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Anafranil Review – 7 Essential Things to Know

By Michelle Giordano

Reviewed by Rebecca Williams, MD, MA, MB, BChir

Last Updated:

Evidence Based | Overview | Nutrition Info | Adverse Effects | Cautions | Directions | Conclusion

Anafranil is a prescription medication used to treat obsessive-compulsive disorder (OCD). OCD is described as unwanted, recurring thoughts or fears (obsession component) and repetitive behaviors (compulsion component). The obsessions can range from fear of germs to wanting things in symmetrical or perfect order. The compulsions may include excessive cleaning and arranging things in a precise manner.

OCD affects over 2 million adults in the United States. [1] Living with this condition is extremely debilitating and interferes with an individual’s daily functions and quality of life; therefore, appropriate treatment is essential if you are diagnosed with this disease.

Anafranil is an FDA-approved medication for OCD in adults, adolescents, and children ages 10 and older. Any decisions on medication therapy should always be made in consultation with your doctor. Read on to see if Anafranil may be right for you.


1) Quick Overview

Anafranil belongs to a class of drugs known as tricyclic antidepressants. Although it belongs to this class, this particular drug is only FDA-approved for OCD. It may, however, be used off-label to treat depression, anxiety, panic disorder, and premature ejaculation.

It works by increasing the levels of two neurotransmitters in the brain, serotonin and norepinephrine. Increasing these chemicals helps improve symptoms associated with OCD.

Nutrition Info

2) Ingredients of Anafranil

The active ingredient found in Anafranil is clomipramine. Inactive ingredients that make up the capsule include:

  • D&C Red #33
  • D&C Yellow #10
  • FD&C Yellow #6
  • Gelatin
  • Magnesium stearate
  • Methylparaben
  • Propylparaben
  • Starch (corn)
  • Titanium Dioxide

3) Does Anafranil Work?

Selective serotonin reuptake inhibitors (SSRIs) are the primary drugs used to treat obsessive-compulsive disorders. Anafranil’s limiting factors are its cardiotoxic side effects and the risk for seizure at high doses, however, it remains a strong alternative if SSRIs are not successful.

Although clomipramine is not considered a first-line option in the treatment of OCD, it is still deemed very effective at treating the symptoms. In fact, data shows that clomipramine is more effective for the treatment of OCD compared to three SSRIs: sertraline, fluoxetine, and fluvoxamine. [2] In children and adolescents, researchers found that clomipramine improved OCD symptoms by 37%, according to the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). [2]

It is important to know that Clomipramine does not work quickly. It can take anywhere from 6 to 12 weeks of treatment before improvement in symptoms is seen.

Adverse Effects

4) Potential Anafranil Adverse Effects

Common side effects that may be experienced when using Anafranil include:

  • Dry mouth
  • Headache
  • Constipation
  • Inability to ejaculate or achieve erection
  • Nausea
  • Fatigue
  • Weight gain
  • Sedation
  • Urinary retention
  • Blurred vision

Life-threatening adverse events that may occur when taking Anafranil are:

  • Arrhythmia (abnormal heart rhythm)
  • Tachycardia (heart rate over 100 beats per minute)
  • Heart attack
  • Seizures
  • Liver failure
  • Hyperthermia (increased body temperature)

5) What You Need to Know Before Taking Anafranil

There is a black box warning associated with this medication that it can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. People in this age group should be closely monitored for any behavioral changes or suicidal tendencies.

This drug interacts with a group of drugs called MAOIs. Anafranil cannot be given earlier than 14 days after discontinuing these types of drugs. It also interacts with linezolid and IV methylene blue.

Anafranil should be avoided in anyone who has any degree of heart block, arrhythmias, heart failure, liver disease, glaucoma, or urinary retention.


6) Directions For Taking Anafranil

This drug is usually started at 25 mg per day. It can be increased every 4 to 7 days by 25 mg, and the maximum daily dose is 250 mg per day. This can be given in divided doses.


7) Conclusion

Anafranil received a 7.9 out of 10 rating on Drugs.com. Reviewers complained about side effects including inability to sleep and anxiety. Our recommendation for this medication is to follow the guidelines. First, you should always speak to your doctor about any potential medicine you are taking. As a result of the side effects associated with this drug, SSRIs should be tried first. Anafranil is a good option if these medicines prove to be ineffective.

4.5/5 - (2 votes)

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