To  Denise
Re  Clomipramine (Anafranil)

As per your question concerning clomipramine and the poor apgar scores observed
in a prior infant.

Several studies document a toxic morbidity associated with prenatal use of
clomipramine.  Clinical symptoms included jitteriness, irregular respirations,
leghargy, floppy symptoms(hypotonia), and cyanosis.  Postnatal convulsions have
been reported in several infants.  In view of these reports,  the mother may
wish to discuss discontinuing of these meds with her physician,  and do it
soon.  Clomipramines' half-life(19-37 hrs) is long and will take more than a
week for complete clearance.



Ben Muza A, Smith, CS. Neonatal effects of maternal clomipramine therapy. Arch
Dis. CHild 54:405, 1979.

Ostergaard GZ.  Neonatal effects of maternal clomipramine therapy . Pediatris
69:233, 1982.


Regards
Tom Hale, Ph.D.
Associate Professor of Pediatrics