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Anafranil (clomipramine)

Indications

• Obsessive-Compulsive Disorder (OCD): Anafranil is primarily prescribed to treat OCD in adults and children aged 10 and older. It helps reduce persistent, unwanted thoughts (obsessions) and repetitive behaviors (compulsions).
• Depression: Effective in managing major depressive episodes in adults, alleviating symptoms such as persistent sadness, loss of interest, and fatigue.
• Panic Disorder: Used to treat panic disorder, reducing the frequency and severity of panic attacks.
• Chronic Pain: Sometimes prescribed off-label for chronic pain management, helping to reduce pain perception.

Dosage and Administration

• Take Anafranil with food to reduce gastrointestinal side effects.
• Follow the dosing schedule prescribed by your doctor, starting with a low dose and gradually increasing.
• Swallow the capsules whole with water, do not crush or chew.
• Do not abruptly stop taking Anafranil without consulting your doctor, as it can cause withdrawal symptoms.
• Avoid consuming alcohol while taking Anafranil, as it can increase the risk of side effects.
• Do not take more than the prescribed dose; overdose can be dangerous.

Mechanism of Action

Anafranil (clomipramine) is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine in the brain. This increases the levels of these neurotransmitters, helping to balance mood and reduce symptoms of OCD and depression.

Contraindications

• Known Allergy to Clomipramine: Do not use if you have had an allergic reaction to clomipramine or any similar tricyclic antidepressants.
• Recent Heart Attack: Avoid taking Anafranil if you have recently had a myocardial infarction.
• Monoamine Oxidase Inhibitors (MAOIs): Do not use Anafranil if you are currently taking or have taken MAOIs within the last 14 days.

Side Effects

Common Side Effects

• Dry mouth
• Constipation
• Drowsiness
• Dizziness
• Weight gain
• Blurred vision
• Sexual dysfunction

Serious Side Effects

• Seizures
• Severe allergic reactions
• Irregular heartbeats
• Serotonin syndrome (symptoms include confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate)
• Severe mood changes (agitation, aggression, suicidal thoughts)

Precautions

• Pregnancy and Breastfeeding: Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• Heart Conditions: Discuss any heart issues with your doctor; Anafranil can affect heart rhythm.
• History of Seizures: Patients with a history of seizures should use Anafranil with caution.
• Monitoring for Mood Changes: Monitor for worsening depression, suicidal thoughts, or unusual changes in behavior, especially when starting the medication or adjusting the dose.
• Avoid Operating Heavy Machinery: Anafranil can cause drowsiness and dizziness; avoid activities that require alertness until you know how the medication affects you.

Storage Instructions

• Store Anafranil at room temperature, between 68°F and 77°F (20°C and 25°C).
• Keep the medication in its original container, tightly closed, and out of reach of children.
• Protect it from moisture and light; do not store it in the bathroom.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019906s037lbl.pdf