Clomipramine

Date: November 2024, Version 3

Quick take

A tricyclic antidepressant (TCA) can be used in pregnancy if recommended by a doctor.

What are they?

Tricyclic antidepressants (TCAs) include the medicines amitriptyline, clomipramine, dosulepin (Thaden®), doxepin (Xepin®), imipramine, lofepramine, nortriptyline and trimipramine. They are used to treat depression, anxiety, and certain types of nerve pain.

There is a separate bump leaflet on ‘Use of amitriptyline in pregnancy’.

Benefits

What are the benefits of taking a TCA in pregnancy?

TCA treatment for nerve pain can improve a woman’s wellbeing and quality of life. A TCA can also prevent relapse of a mental health condition, which is important both during pregnancy and while looking after your baby.

Risks

Are there any risks of taking a TCA during pregnancy?

Use of a TCA in pregnancy is not known to harm the baby.

TCA use around the time of delivery might cause your newborn baby to have withdrawal symptoms such as jitteriness, and problems with feeding and sleeping. A hospital delivery will be recommended so that your baby can be examined after birth and looked after as necessary until these symptoms pass.

Alternatives

Are there any alternatives to taking a TCA in pregnancy?

Possibly. There may be other alternatives to treat nerve pain or a mental health condition. Your doctor will be able to advise whether a TCA is still the best treatment during pregnancy depending on your circumstances.

No treatment

What if I prefer not to take medicines during pregnancy?

Use of a TCA in pregnancy will only be recommended if you need it to stay well. You can discuss the risks and benefits with your doctor.

Will my baby need extra monitoring?

Women in the UK will be offered a very detailed scan at around 20 weeks of pregnancy as part of routine antenatal care. Taking a TCA in pregnancy would not normally require extra monitoring for birth defects.

If you have taken a TCA around the time of delivery your baby may require extra monitoring to check for withdrawal symptoms.

Are there any risks to my baby if the father has taken a TCA?

We do not expect any increased risk to your baby if the father takes a TCA.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.