Clomipramine Acute polyradiculoneuropathy

A 61-year-old man had received clomipramine 25-100 mgj day since 1974 and temazepam 10-25mg occasionally at night . Four years previously, the patient developed paraesthesia in both feet which had deteriorated in the last 9 months into burning and tingling in his toes . This kept him awake and interfered with his daily life and the increasing severity of his symptoms prompted SUicidal feelings . At this stage laboratory measurements and results of a neurological examination were normal and the patient had good peripheral circulation . Treatment with analgesics. anticonvulsants, acupuncture . local steroid injection, homeopathy. epidural injection and IV sympathetic blockade was unsuccessful .

Peripheral neuritis was diagnosed after an increase in clomipramine dose produced a worsening of symptoms. On slowly reducing clomipramine, the patient's condition gradually improved .

The occurrence of acute polyradiculoneuropathy In this patient, and in previous cases of amitriptyline overdose indicates that ' __ . a neurotoxic effect should be considered In any patient taking tricyclic antidepressants who develop unusual neurological symptoms '.

Marley J Briti sh Medical Journal 294 1616.20 Jun 1987

0157-7271 / 87/ 0711-0005/ 0$0100/ 0 © ADIS Press REACTIONS ' 11 July 1987 5