Anafranil (clomipramine) is a prescription-only medication from a class of drugs called tricyclic antidepressants (TCAs). These drugs derive their name from the three rings that make up their chemical structure. This medication works by increasing the amount of serotonin and norepinephrine in the body—two neurotransmitters that, when increased, may help reduce anxiety and behaviors associated with obsessive compulsion.

What Mental Health Conditions Are Treated with Anafranil?

Anafranil is prescribed by psychiatrists to address obsessive compulsive thoughts and behaviors in children, teens, and adults. This medication may help control the thoughts and repetitive behaviors that accompany OCD; however, it is not intended as a cure for the condition. Typically people experiencing obsessive compulsive behaviors also seek treatment from a trained therapist or mental health professional.

Medication and Dosage FAQs

  • How should I take this medication?
    Anafranil comes in capsule form and should be taken with food. Your doctor may advise you to start by taking this medication three times per day, with meals, in order to help your body acclimatize to the drug. Over time, your dosage may be adjusted to a single capsule taken at bedtime. You should not adjust your own dosage; instead, work with your health care provider to find the most effective amount of medication for you. It may take several weeks before you experience the full benefits of taking this medication. It is important to take this medication exactly as directed by your doctor. Always read the medication guide each time you refill your prescription as new information may have been added.

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    What should I do if I forgot to take my medication?
    Take the dose you forgot as soon as you remember it. However, if it will soon be time for your next regular dose, skip the missed dose completely. Do not take two doses of this medication over a short period of time, as this may result in an overdose.
     
  • What should I do if I took too much of this medication?
    Call a poison helpline, contact your health care provider, and seek emergency medical attention immediately. An overdose of this medication may be deadly. Signs of Anafranil overdose include drowsiness, slurred or slow speech, rapid heart rate, congestive heart failure, seizures, coma, or loss of consciousness.
     
  • Who should not take this medication?
    People who are being treated with methylene blue injection and people who have taken a monoamine oxidase inhibitor (MAOI) in the past two weeks should not take this drug as a deadly drug interaction may occur. This medication is not approved for use by elderly people unless it is being used to treat OCD. Individuals under the age of 18 should not use this medication unless advised by a medical professional.
     
  • How can I get the most out of my treatment with this drug?
    Anafranil is primarily prescribed to treat OCD behaviors and thoughts. These conditions are also regularly treated with various types of psychotherapy, resulting in positive outcomes for many. Although this medication may lessen the severity of symptoms, it cannot address the issue in the same way as a therapist or counselor, who may help you develop positive coping strategies, a good self-care routine, and teach you more about what you are experiencing. If you are prescribed this drug, please consider finding a therapist or counselor with whom you can establish a good therapeutic relationship and work toward better long-term mental health.
     
  • How should I store this medication?
    Keep Anafranil at a temperature between 68 and 77 degrees Fahrenheit (20 and 25 degrees Celsius). Store this medication in a container with a child-protected closure, away from moisture.

Important Information to Consider Before Use

Within the first few months of treatment, this medication may cause an increase in suicidal thoughts and actions in children, teenagers, and young adults. Similar effects may be observed if the dose is changed. People who have a family history of bipolar issues may be at a higher risk for developing thoughts of suicide. Pay close attention to any sudden or severe changes in mood, thoughts, feelings, or behavior. Call your doctor if any symptoms cause you to worry.

Older antidepressants like Anafranil have been linked with heart attack in people of any age. If you have or have ever had heart disease, heart failure, irregular heartbeat, heart attack, high or low blood pressure, brain damage, stroke, urinary problems, overactive thyroid, narrow-angle glaucoma, schizophrenia, bipolar issues, seizures, or tumors on your adrenal glands, you should talk to your doctor about these medical conditions before you take this drug. Tell your doctor if you currently have or have ever experienced alcohol addiction. Mention any serious reactions you may have had to other similar medications.

If you are taking other prescription drugs or supplements, you should check with your doctor or pharmacist before taking Anafranil. This drug may interact with other medications or supplements, including MAOIs, antihistamines, other antidepressants, antacids, antifungal creams and medications, sleeping pills, antipsychotics, vitamins, minerals, high blood pressure medications, herbal products, and more.

Considerations During Use

Anafranil, along with other TCAs, carries significant warnings of which to be aware. If you are prescribed this drug, make sure your doctor and/or pharmacist discusses the following information with you:

  • This medication may cause problems in newborns if taken during pregnancy or while breastfeeding. If you are pregnant or become pregnant while taking Anafranil, you should speak with your doctor about other possible treatments for what you are experiencing.
  • This drug may make you extremely drowsy; do not drive, climb, or work with heavy machinery until you are sure how it will affect you.
  • Do not drink alcohol while taking this medication. Alcohol may interact with this medication to produce serious side effects.
  • Your surgeon or anesthesiologist needs to know that you are taking this medication if you are scheduled for or plan on having any type of surgery, including oral surgery.
  • Avoid cigarettes and tobacco products when taking this medication; these items may interfere with the effectiveness of the medication.

Possible Side Effects

If you experience serious or severe side effects from Anafranil, you should call your doctor. Your doctor will help you decide if the benefits of this medication outweigh the risks of using it. Serious side effects of this drug may include:

  • Hallucinations or paranoia
  • Irregular or rapid heartbeat
  • Difficult or heavy, rapid breathing
  • Seizures
  • Eye pain
  • Unusual, uncontrollable shaking
  • Sore throat, fever, or other infection signs
  • Incontinence or difficulty urinating

Less serious side effects from taking this medication may include:

  • Drowsiness
  • Headache or nasal congestion
  • Decreased ability to concentrate or remember things
  • Nervousness
  • Dry mouth
  • Weight gain or increase in appetite
  • Restlessness or agitation
  • Nausea, vomiting, diarrhea, or constipation
  • Decreased sexual ability

How to Safely Withdraw

Do not stop taking Anafranil abruptly as your body may have become accustomed to the medication. Slowly tapering off of this medication will help reduce the occurrence and severity of withdrawal symptoms. Always talk to your doctor before reducing or discontinuing this medication. Possible symptoms of withdrawal include:

  • Insomnia or sleep disturbances
  • Nausea or vomiting
  • Headache
  • Return of OCD symptoms

Discuss any withdrawal symptoms you experience with your doctor.

References:

  1. Citizens Commission on Human Rights International. (2012). The side effects of common psychiatric drugs. Retrieved from http://www.cchrint.org/pdfs/The_Side_Effects_of_Common_Psychiatric_Drugs.pdf
  2. Drugs.com. (2014). Anafranil. Retrieved from http://www.drugs.com/mtm/anafranil.html
  3. Medline Plus. (2014). Clomipramine. Retrieved from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a697002.html
  4. RxList. (2012). Anafranil. Retrieved from http://www.rxlist.com/anafranil-drug.htm
  5. United States Food and Drug Administration. (2012). Medication guide: Anafranil. Retrieved from http://www.fda.gov/downloads/drugs/drugsafety/ucm085910.pdf

Page content reviewed by James Pendleton, ND.