidase / blood
  • Norepinephrine / blood
  • Obsessive-Compulsive Disorder / blood
  • Obsessive-Compulsive Disorder / drug therapy*
  • Obsessive-Compulsive Disorder / psychology
  • Platelet Count
  • Psychiatric Status Rating Scales
  • Pulse / drug effects
  • Serotonin / blood


  • Serotonin
  • Monoamine Oxidase
  • Clomipramine
  • Norepinephrine
  • Epinephrine