Anafranil (clomipramine hydrochloride) is a tricyclic antidepressant (TCA) approved for the treatment of obsessions and compulsions in patients with obsessive-compulsive disorder (OCD). It works by increasing the levels of serotonin, a neurotransmitter in the brain that helps regulate mood, anxiety, and repetitive behaviors. With a well-established efficacy profile supported by extensive clinical research, Anafranil remains a cornerstone pharmacological intervention for moderate to severe OCD, offering significant symptom reduction and improved daily functioning for appropriate patients under medical supervision.

Features

• Active ingredient: Clomipramine hydrochloride
• Available in 10 mg, 25 mg, and 50 mg film-coated tablets
• Selective and potent serotonin reuptake inhibition
• Long half-life allowing for once or twice daily dosing after titration
• Requires prescription and careful medical monitoring

Benefits

• Reduces the frequency and intensity of obsessive thoughts and compulsive rituals
• Improves overall quality of life and social functioning
• Helps restore normal daily routines and reduces time consumed by OCD symptoms
• Supported by decades of clinical evidence and long-term studies
• May alleviate associated depressive and anxiety symptoms in some patients
• Provides a non-psychotherapeutic option for patients unresponsive to other interventions

Common use

Anafranil is primarily indicated for the treatment of obsessive-compulsive disorder (OCD). It is used when symptoms cause significant distress or interfere with social, occupational, or other important areas of functioning. It may also be used off-label under specialist guidance for conditions such as panic disorder, chronic pain syndromes, cataplexy associated with narcolepsy, and treatment-resistant depression. Use is strictly based on a comprehensive psychiatric or medical evaluation.

Dosage and direction

Dosage must be individualized under close medical supervision. For adults, treatment typically begins with a low dose (e.g., 25 mg daily), gradually increasing to a therapeutic range, often between 100 mg and 250 mg daily, divided into two or three doses. Maximum daily dose should not exceed 250 mg. For elderly or adolescent patients, dosing is more conservative, starting at 10–25 mg daily with very gradual titration. Always take with food to minimize gastrointestinal upset. Do not abruptly discontinue; taper gradually under medical guidance.

Precautions

• Regular monitoring of blood pressure, heart rate, and ECG is advised due to potential cardiovascular effects.
• Use with caution in patients with a history of seizures, cardiovascular disease, glaucoma, urinary retention, or hyperthyroidism.
• May impair mental or physical abilities required for driving or operating machinery.
• Avoid alcohol consumption during treatment.
• Inform your physician of any family history of bipolar disorder, suicide, or mania.
• Not recommended during pregnancy or breastfeeding unless potential benefits outweigh risks.

Contraindications

• Hypersensitivity to clomipramine or other tricyclic antidepressants
• Concurrent use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy
• Recent myocardial infarction
• History of severe liver impairment
• Narrow-angle glaucoma
• Severe urinary retention

Possible side effect

Common side effects may include dry mouth, constipation, blurred vision, drowsiness, dizziness, weight gain, increased sweating, and orthostatic hypotension. Less frequently, patients may experience tremors, sexual dysfunction, nausea, or insomnia. Serious side effects requiring immediate medical attention include seizures, suicidal thoughts, serotonin syndrome, irregular heartbeat, severe allergic reactions, or signs of infection such as fever and sore throat.

Drug interaction

Anafranil has numerous potential drug interactions. It should not be combined with MAOIs, SSRIs, SNRIs, triptans, or other serotonergic drugs due to risk of serotonin syndrome. Concurrent use with anticonvulsants, antihypertensives, CNS depressants, anticholinergics, or thyroid medications may require dose adjustments. Always inform your healthcare provider of all prescription, over-the-counter, and herbal products you are taking.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to catch up. Maintain regular dosing schedule to ensure stable blood levels. If unsure, contact your physician or pharmacist for guidance.

Overdose

Anafranil overdose can be severe and potentially fatal, presenting with symptoms such as drowsiness, agitation, confusion, tachycardia, hypotension, seizures, coma, or cardiac arrhythmias. Immediate medical attention is critical. Contact emergency services or a poison control center without delay. Treatment is supportive and may include gastric lavage, activated charcoal, and monitoring of vital signs and cardiac function.

Storage

Store at room temperature (15–30°C or 59–86°F) in a dry place, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Dispose of unused medication properly via a drug take-back program or as advised by your pharmacist.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis, treatment decisions, and personalized medical guidance. Do not initiate, adjust, or discontinue medication without professional supervision.

Reviews

Clinical studies and patient reports consistently indicate that Anafranil is effective in reducing OCD symptoms, though individual responses vary. Many patients experience meaningful improvement within 4–6 weeks of reaching therapeutic dosage. Side effects are common but often manageable with dose adjustment or supportive care. Long-term users emphasize the importance of regular follow-up and adherence to prescribed regimens. Overall, it is regarded as a valuable option for treatment-resistant OCD.