Clomipramine treatment of obsessive-compulsive disorder. II. Biochemical aspects

Arch Gen Psychiatry. 1980 Nov;37(11):1289-94. doi: 10.1001/archpsyc.1980.01780240087010.


Concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), the dopamine metabolite homovanillic acid, and the noradrenaline metabolite 4-hydroxy-3-methoxyphenyl glycol were measured in CSF before and after three weeks' treatment of severe obsessive-compulsive disorder with clomipramine hydrochloride. Patients who responded to clomipramine treatment had significantly higher CSF levels of 5-HIAA before treatment. The amelioration of obsessive-compulsive symptoms was positively correlated to the reduction of CSF concentrations of 5-HIAA during clomipramine treatment but negatively correlated to plasma concentrations of clomipramine. Reduction of CSF concentrations of 5-HIAA, which probably reflects drug action on central serotonin neurons, was maximal at a plasma clomipramine concentration of about 300 nmole/L. At higher levels, the reduction of CSF levels of 5-HIAA was smaller. The antiobsessive effect of clomipramine may be connected to its capacity to inhibit serotonin uptake.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clomipramine / blood
  • Clomipramine / therapeutic use*
  • Female
  • Glycols / cerebrospinal fluid*
  • Homovanillic Acid / cerebrospinal fluid*
  • Humans
  • Hydroxyindoleacetic Acid / cerebrospinal fluid*
  • Male
  • Methoxyhydroxyphenylglycol / cerebrospinal fluid*
  • Middle Aged
  • Obsessive-Compulsive Disorder / cerebrospinal fluid
  • Obsessive-Compulsive Disorder / drug therapy*
  • Phenylacetates / cerebrospinal fluid*


  • Glycols
  • Phenylacetates
  • Methoxyhydroxyphenylglycol
  • Hydroxyindoleacetic Acid
  • Clomipramine
  • Homovanillic Acid