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Anafranil
Anafranil (clomipramine) is a tricyclic antidepressant (TCA) used primarily to treat obsessive-compulsive disorder (OCD). It works by affecting the balance of neurotransmitters, particularly serotonin, in the brain. By increasing serotonin levels, Anafranil helps reduce obsessive thoughts and compulsive behaviors. It may also be prescribed off-label for other conditions such as depression and panic disorder.
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Frequently Asked Questions
How long does it take for Anafranil to work?
It may take 2 to 3 weeks before you notice improvements in OCD symptoms. Full benefits may take longer, possibly up to 8 to 12 weeks.
Can Anafranil cause weight gain?
Yes, weight gain is a potential side effect of Anafranil, as it can increase appetite in some individuals.
Is Anafranil safe for children?
Anafranil is FDA-approved for treating OCD in children aged 10 years and older. However, close monitoring is needed due to the increased risk of suicidal thoughts in younger patients.
Can I drink alcohol while taking Anafranil?
No, it is best to avoid alcohol while taking Anafranil, as it can increase side effects like drowsiness, dizziness, and impaired motor skills.
What should I do if I miss a dose of Anafranil?
If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and take the next one as planned. Do not double the dose to make up for the missed one.
Comprehensive Drug Guide
How Does Anafranil Work?
Anafranil works by inhibiting the reuptake of serotonin and norepinephrine, which increases the levels of these neurotransmitters in the brain. This action helps balance mood and reduce the symptoms of obsessive-compulsive disorder, such as persistent, unwanted thoughts (obsessions) and the urge to perform repetitive actions (compulsions).
Common Dosages
- Capsules: 25 mg, 50 mg, and 75 mg
- The dosage will vary depending on the severity of the condition and the patient's response to treatment.
Typical Dosing
- For OCD, the usual starting dose is 25 mg daily, which can be gradually increased up to a maximum of 250 mg per day, based on the patient’s tolerance and therapeutic response.
- The dose is typically divided into smaller doses throughout the day or taken once daily at bedtime to minimize side effects.
Typical Dosing
FDA Approved Indications
- Obsessive-compulsive disorder (OCD)
- Depression
- Panic disorder
- Chronic pain
- Premature ejaculation
Who Shouldn't Take Anafranil?
- A known hypersensitivity to clomipramine or other TCAs
- A recent history of a heart attack
- Concurrent use of monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping an MAOI
- Narrow-angle glaucoma
Advice From The Pharmacist
- Anafranil should be taken as prescribed, typically with food to reduce stomach upset.
- It is important to continue taking the medication even if symptoms improve, as OCD may require long-term treatment.
- Do not stop taking Anafranil suddenly, as doing so can lead to withdrawal symptoms such as nausea, headache, and dizziness.
- Alcohol should be avoided, as it can increase the risk of side effects such as drowsiness and dizziness.
- Regular monitoring of heart function may be necessary, as Anafranil can affect heart rhythm, particularly in higher doses.
Side Effects of Anafranil
Common Side Effects
- Drowsiness
- Dry mouth
- Constipation
- Weight gain
- Blurred vision
- Dizziness
Uncommon/Severe Side Effects
- Irregular heartbeat
- Seizures
- Suicidal thoughts or behaviors (particularly in young adults)
Risks and Warnings of Anafranil
- Suicidal thoughts: Like other antidepressants, Anafranil may increase the risk of suicidal thoughts or behaviors in children, adolescents, and young adults during the initial period of treatment. Close monitoring is required.
- Cardiovascular effects: Anafranil can cause changes in heart rhythm, particularly in patients with pre-existing heart conditions or at higher doses. Heart function should be monitored during treatment.
- Seizures: Anafranil lowers the seizure threshold and should be used with caution in patients with a history of seizures.
Interactions with Anafranil
Common Drug Interactions
- MAO inhibitors (MAOIs): Taking Anafranil with MAOIs can cause a dangerous drug interaction leading to serotonin syndrome. A waiting period of at least 14 days is required between discontinuing an MAOI and starting Anafranil.
- SSRIs and SNRIs: Co-administration of these antidepressants can increase the risk of serotonin syndrome.
- Anticholinergic medications: These drugs can exacerbate side effects like dry mouth, constipation, and blurred vision.
Alternatives to Anafranil
- SSRIs (Selective serotonin reuptake inhibitors): Such as fluoxetine, sertraline, or fluvoxamine, which are commonly used to treat OCD and depression.
- Other TCAs: Such as amitriptyline or nortriptyline, used for depression and anxiety.
- Cognitive Behavioral Therapy (CBT): A non-medication alternative for OCD, often used in conjunction with medication for optimal results.
