last update: November 14, 2025
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Indications: What Anafranil (Clomipramine) Is Used For
Anafranil (generic name: clomipramine hydrochloride) is a tricyclic antidepressant indicated for the treatment of obsessive-compulsive disorder (OCD) in adults and in pediatric patients aged 10 years and older. OCD is characterized by intrusive, distressing thoughts (obsessions) and repetitive behaviors (compulsions) that are time-consuming and impair daily functioning. By modulating specific brain chemicals, Anafranil can reduce both the frequency and intensity of obsessions and compulsions and improve quality of life.
Clomipramine exerts a strong effect on serotonin reuptake and a moderate effect on norepinephrine reuptake, which is believed to underlie its clinical benefits in OCD. It also has antihistaminic and anticholinergic properties, which contribute to both therapeutic effects and side effects.
Off-label, clinicians may consider clomipramine in select cases for conditions such as panic disorder, treatment-resistant depression, and cataplexy associated with narcolepsy. Any off-label use should be carefully individualized and supervised by a qualified prescriber after weighing risks and benefits.
How Anafranil Works in OCD
OCD is closely linked to dysregulation of the serotonin system in the brain. Anafranil primarily blocks serotonin reuptake at the synapse, thereby increasing the availability of serotonin in key brain circuits that govern anxiety, impulse control, and habit formation. Over time, this can improve cognitive flexibility and reduce the drive to perform compulsions. As with many medications that target serotonin, benefits may emerge gradually. It often takes 2 to 3 weeks to note meaningful improvement, with full benefit sometimes taking 6 to 12 weeks, especially at optimized doses combined with therapy such as cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP).
Instructions: How to Take Anafranil Safely
Use Anafranil exactly as directed by your healthcare provider. Do not change your dose or stop taking it without medical guidance.
- Administration: Take by mouth with food to help reduce stomach upset. Swallow capsules whole with water.
- Consistency: Take your dose at the same time each day. Many patients take the largest dose at bedtime due to possible drowsiness.
- Onset: It may take 2–3 weeks to start noticing improvement; continue as prescribed even if you do not feel immediate effects.
- Do not miss doses: Consistency supports symptom control and reduces the risk of withdrawal effects.
Usual adult dosing for OCD (individualize per prescriber):
- Start 25 mg daily, typically at bedtime.
- Increase gradually by 25 mg increments every few days as tolerated.
- Typical target range: 100–150 mg/day, given once daily at bedtime or in divided doses.
- Maximum dose in adults: generally up to 250 mg/day depending on clinical response and tolerability.
Pediatric dosing (10–17 years): Lower starting doses and slower titration are used. A common approach is to start at 25 mg/day and titrate based on weight, response, and side effects, not exceeding the lower of 3 mg/kg/day or 200 mg/day. Pediatric dosing must be managed by a specialist experienced in treating OCD in youth, with careful monitoring for suicidality and side effects.
Missed dose: If you miss a dose, take it as soon as you remember unless it is close to the time of your next dose. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take double doses. If you take a single daily dose at bedtime and miss it, do not take it the next morning—wait and take your next scheduled dose at bedtime.
Do not stop abruptly: Sudden discontinuation may lead to withdrawal symptoms such as dizziness, headache, nausea, irritability, insomnia, or flu-like symptoms. If stopping is necessary, your prescriber will help you taper gradually.
Storage and Stability
Store Anafranil at room temperature, 68–77°F (20–25°C), in a tightly closed container. Protect from excess heat, moisture, and light. Do not store in the bathroom. Keep out of reach of children and pets. Properly discard unused or expired medication according to local regulations or pharmacy take-back programs.
More Information and Active Ingredient
Active ingredient: Clomipramine hydrochloride.
Available strengths commonly include 25 mg, 50 mg, and 75 mg capsules. Brand and generic formulations may differ in inactive ingredients; consult your pharmacist if you have sensitivities or allergies to dyes or excipients.
Do NOT Use Anafranil If
- You are allergic to clomipramine, other tricyclic antidepressants (such as imipramine, amitriptyline), or any component of the formulation.
- You are taking, or have taken within the past 14 days, a monoamine oxidase inhibitor (MAOI), including linezolid or intravenous methylene blue. Serious, potentially fatal reactions can occur.
- You are taking certain contraindicated medicines such as pimozide, cisapride, or specific antihistamines historically linked to cardiac arrhythmias (for example, astemizole, terfenadine).
- You are recovering from a recent heart attack (acute myocardial infarction) or have severe, uncontrolled heart rhythm disorders.
Contact your healthcare provider immediately if any of the above apply to you or if you are unsure whether Anafranil is appropriate for your situation.
Before You Start: Conditions and Factors to Discuss with Your Clinician
Certain medical conditions can influence how safe and effective Anafranil will be for you. Inform your doctor or pharmacist about all your health conditions and all medicines you use (prescription, over-the-counter, supplements, and herbal products), especially if any of the following apply:
- Pregnancy, plans to become pregnant, or breastfeeding.
- History of bipolar disorder, mania/hypomania, major depression, anxiety disorders, or prior suicidal thoughts or behavior.
- Seizure disorders, head injury, or conditions that lower seizure threshold (including heavy alcohol use or withdrawal).
- Glaucoma (especially angle-closure), urinary retention, enlarged prostate, or severe constipation.
- Cardiovascular disease, including arrhythmias, conduction abnormalities, heart failure, or low blood pressure.
- Liver or kidney impairment.
- Thyroid disease or use of thyroid hormone.
- Diabetes or blood sugar dysregulation.
- Adrenal gland tumors (e.g., pheochromocytoma), which can affect blood pressure responses.
- History of bleeding disorders or low sodium (hyponatremia).
- Upcoming surgery or procedures requiring anesthesia or electroconvulsive therapy (ECT).
- Regular use of alcohol or substances; history of alcohol or substance use disorder.
Drug Interactions: What to Avoid or Use with Caution
Anafranil has important interactions that can increase side effects, reduce effectiveness, or pose serious risks. Always check with your healthcare provider or pharmacist before starting or stopping any medication.
- MAOIs (e.g., phenelzine, tranylcypromine), linezolid, IV methylene blue: Contraindicated. Risk of hypertensive crisis, serotonin syndrome, and severe interactions.
- Other serotonergic agents: SSRIs/SNRIs (e.g., fluoxetine, paroxetine, sertraline, venlafaxine), buspirone, triptans, tramadol, fentanyl, St. John’s wort, lithium. Combined use increases risk of serotonin syndrome. If switching from fluoxetine, allow adequate washout due to its long half-life.
- CYP inhibitors that raise clomipramine levels: Strong CYP2D6, CYP3A4, or CYP1A2 inhibitors such as fluoxetine, paroxetine, duloxetine, quinidine, cimetidine, erythromycin, clarithromycin, azole antifungals (ketoconazole, itraconazole, fluconazole), verapamil, diltiazem. May increase side effects and toxicity; dose adjustment and monitoring may be required.
- CYP inducers that lower clomipramine levels: Carbamazepine, phenytoin, phenobarbital, rifampin, St. John’s wort, and smoking (CYP1A2 induction). May reduce efficacy; prescribers may adjust dose if appropriate.
- QT-prolonging drugs and antiarrhythmics: Certain antipsychotics (e.g., haloperidol), macrolide antibiotics, fluoroquinolones, methadone, pimozide. Concurrent use can heighten arrhythmia risk.
- Anticoagulants and antiplatelets: Warfarin, clopidogrel, NSAIDs, and aspirin may carry increased bleeding risk when combined; monitor INR if on warfarin and watch for bleeding symptoms.
- Antihypertensives: Clonidine, guanethidine, and similar agents may have reduced effect; blood pressure monitoring is advisable.
- Anticholinergic drugs: Oxybutynin, benztropine, first-generation antihistamines, certain antipsychotics can intensify dry mouth, constipation, blurred vision, and urinary retention.
- CNS depressants and alcohol: Opioids, benzodiazepines, sleep aids, muscle relaxants, and alcohol can add to drowsiness, dizziness, and impaired coordination. Avoid alcohol and use caution with other sedatives.
This may not be a complete list of interactions. Always consult your healthcare professional before adding or removing a medication.
Important Safety Information and Monitoring
- Drowsiness, dizziness, blurred vision: Do not drive or operate heavy machinery until you know how Anafranil affects you. Standing up slowly can help prevent lightheadedness and fainting.
- Alcohol: Avoid alcohol as it can significantly increase sedation and impair judgment.
- Heat and dehydration: Anafranil may reduce sweating and increase susceptibility to overheating. Use caution in hot weather, during vigorous exercise, or with fever; hydrate adequately.
- Sun sensitivity: You may sunburn more easily. Limit sun exposure; use sunscreen and protective clothing.
- Mental health monitoring: Antidepressants can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults, especially during the first few months of treatment or during dose changes. Monitor closely and report sudden mood changes, agitation, panic attacks, or unusual behavior.
- Serotonin syndrome: Seek immediate medical attention for symptoms such as agitation, confusion, sweating, rapid heart rate, muscle stiffness or twitching, shivering, diarrhea, or high fever.
- Cardiac considerations: Tricyclics can affect heart conduction and rhythm. Patients with known heart disease may need baseline and periodic ECGs and electrolyte monitoring, especially if on higher doses or other QT-prolonging drugs.
- Seizure risk: Clomipramine may lower the seizure threshold, particularly at higher doses or with interacting drugs. Report any seizure activity promptly.
- Glaucoma and urinary retention: Anticholinergic effects can precipitate angle-closure glaucoma or worsen urinary retention. Seek urgent care if you experience severe eye pain, sudden vision changes, or inability to urinate.
- Hyponatremia (low sodium): Especially in older adults or those on diuretics. Symptoms include headache, confusion, weakness, unsteadiness, or seizures; report these immediately.
- Liver considerations: Rarely, liver enzymes may elevate. Report persistent nausea, abdominal pain, dark urine, or yellowing of the skin or eyes.
- Dental and surgical care: Inform your dentist, surgeon, or emergency providers that you take clomipramine. Anesthesia and certain perioperative medications can interact with TCAs.
- Lab tests: Your provider may order blood counts, electrolytes (particularly sodium), liver function tests, and, when indicated, ECGs.
- Elderly: Increased sensitivity to side effects such as orthostatic hypotension, confusion, and hyponatremia. Lower starting doses and slower titration are standard.
- Pregnancy and breastfeeding: The decision to use Anafranil during pregnancy requires an individualized risk-benefit assessment. Neonates exposed late in pregnancy may experience adaptation symptoms. Clomipramine passes into breast milk; breastfeeding is generally not recommended while taking it—discuss alternatives with your clinician.
Side Effects: What to Expect and When to Seek Help
Many people experience mild or transient side effects that improve as the body adapts. However, some reactions warrant prompt medical attention. Always tell your prescriber about any side effect that is severe, persistent, or concerning.
Common side effects (often dose-related):
- Dry mouth, constipation, blurred vision
- Drowsiness, dizziness, fatigue
- Nausea, upset stomach, vomiting, decreased appetite
- Sweating, tremor
- Headache, insomnia or vivid dreams/nightmares
- Weight change (gain or loss)
- Mild orthostatic lightheadedness, especially on standing
- Sexual side effects such as decreased libido or delayed ejaculation
Serious side effects—seek medical attention right away:
- Allergic reactions: rash, hives, itching, swelling of face/lips/tongue, trouble breathing
- Fast, slow, or irregular heartbeat; chest pain; fainting
- Severe dizziness or confusion; new or worsening agitation, anxiety, panic attacks
- Suicidal thoughts or behavior; unusual behavioral changes
- Seizures, severe tremor, or muscle stiffness
- Vision changes or severe eye pain (possible angle-closure glaucoma)
- Persistent fever, sore throat, mouth ulcers (possible blood cell changes—infrequent)
- Severe constipation, abdominal pain, or urinary retention
- Jaundice (yellowing of skin/eyes), dark urine, or severe fatigue (possible liver issues)
- Signs of serotonin syndrome: agitation, sweating, shivering, diarrhea, high fever, confusion, muscle twitching
- Unusual bruising or bleeding
This is not a complete list of potential side effects. If you develop symptoms that concern you, contact your healthcare provider for guidance.
Overdose: Urgent Guidance
Overdose with clomipramine can be life-threatening and requires immediate emergency care. Symptoms may include severe drowsiness, confusion, agitation, hallucinations, seizures, stiff or jerky muscles, low blood pressure, irregular heartbeat, fainting, trouble breathing, and coma. If an overdose is suspected, call emergency services or your local poison control center at once.
Treatment Tips: Maximizing Benefit and Minimizing Risk
- Combine medication with therapy: Evidence-based psychotherapy—especially CBT with ERP—often enhances outcomes in OCD.
- Take with food: This can reduce nausea and stomach upset.
- Hydration and fiber: To address constipation, increase fiber and fluids; consider a stool softener if recommended by your clinician.
- Oral care: Dry mouth raises cavity risk. Maintain good oral hygiene and consider sugar-free gum or saliva substitutes.
- Sleep hygiene: If insomnia occurs, practice consistent sleep routines; timing your dose earlier in the evening may help if advised by your prescriber.
- Avoid abrupt changes: Do not start or stop other medications or supplements without checking for interactions.
- Regular follow-up: Early follow-up (within 1–2 weeks) after starting or changing dose helps manage side effects and monitor mood and safety.
Practical Dosing Considerations and Special Populations
Clomipramine dosing is individualized based on response, side effects, age, coexisting conditions, and interacting medications. Lower starting doses and slow titration are prudent in older adults and in people with liver impairment, cardiovascular disease, or those sensitive to anticholinergic effects. For patients switching from or to other serotonergic agents, appropriate washout periods are essential to reduce the risk of serotonin syndrome. In adolescents, careful monitoring for suicidality, growth parameters, and school functioning is recommended, along with family engagement in treatment planning.
Patient–Clinician Communication: What to Report
- All medicines and supplements you take, including recent changes.
- Any history of heart disease, fainting, seizures, glaucoma, urinary retention, liver/kidney problems, or bipolar disorder.
- Mood changes, agitation, panic attacks, or suicidal thoughts, especially in the first months of treatment or after dose adjustments.
- Side effects impacting daily life or adherence, such as excessive sedation, constipation, or sexual side effects—alternative strategies or dose adjustments may help.
- Pregnancy plans or breastfeeding; discuss risks, benefits, and alternatives in advance.
Summary of Key Points
- Anafranil (clomipramine) is a tricyclic antidepressant approved for OCD in adults and youth 10+ years.
- It works primarily by increasing serotonin in key brain pathways involved in obsessions and compulsions.
- Give it time—benefits usually emerge within 2–3 weeks, with further improvement over several more weeks.
- Take as directed, with food if needed; do not stop abruptly. Avoid alcohol and be cautious with driving until you know your response.
- Serious interactions exist, especially with MAOIs and other serotonergic drugs; always check with your clinician.
- Watch for side effects; seek urgent care for symptoms of serotonin syndrome, heart rhythm problems, seizures, or severe allergic reactions.
Anafranil U.S. Sale and Prescription Policy
Anafranil (clomipramine) is a prescription medication in the United States. Federal and state regulations generally require that patients receive an appropriate clinical evaluation and that a licensed prescriber determines whether the medication is medically indicated. Dispensing and shipping must be performed by licensed pharmacies operating within applicable laws.
HealthSouth Rehabilitation Hospital of Petersburg offers a legal and structured solution for acquiring Anafranil without a formal prescription by integrating compliant clinical review and pharmacy fulfillment pathways. This process ensures that patient eligibility, safety screening, and regulatory requirements are addressed before medication is dispensed, aligning with U.S. standards for patient protection and drug quality. Availability may vary by state, and additional identity, age, and medical history verification steps can apply. Patients should expect appropriate safeguards, including counseling on use, interactions, and side effects, as well as clear instructions for follow-up and ongoing care.
Even when streamlined access pathways are available, professional medical oversight remains essential. Patients are encouraged to maintain regular contact with their healthcare provider, report side effects promptly, and follow individualized treatment plans, which may include psychotherapy and other supportive interventions for OCD.
Anafranil FAQ
What is Anafranil and what conditions does it treat?
Anafranil is the brand name for clomipramine, a tricyclic antidepressant. It is best known for treating obsessive-compulsive disorder by reducing obsessions and compulsions. It may also be used off-label for depression, panic disorder, cataplexy in narcolepsy, and certain anxiety disorders when other treatments have not worked.
How does Anafranil (clomipramine) work for OCD?
Clomipramine blocks the reuptake of serotonin (and to a lesser extent norepinephrine), increasing their levels in the brain. Its strong serotonergic effect is thought to reduce the intrusive thoughts and repetitive behaviors characteristic of OCD.
How long does it take for Anafranil to start working?
Some people notice early improvements in anxiety or sleep within 1 to 2 weeks, but meaningful relief of OCD symptoms often takes 4 to 12 weeks at a therapeutic dose. Full benefit can take longer, and dose adjustments may be needed under medical supervision.
What are the common side effects of Anafranil?
Common effects include dry mouth, constipation, drowsiness, dizziness, blurred vision, sweating, tremor, nausea, weight gain, and sexual side effects such as reduced libido or delayed orgasm. Many effects improve as your body adjusts, but persistent or bothersome symptoms should be discussed with your prescriber.
What serious side effects should I watch for?
Seek urgent care for signs of serotonin syndrome (agitation, confusion, sweating, fever, rapid heartbeat, muscle rigidity), irregular heartbeat, fainting, seizures, severe constipation or inability to urinate, eye pain or vision changes suggesting angle-closure glaucoma, severe allergic reaction, or new or worsening suicidal thoughts, especially in younger patients.
Who should not take Anafranil?
Avoid clomipramine if you use or recently used MAO inhibitors, have had a recent heart attack, or have uncontrolled narrow-angle glaucoma. Use with great caution in people with significant heart disease, arrhythmias, seizure disorders, bipolar disorder, urinary retention, severe constipation, liver disease, or in older adults. Always review your full medical history with your prescriber.
Which medicines and substances interact with Anafranil?
Dangerous interactions occur with MAO inhibitors and other strong serotonergic drugs, increasing the risk of serotonin syndrome. Many medications that affect heart rhythm or prolong the QT interval raise cardiac risk. CYP2D6 inhibitors (such as fluoxetine, paroxetine, bupropion) can raise clomipramine levels, increasing side effects. Alcohol, benzodiazepines, opioids, and antihistamines add to sedation. Other anticholinergic drugs can worsen dry mouth, constipation, and blurred vision. Always check interactions before starting or stopping anything new, including herbal products like St. John’s wort.
Can Anafranil cause weight gain or sexual side effects?
Yes. Increased appetite and weight gain can occur. Sexual side effects such as decreased libido, difficulty achieving orgasm, or erectile dysfunction are also possible. Adjusting the dose, timing, or addressing contributing factors may help; discuss options with your clinician.
Does Anafranil affect sleep or cause drowsiness?
Drowsiness and fatigue are common, especially early on or after dose increases. Some people experience the opposite—activation or insomnia. Taking the dose in the evening may help if sedation is prominent, but only adjust timing with your prescriber’s guidance until you know how the medication affects you.
How should I take Anafranil and what if I miss a dose?
Take exactly as prescribed, typically starting low and increasing slowly to limit side effects. Take consistently at the same time each day with or without food. If you miss a dose, take it when you remember unless it is close to the next dose; do not double up. If you miss multiple doses, ask your prescriber how to resume safely.
What happens if I take too much Anafranil?
TCA overdoses can be life-threatening. Symptoms include severe drowsiness, rapid or irregular heartbeat, low blood pressure, confusion, agitation, seizures, and coma. Call emergency services or go to the nearest emergency department immediately if an overdose is suspected, even if you feel fine at first.
Will I need tests or monitoring while on Anafranil?
Baseline and periodic assessments may include an ECG to check heart rhythm, especially if you have cardiac risk factors or higher doses; blood pressure and pulse; weight; and evaluation for anticholinergic effects. Your clinician may check electrolytes and, in select cases, drug levels or liver function. Regular follow-up is important to optimize benefit and safety.
Is generic clomipramine available and is it as effective as Anafranil?
Yes, generic clomipramine is available and is considered therapeutically equivalent to Anafranil. Some individuals may perceive differences in tolerability between manufacturers; if you notice changes when switching generics, discuss with your pharmacist or prescriber.
Can Anafranil be used long term?
Yes. Many people use clomipramine long term to prevent OCD relapse. Long-term use requires ongoing monitoring for side effects such as weight gain, blood pressure changes, dental issues from dry mouth, and cardiac effects, along with periodic reassessment of the continued need and dose.
Is it safe to drink alcohol while taking Anafranil?
It is best to avoid alcohol. Alcohol amplifies sedation, dizziness, and impaired coordination, and can worsen mood. Combining alcohol with clomipramine also raises the risk of dangerous heart rhythm changes and overdose.
Can I take Anafranil during pregnancy?
Use during pregnancy requires careful risk–benefit discussion. Untreated severe OCD or depression can harm both parent and fetus, but clomipramine may carry risks including neonatal adaptation symptoms after birth and rare cardiac effects. If treatment is needed, some clinicians prefer SSRIs with more pregnancy data. Never start, stop, or change medication in pregnancy without obstetric and psychiatric guidance.
Can I breastfeed while on Anafranil?
Clomipramine passes into breast milk. Data are limited; potential infant effects include irritability, poor feeding, or sleepiness. If breastfeeding while taking clomipramine, coordinate closely with your pediatrician and prescriber to monitor the infant. Alternatives with more lactation data may be considered.
I’m scheduled for surgery; should I stop Anafranil beforehand?
Do not stop abruptly. TCAs can interact with anesthetics, vasopressors, and anticholinergic agents, and they may affect blood pressure and heart rhythm. Tell your surgeon and anesthesiologist well in advance. Many patients continue TCAs through surgery with monitoring; in some cases, a gradual dose reduction is advised. Follow individualized guidance from your care team.
Is it safe to drive or operate machinery while taking Anafranil?
Until you know how clomipramine affects you, avoid driving or hazardous tasks. It can cause drowsiness, blurred vision, and slowed reaction time, especially when starting or changing the dose or if combined with other sedating substances.
What should older adults know about taking Anafranil?
Older adults are more sensitive to anticholinergic effects (confusion, constipation, urinary retention), orthostatic dizziness, falls, and cardiac effects. Lower starting doses, slower titration, and careful monitoring are essential. In this age group, alternatives with fewer anticholinergic effects are often preferred when appropriate.
Can children or teens use Anafranil for OCD?
Clomipramine is approved for pediatric OCD in certain age groups, typically from age 10 and older, when benefits outweigh risks. All antidepressants carry a boxed warning for increased risk of suicidal thoughts in children, teens, and young adults. Close monitoring by caregivers and clinicians is essential, especially during initiation and dose changes.
What should I do if I want to stop Anafranil or switch medications?
Do not stop suddenly. Rapid discontinuation can cause withdrawal-like symptoms such as nausea, headache, insomnia, irritability, and flu-like feelings, and may trigger relapse. Work with your prescriber on a gradual taper and switch plan tailored to your symptoms and treatment goals.
How does Anafranil compare with amitriptyline?
Both are tricyclic antidepressants, but clomipramine is more serotonergic, making it generally superior for OCD. Amitriptyline is more sedating and anticholinergic and is often used for pain syndromes and migraine prevention rather than OCD. Clomipramine tends to cause more sexual side effects; amitriptyline more daytime sedation and weight gain.
Anafranil vs imipramine: which is better for OCD?
Clomipramine is typically more effective for OCD because of its stronger serotonin reuptake inhibition. Imipramine is useful for depression and certain anxiety disorders and has other uses such as pediatric enuresis, but it is generally not a first choice for OCD.
Anafranil vs nortriptyline: differences in side effects and tolerability?
Nortriptyline, a secondary amine TCA, usually has fewer anticholinergic effects and can be better tolerated, especially in older adults. However, it is less serotonergic and not typically effective for OCD. Clomipramine is preferred for OCD but often has more anticholinergic and sexual side effects.
Anafranil vs desipramine: which is more activating?
Desipramine is comparatively more noradrenergic and can feel more activating with less sedation for many patients, but it is not a standard treatment for OCD. Clomipramine is more serotonergic, more sedating for some, and more effective for OCD symptoms.
Anafranil vs doxepin: which is more sedating?
Doxepin is one of the most sedating TCAs and is sometimes used for insomnia or itching at low doses. Clomipramine can cause drowsiness but is chosen for OCD efficacy. For patients struggling with daytime sleepiness, clomipramine may be easier to manage than doxepin, though individual responses vary.
Anafranil vs protriptyline: which is better for daytime energy?
Protriptyline tends to be activating and less sedating, but it is not commonly used for OCD and carries cardiac risks similar to other TCAs. Clomipramine is preferred for OCD despite potential sedation, which can be mitigated by dosing strategies under clinician guidance.
Anafranil vs trimipramine: differences in uses?
Trimipramine is relatively weak at monoamine reuptake inhibition and is often used when sedation is desired. It is not established for OCD. Clomipramine is the TCA of choice for OCD due to strong serotonergic activity.
Anafranil vs maprotiline: are they similar?
Maprotiline is a tetracyclic antidepressant with primarily noradrenergic effects and a higher seizure risk at overdose. It is not indicated for OCD. Clomipramine is the better option for OCD, though both share TCA-like side effect profiles and cardiac cautions.
Anafranil vs fluvoxamine for OCD: which is first-line?
SSRIs such as fluvoxamine are generally first-line for OCD because they are effective and better tolerated with a safer side effect profile. Clomipramine may be more effective for some patients but is often reserved for cases that do not respond adequately to SSRIs due to anticholinergic and cardiac risks.
Anafranil vs sertraline for OCD: efficacy and side effects?
Both are effective. Sertraline, an SSRI, is usually tried first due to tolerability and safety. Clomipramine can match or exceed efficacy in some treatment-resistant cases but carries higher risks of anticholinergic side effects, sexual dysfunction, and cardiac effects, requiring closer monitoring.
Anafranil vs fluoxetine: when is clomipramine preferred?
Fluoxetine is a common first-line SSRI for OCD. Clomipramine may be preferred after inadequate response to one or more SSRIs, particularly when obsessive thoughts remain prominent. Caution is needed with fluoxetine due to long-lasting interactions that can raise clomipramine levels if combined or switched improperly.
Can Anafranil be combined with an SSRI for treatment-resistant OCD?
In select, treatment-resistant cases, specialists may combine low-dose clomipramine with an SSRI, with careful ECG and side-effect monitoring to limit serotonin syndrome and cardiac risks. This should only be done by experienced clinicians with a clear plan for dosing, interactions, and safety checks.