Anafranil: Restoring Balance in Severe OCD Treatment
Anafranil
| Product dosage: 25mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 60 | $0.88 | $53.00 (0%) | 🛒 Add to cart |
| 90 | $0.80 | $79.50 $72.00 (9%) | 🛒 Add to cart |
| 120 | $0.76 | $106.00 $91.00 (14%) | 🛒 Add to cart |
| 180 | $0.72 | $159.00 $129.00 (19%) | 🛒 Add to cart |
| 270 | $0.69 | $238.50 $185.00 (22%) | 🛒 Add to cart |
| 360 | $0.67
Best per pill | $318.00 $242.00 (24%) | 🛒 Add to cart |
| Product dosage: 50mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.87 | $56.00 (0%) | 🛒 Add to cart |
| 60 | $1.47 | $112.00 $88.00 (21%) | 🛒 Add to cart |
| 90 | $1.34 | $168.00 $121.00 (28%) | 🛒 Add to cart |
| 120 | $1.27 | $224.00 $153.00 (32%) | 🛒 Add to cart |
| 180 | $1.22 | $336.00 $219.00 (35%) | 🛒 Add to cart |
| 270 | $1.17 | $504.00 $315.00 (38%) | 🛒 Add to cart |
| 360 | $1.15
Best per pill | $672.00 $413.00 (39%) | 🛒 Add to cart |
| Product dosage: 75mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $2.60 | $78.00 (0%) | 🛒 Add to cart |
| 60 | $2.08 | $156.00 $125.00 (20%) | 🛒 Add to cart |
| 90 | $1.91 | $234.00 $172.00 (26%) | 🛒 Add to cart |
| 120 | $1.83 | $312.00 $220.00 (29%) | 🛒 Add to cart |
| 180 | $1.75 | $468.00 $315.00 (33%) | 🛒 Add to cart |
| 270 | $1.69
Best per pill | $702.00 $457.00 (35%) | 🛒 Add to cart |
Synonyms | |||
Anafranil (clomipramine hydrochloride) is a tricyclic antidepressant (TCA) with potent serotonin reuptake inhibition properties, specifically approved for the treatment of obsessive-compulsive disorder (OCD). It represents a foundational pharmacological intervention for moderate to severe OCD cases where first-line treatments prove insufficient. Its efficacy is well-documented in clinical literature, offering a robust option for patients struggling with intrusive thoughts and compulsive behaviors. By modulating key neurotransmitter systems, it helps reduce the core symptoms that significantly impair daily functioning and quality of life.
Features
- Active ingredient: Clomipramine hydrochloride
- Available in 10 mg, 25 mg, and 50 mg oral capsules
- Potent serotonin reuptake inhibitor (SRI)
- Also exhibits noradrenergic reuptake inhibition
- FDA-approved for the treatment of obsessive-compulsive disorder (OCD)
- Used off-label for major depressive disorder, panic disorder, and chronic pain syndromes
- Requires gradual titration to minimize initial side effects
- Typically administered in divided doses to improve tolerability
Benefits
- Significantly reduces the frequency and intensity of obsessive thoughts and compulsive rituals
- Improves overall psychosocial functioning and daily activity engagement
- Provides long-term maintenance of therapeutic gains with consistent use
- May alleviate associated depressive and anxiety symptoms commonly comorbid with OCD
- Offers a well-established efficacy profile with decades of clinical use and research
- Serves as an alternative when newer antidepressants are ineffective or poorly tolerated
Common use
Anafranil is primarily indicated for the treatment of obsessive-compulsive disorder in adults and children aged 10 years and older. Its use extends to cases where the obsessions or compulsions cause marked distress, are time-consuming, or significantly interfere with social, occupational, or educational functioning. Off-label applications include treatment-resistant depression, panic disorder with or without agoraphobia, cataplexy associated with narcolepsy, and certain chronic pain conditions such as neuropathic pain. It is generally reserved for more severe presentations due to its side effect profile and requires careful patient selection and monitoring.
Dosage and direction
Initial dosing for adults typically begins at 25 mg daily, administered in divided doses with meals to minimize gastrointestinal upset. The dosage may be gradually increased by 25 mg every 4-7 days as tolerated, targeting a therapeutic range of 100-250 mg daily. Maximum recommended dose is 250 mg per day for adults and 3 mg/kg or 200 mg daily (whichever is smaller) for children and adolescents. Maintenance therapy usually continues at the lowest effective dose once symptom control is achieved. Dose adjustments should be made cautiously in elderly patients or those with hepatic impairment. Abrupt discontinuation should be avoided; instead, taper gradually over several weeks to prevent withdrawal symptoms.
Precautions
Patients should be monitored closely for emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia, hypomania, mania, or other unusual changes in behavior, particularly during initial treatment or dose adjustments. Use with caution in patients with a history of seizures, as clomipramine lowers seizure threshold. Cardiovascular monitoring is recommended due to potential effects on conduction intervals; baseline and periodic ECGs are advised, especially in those with pre-existing heart conditions. May impair mental or physical abilities required for hazardous tasks; caution patients about operating machinery or driving. Orthostatic hypotension may occur, particularly in elderly patients. Regular monitoring of blood counts is recommended due to rare reports of bone marrow suppression.
Contraindications
Anafranil is contraindicated in patients with known hypersensitivity to clomipramine or other tricyclic antidepressants. Should not be used concomitantly with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to risk of serotonin syndrome. Contraindicated during the acute recovery phase after myocardial infarction. Not recommended for patients with uncontrolled narrow-angle glaucoma or significant urinary retention. Avoid use in those with severe liver impairment. Contraindicated in patients with history of Long QT syndrome or other serious cardiac arrhythmias.
Possible side effects
Common adverse reactions include dry mouth, constipation, blurred vision, dizziness, drowsiness, weight gain, increased sweating, and orthostatic hypotension. Sexual dysfunction including decreased libido, erectile dysfunction, and anorgasmia may occur. Gastrointestinal disturbances such as nausea and vomiting are frequent during initial treatment. Less common but serious side effects include seizures, cardiac arrhythmias, neuroleptic malignant syndrome, serotonin syndrome, hyponatremia, and bone marrow suppression. Elderly patients may be more susceptible to anticholinergic effects, confusion, and falls.
Drug interaction
Concomitant use with MAOIs may cause serious, sometimes fatal, reactions including hyperthermia, rigidity, myoclonus, autonomic instability, and mental status changes. May potentiate effects of CNS depressants including alcohol, barbiturates, and benzodiazepines. Serotonergic drugs (SSRIs, SNRIs, triptans, tramadol) may increase risk of serotonin syndrome. Drugs that inhibit CYP2D6 (fluoxetine, paroxetine, quinidine) may increase clomipramine levels. Anticholinergic drugs may compound anticholinergic side effects. May potentiate effects of sympathomimetic amines. Cimetidine may increase plasma concentrations of clomipramine. Barbiturates may decrease plasma levels through enzyme induction.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is close to the time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed one. Consistent daily administration is important for maintaining therapeutic blood levels, particularly in the management of OCD where symptom control depends on stable medication concentrations.
Overdose
Anafranil overdose can be serious and potentially fatal. Symptoms may include severe drowsiness, agitation, confusion, hallucinations, tachycardia, cardiac arrhythmias, hypotension, respiratory depression, seizures, coma, and cardiac arrest. Management involves immediate gastric lavage if presentation is early, followed by activated charcoal. Cardiac monitoring is essential for at least 72 hours due to risk of delayed arrhythmias. Supportive care includes maintaining airway, respiration, and circulation. Benzodiazepines may be used for seizure control. Sodium bicarbonate is indicated for QRS prolongation (>100 ms) or ventricular arrhythmias. Forced diuresis, dialysis, or hemoperfusion are not effective due to high protein binding and large volume of distribution.
Storage
Store at room temperature (15-30°C or 59-86°F) in a tightly closed container, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly dispose of any unused medication through medication take-back programs or according to FDA-recommended disposal methods if no take-back program is available.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Anafranil is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to medication may vary, and only a healthcare provider can determine the appropriate treatment based on a patient’s specific medical condition, history, and current medications. Patients should not initiate, adjust, or discontinue medication without consulting their physician.
Reviews
Clinical studies demonstrate that approximately 60-70% of OCD patients experience significant symptom reduction with Anafranil therapy. Many patients report substantial improvement in quality of life after 8-12 weeks of treatment at therapeutic doses. Some reviews note that while side effects can be challenging initially, they often diminish with continued treatment. Long-term users frequently describe it as life-changing for severe OCD, though many emphasize the importance of patience during the titration period. Several meta-analyses confirm its superiority over placebo and comparable efficacy to SSRIs for OCD, with particular benefit for patients with comorbid tic disorders.