- central nervous system: Often, fatigue, dizziness, lightheadedness, headaches, confusion, agitation, insomnia, nightmares, increased anxiety, seizures (0.5% to 2%, see above), rarely hypomania or induction of schizophrenia (immediate termination of therapy required), and extrapyramidal side-effects (pseudoparkinsonism, dyskinesia, rarely tardive dyskinesia) are noted.
- Anticholinergic side effects in different grades of severity are quite common: dry mouth, constipation, rarely ileus (paralysis of the large intestine, life-threatening), difficulties in urinating, sweating, precipitation of glaucoma (may lead to permanent eye-damage or even blindness, if untreated). The incidence of dental caries may be increased due to dry mouth.
- antiadrenergic side effects occur very frequently due to strong central and peripheral blockage of alpha receptors: hypotension, postural collapse (when patient is rising too fast from lying or sitting position to standing), arrhythmias (sinus tachycardia, bradycardia, AV block, rarely other forms of cardiac problems). Preexisting heart insufficiency can be worsened.
- Allergic/toxic: skin reactions and photosensitivity with increased frequency of sunburns are seen in a few percentage of cases. Rarely liver damage of the cholostatic type, hepatitis, and leukopenia or other forms of blood dyskrasia are seen, also severe acute allergy including difficulties in breathing, skin reaction, chest pain etc.
- Other side effects may include heartburn, weight gain, but also nausea and bruxism – teeth-grinding while asleep – (the latter due to the strong inhibition of reuptake of serotonin).
It’s frightening enough to risk these side effects for yourself, when doctors have pages and pages of studies for exactly what dosage to take and what to watch out for when you take it – but for your dog, the dose may be not nearly so precise, and more pressingly, unless your dog is from a Pixar movie, you cannot ask it about its internal state. A condition that causes deep internal distress or pain to your dog may only be manifest as a slight fatigue, or even not at all. Your dog doesn’t know to report symptoms or changes in its experience – and so Clomipramine may be ten times the gamble in a dog as it would be for a human, where it’s already considered a last option to treat humans.
Another notable difference is that in humans, where it’s already only resorted to if other drugs fail, Clomipramine is used to treat conditions that may be disabling and immediately life-threatening. Although dogs with noise anxiety can be dangerous to themselves in storm situations, there is no way this danger is comparable to deep depression in humans – and so, for treating dogs, these side effects are not in parity with the problem.
If you’re searching the internet for information on helping your dog’s anxiety through storm season, make sure and search past those drug-company websites and go a few pages further to find actual pet-owner experiences. This is a good rule of thumb for any treatment you’re uncertain of, and in the case of Clomipramine, take note of all the dog owners who report that loss of personality, loss of energy, of liveliness – then, ask yourself if there isn’t a better remedy to your dog’s anxiety than one that risks liver damage, nervous system problems, and the alteration of all that which you love about your dog.