ADHD Medication and Treatment Reviews


Generic Name: clomipramine hydrochlorine

What is Anafranil?

Anafranil (Generic Name: clomipramine hydrochlorine) is an antidepressant taken orally that is primarily used to treat obsessive-compulsive disorder (OCD) in adolescents and adults. It relieves recurring unwanted thoughts that are beyond the person’s control, and repetitive behaviors or mental acts that a person with OCD may feel compelled to perform in order to ‘undo’ the obsessive thought. It is not considered a controlled substance by the FDA.

Anafranil has only been found effective for pediatric patients with OCD, not depression. Its safety has not been studied in children under age 10. The safety of long-term use in adolescents ages 10-17 has not been established.

Anafranil is also used to treat sleep paralysis, depression, irritable bowel syndrome, and panic disorder.

How to Use Anafranil

Before starting or refilling an Anafranil prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage for Anafranil

As with all medications, follow your Anafranil prescription instructions exactly. When you first start taking Anafranil, your physician may prescribe several small doses throughout the day to avoid side effects. Then, Anafranil is often taken once daily at bedtime to limit daytime sedation.

Do not drink alcohol, or take barbituates or other central nervous system depressants while taking this drug.

Capsules are available in 25mg, 50mg, and 75mg dosages.

The optimal dosage varies patient by patient. Anafranil is processed very slowly by the body, so after deciding on an initial dose, your doctor may wait two to three weeks before making additional adjustments.

Your doctor may adjust your daily dosage by increments until you experience the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication. Stopping Anafranil suddenly can create withdrawal symptoms including dizziness, nausea, vomiting, headache, malaise, sleep disturbance, and irritability.

Side Effects Associated with Anafranil

The most common side effects of Anafranil are similar to those associated with other tricyclic antidepressants, like Imipramine, and are as follows: blurred vision, constipation, lightheadedness when standing, dizziness, drowsiness, weight gain, dry mouth, constipation, upset stomach, sexual dysfunction, and excessive sedation.

Other serious side effects include an increased risk of suicide or suicidal thoughts and seizures.

Taking Anafranil may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects. Patients should be monitored and observed closely for worsening depression, changes in behavior, or suicidality.

Disclose to your physician all mental health issues, including any family history of suicide, bipolar illness, or depression. Anafranil may create new or exacerbate existing psychosis, delusions, and paranoia. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms, including hallucinations or confusion. This drug may trigger a psychotic episode for patients with previously undiagnosed schizophrenia. Treatment with Anafranil can increase the risk of simultaneous treatment for depression with electroconvulsive therapy.

Talk with your doctor about any liver function problems or blood conditions. Anafranil rarely can have dangerous side effects for patients with liver disease or conditions like anemia and leukopenia.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions Associated with Anafranil

You should use caution when taking any tricyclic antidepressants, including Anafranil, if you have any of the following conditions: thyroid problems, narrow-angle glaucoma, urinary retention, tumors of the adrenal medulla, or impaired renal function.

If you’re thinking of becoming pregnant, discuss the use of Anafranil with your doctor. Animal studies indicate a potential risk of fetal harm. Anafranil is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The effects of Anafranil on the elderly have not been studied.

Interactions Associated with Anafranil

Before taking Anafranil, discuss all other active prescription medications with your doctor.

You should not take Anafranil if you are taking monoamine oxidase inhibitors (MAOIs), or central nervous system depressants such as Alprazolam and Diazepam. This can cause a serious or fatal drug interaction.

Use caution when taking Anafranil with anticholinergics like atropine, certain medications used to treat high blood pressure, cisapride, digoxin, thyroid mediation, blood thinners like warfarin, and anti-platelet drugs like aspirin or ibuprofen. Other tricyclic antidepressants similar to Anafranil have had interactions with these drugs.

Drugs containing pain relievers can increase risk for bleeding when taken with Anafranil. Drugs that cause drowsiness can impact heart rate and blood pressure when taken with Anafranil. Drugs that increase serotonin production can increase risk for serotonin toxicity when taken with Anafranil.

Smoking cigarettes can decrease the level of medication in the blood. Tell your doctor if you are a smoker, or recently quit smoking.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness. Let all doctors and physicians know you are taking Anafranil before having any surgery or laboratory tests.

The above is not a complete list of all possible drug interactions.


Anafranil: Next Steps