Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.
Clomipramine is a tricyclic antidepressant (TCA) with a particularly strong effect on serotonin. It is used for obsessive-compulsive disorder, for depression, and in some countries for panic disorder and cataplexy in narcolepsy. It is sold as Anafranil, among other names.
Two liver enzymes handle clomipramine. CYP2C19 turns it into desmethylclomipramine, which acts more on noradrenaline, and CYP2D6 breaks both forms down further. People with little CYP2D6 activity can build up higher levels with more side effects, and CYP2C19 variants shift the balance between the two forms. CPIC and DPWG have published guidelines on CYP2D6 and CYP2C19 for clomipramine (CPIC's covers the tricyclics as a group), and the US FDA lists an effect on drug levels. A few other genes have been studied, with weaker evidence.
Clinical guidelines that name a gene for Clomipramine. They sort people into groups by the gene copies they carry.
DPWG guideline: CYP2D6. CYP2D6 activity score 0 to 6 or more. 2026.
Every published finding on gene variants and Clomipramine. Upload your DNA file to see which of these rows apply to you.
PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.
CYP2D6 CYP2D6*1, CYP2D6*1xN, CYP2D6*2, CYP2D6*3, CYP2D6*4, CYP2D6*5, CYP2D6*6, CYP2D6*10, CYP2D6*41: Level 1A · replicated. Metabolism/PK: Major Depressive Disorder, Mental Disorders. 13.
CYP2D6 CYP2D6*1, CYP2D6*3, CYP2D6*4, CYP2D6*5, CYP2D6*6: Level 1A · replicated. Toxicity: Major Depressive Disorder. 5.
CYP2C19 CYP2C19*1, CYP2C19*2, CYP2C19*3, CYP2C19*17: Level 1A · replicated. Metabolism/PK: Mental Disorders. 4.
FKBP5 rs1360780: Level 3. Efficacy: Depression. 7.
Studies of how quickly the body processes this medication.
Studies of how well it worked in people carrying a variant.
Studies of how much of the drug people needed or tolerated.
Studies of side effects in people carrying a variant.
Studies that do not fall into the groups above.
Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.
More drugs from the same category
Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.
Content updated September 2026.
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