# Clomipramine for Cats: Inappropriate Urination and Spraying Clomipramine for cats inappropriate urination is a prescription tricyclic antidepressant that veterinarians sometimes use to calm the anxiety driving urine marking and spraying. It is not a litter box cleaner or a quick fix, and it does not work for every cat. It only makes sense after your veterinarian has ruled out medical causes and you have addressed litter box basics. This article is educational and is not a substitute for veterinary diagnosis or treatment. ## Quick Answer - Clomipramine is a tricyclic antidepressant given by mouth, most often as a capsule or compounded liquid, to reduce anxiety-related urine marking and spraying in cats. - It is a second-line tool. Your veterinarian should first rule out urinary tract disease, pain, and other medical triggers, because inappropriate urination is often a physical problem, not a behavioral one. - It usually takes weeks, not days, to see a full effect, and behavior therapy plus litter box changes still matter. - Common side effects include sleepiness, drooling, vomiting, and appetite loss. Serious effects like agitation, aggression, or urinary retention need a call to your vet. - Never start, stop, or change the dose on your own. Your veterinarian calculates the dose from your cat's weight and health. ## What Clomipramine Is and What Veterinarians Use It For Clomipramine belongs to a class of drugs called tricyclic antidepressants. In cats, veterinarians prescribe it to reduce anxiety that shows up as unwanted behavior, including urine marking, spraying, and some forms of aggression. It is worth knowing that the evidence for clomipramine in cats is mixed. One review of medications for lower urinary tract disease in cats noted that drugs like amitriptyline, clomipramine, and fluoxetine have produced mixed results [1]. That does not mean the drug never helps. It means response varies, and your veterinarian will weigh the possible benefit against the risks for your individual cat. A recent retrospective case series looked at cats with long-standing unacceptable urination that had compulsive features, meaning the behavior was repetitive and rigid. After medical causes were excluded, cats treated with behavior modification plus clomipramine had far better outcomes than cats treated with behavior modification alone. A positive outcome was recorded in 10 of 11 cats in the clomipramine group versus 1 of 10 cats in the behavior-only group at the first follow-up 30 days later [2]. This is a small, retrospective study, so it is encouraging instead of proof, but it supports the idea that medication can help when the behavior has become stuck and repetitive. Clomipramine is also sometimes discussed for other anxiety-driven problems, including overgrooming and aggression. For psychogenic alopecia, the only controlled study found no evidence that clomipramine alone reduced grooming episodes, alopecia, or improved hair regrowth [3]. For owner-directed aggression, severe cases are often treated with selective serotonin reuptake inhibitors such as fluoxetine, though side effects like short-term appetite loss can discourage owners from starting treatment [4]. If your cat's main problem is aggression, ask your veterinarian whether clomipramine or another medication is the better fit. ## How Clomipramine Works Clomipramine changes the balance of chemical messengers in the brain, mainly serotonin and norepinephrine. In plain terms, it helps turn down the anxiety signal that keeps your cat returning to the same door, wall, or couch to spray. Spraying and inappropriate peeing are often communication, not spite. A cat who feels threatened by another cat, a new baby, a moved litter box, or a change in schedule may mark to make the space feel safer. Clomipramine does not teach your cat a new habit. It lowers the anxiety enough that behavior work can take hold. That is why medication and behavior therapy are usually paired. If you have not yet sorted out whether your cat is spraying or urinating, start with [Cat Spraying vs. Urinating: How to Tell the Difference and What to Do](/knowledge/veterinary-medicine/anxiety-and-behavior-support/cat-spraying-vs-urinating). The two look similar but point to different problems. ## Dosing Basics for Clomipramine for Cats ### Who decides the dose Your veterinarian does. The dose depends on your cat's weight, overall health, kidney and liver function, and other medications. Never use a dose you found online or a dose meant for a dog or a person. ### How it is given Clomipramine is given by mouth. It comes as a tablet or capsule, and it can also be compounded into a liquid for cats who will not take pills. If you are searching for "clomipramine for cats liquid," that is a real option, but a compounding pharmacy prepares it and your veterinarian writes the prescription. Many cats are dosed once daily, though your veterinarian may split the dose. Follow the label exactly. If your cat spits out a pill or you are not sure it went down, do not give a second dose without asking your vet. ### What to do about a missed dose If you miss a dose, give it when you remember, unless it is almost time for the next one. In that case, skip the missed dose and go back to your normal schedule. Do not double up. If you miss several doses in a row, call your veterinarian before restarting, because stopping and starting this drug abruptly can cause problems. ## Common and Serious Side Effects Cats can react to clomipramine in different ways. Some side effects are mild and fade as the body adjusts. Others mean you should call your veterinarian. | Side effect | How common or serious | What to do | |---|---|---| | Sleepiness or lethargy | Common, usually mild | Watch for improvement over the first week. Call if your cat seems overly sedated. | | Vomiting | Common, usually mild | Try giving the dose with a small amount of food if your vet approves. Call if vomiting continues. | | Drooling or hypersalivation | Common, usually mild | This often happens with bitter pills. Ask about a compounded liquid or a treat pocket. | | Appetite loss | Common, can become serious | Call your vet if your cat stops eating for more than a day. | | Increased thirst and urination | Possible | Mention it at your next visit. It can also be a sign of a medical problem that needs checking. | | Anxiety or agitation | Less common, serious | Stop and call your veterinarian. A cat who seems more wired, not calmer, needs a plan change. | | Aggression | Less common, serious | Call your veterinarian. Do not wait for the next refill. | | Urinary retention or trouble peeing | Serious, emergency | Go to a veterinarian right away. A cat who cannot pee is in danger. | | Swollen vulva, mammary enlargement, or estrous behavior | Uncommon | These estrogen-like effects generally resolve when the dose is lowered [5]. Call your vet. | Some of these effects, including appetite loss, vomiting, increased thirst, anxiety, aggression, lethargy, drooling, swollen vulva, estrous behavior, and mammary hyperplasia, are listed among the adverse effects of this drug class [5]. If your cat is female and shows signs of heat or unusual attractiveness to other cats, that is a known effect and usually settles with a dose adjustment [5]. If your cat is straining to pee, that is a different emergency. Read [Cat Straining To Pee](/knowledge/veterinary-medicine/behavior/cat-straining-to-pee) and call your veterinarian or an emergency clinic now. ## Who Should Not Take Clomipramine and Drug Interactions Clomipramine is not right for every cat. Tell your veterinarian about every medication, supplement, and topical product your cat receives, including flea and tick products. Cats with certain heart, liver, kidney, or seizure conditions may not be good candidates. Pregnant or nursing cats, and very young or very old cats, need extra caution [5]. Your veterinarian will decide whether the benefits outweigh the risks. Drug interactions matter with this class. Do not combine clomipramine with other antidepressants, MAO inhibitors, or certain pain medications unless your veterinarian specifically approves it. Estriol should not be used with other estrogens [5]. If your cat is already on a behavior medication, your vet needs to know before adding anything new. ## Overdose and When to Call for Help Too much clomipramine can cause serious problems, including severe sedation, agitation, tremors, vomiting, rapid or irregular heartbeat, and dangerously high body temperature. If you think your cat ate extra pills or lapped a compounded liquid, treat it as an emergency. Call your veterinarian or an emergency clinic immediately. You can also call the ASPCA Animal Poison Control Center at (888) 426-4435 or the Pet Poison Helpline at (855) 764-7661. Keep the pill bottle or packaging with you so you can tell them the drug, the strength, and how much your cat may have taken. Do not wait for symptoms to appear. With tricyclic antidepressants, early treatment matters. ## Limitations and When to Contact a Veterinarian Clomipramine is not a cure for inappropriate urination on its own. It works best as part of a plan that includes ruling out medical causes, fixing litter box problems, reducing stress, and giving the drug time to work. If your cat's behavior does not improve, that is information your veterinarian needs, not a reason to give up. Call your veterinarian the same day if your cat stops eating, vomits repeatedly, seems unusually sedated or unusually agitated, or develops a swollen vulva or mammary swelling. Call right away if you miss several doses and are unsure how to restart. Go to an emergency clinic now if your cat is straining to urinate, crying in the litter box, licking the genital area constantly, hiding, vomiting, or acting painful. A blocked cat can die within a day or two without treatment. If you are unsure whether it is urgent, [Cat Straining to Pee: Emergency or Urgent?](/knowledge/veterinary-medicine/online-vet-and-care-costs/cat-straining-to-pee-emergency) walks through the signs. Schedule a routine visit if the marking continues after several weeks on medication, if you are struggling to give the pills, or if you want to discuss a different medication or a referral to a veterinary behaviorist. Individual cases need a veterinarian who can examine your cat and review the whole picture. ## Frequently Asked Questions ### How long does clomipramine take to work in cats? Most cats need several weeks before you see a clear change. In one case series, the first follow-up was at 30 days, and most cats in the medication group had improved by then [2]. If you see no improvement after a month, your veterinarian may adjust the dose or try a different approach. ### Can clomipramine help with cat spraying? It can help some cats, especially when the spraying is driven by anxiety and behavior therapy is also in place. The evidence is mixed, so it is not a guaranteed fix [1]. Your veterinarian will want to rule out medical causes and litter box problems first. ### Is clomipramine the same as fluoxetine for cats? No, they are different drugs. Clomipramine is a tricyclic antidepressant, while fluoxetine is a selective serotonin reuptake inhibitor. Both are used for behavior problems in cats, and your veterinarian will choose based on your cat's specific issue and health history. ### Can I give my cat clomipramine liquid instead of a pill? Yes, a compounding pharmacy can make clomipramine into a liquid, which many owners find easier. You still need a prescription and a dose set by your veterinarian. Never measure a dose yourself from a human liquid product. ### What if my cat's peeing problem is actually a medical issue? That is common, and it is why testing comes first. Cats with androgen-secreting adrenal tumors, for example, have been evaluated for inappropriate urination and pungent urine before the real cause was found [6]. Bloodwork, a urine test, and sometimes imaging help sort out behavior from disease. ## Related Articles - [Cat Spraying vs. Urinating: How to Tell the Difference and What to Do](/knowledge/veterinary-medicine/anxiety-and-behavior-support/cat-spraying-vs-urinating) - [Cat Straining To Pee](/knowledge/veterinary-medicine/behavior/cat-straining-to-pee) - [Cat Urinary Problems Home Treatment: Safe Steps and Red Flags](/knowledge/veterinary-medicine/digestive-and-urinary-care/cat-urinary-problems-home-treatment) - [Treatment Of Urinary Tract Infection In Cats](/knowledge/veterinary-medicine/clinical-methods/treatment-of-urinary-tract-infection-in-cats) - [Cat Straining to Pee: Emergency or Urgent?](/knowledge/veterinary-medicine/online-vet-and-care-costs/cat-straining-to-pee-emergency) - [Cat Constipation Remedies](/knowledge/veterinary-medicine/symptom-guides/cat-constipation-remedies) ## References 1. [Lower Urinary Tract Disease in Cats - Urinary System](https://www.merckvetmanual.com/urinary-system/noninfectious-diseases-of-the-urinary-system-in-small-animals/lower-urinary-tract-disease-in-cats). Merck Veterinary Manual. 2. [Retrospective Analysis of Compulsive-like Long-Standing Unacceptable Urination in Cats](https://pubmed.ncbi.nlm.nih.gov/41893650/). Veterinary sciences, 2026. 3. [Does treatment with clomipramine reduce cat psychogenic alopecia?](https://pubmed.ncbi.nlm.nih.gov/42007014/). Veterinary evidence, 2022. 4. [Owner-Directed Feline Aggression in Thailand: Characteristics, Associated Factors, and a Clinical Comparison of Treatments](https://pubmed.ncbi.nlm.nih.gov/41752943/). Life (Basel, Switzerland), 2026. 5. [Pharmacotherapeutics in Urinary Incontinence in Dogs and Cats - Pharmacology](https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-urinary-system/pharmacotherapeutics-in-urinary-incontinence-in-dogs-and-cats). Merck Veterinary Manual. 6. [Case report: Androgen-secreting adrenocortical tumors in eight cats](https://pubmed.ncbi.nlm.nih.gov/37383353/). Frontiers in veterinary science, 2023. ## Further Reading - [American Veterinary Medical Association: First Aid Tips for Pet Owners](https://www.avma.org/resources-tools/pet-owners/emergencycare/first-aid-tips-pet-owners) - [Merck Veterinary Manual: Cat Owners](https://www.merckvetmanual.com/cat-owners) - [Cornell Feline Health Center: Health Information](https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information)