Brand Name: Anafranil (not available in generic)

Manufacturer: Novartis Pharmaceuticals

Description: Clomipramine is an antiobsessional drug belonging to the class of drugs known as tricyclic antidepressants. It has a dual mode of action and is believed to block the reuptake of both serotonin and norepinephrine (neurotransmitters in the brain). Specifically Clomipramine is highly selective in blocking the reuptake of serotonin, a deficiency of which is believed to be significant in causing obsessions and compulsions. 

Indications and Use: Clomipramine is indicated only for the treatment of obsessive-compulsive disorder. It was the first drug marketed in this country for that use.

Contraindications, Warnings, and Precautions: Clomipramine is contraindicated in patients on MAOIs (monoamine oxidase inhibitors), patients with a known hypersensitivity, and patients recently recovering from a heart attack. It does lower the seizure threshold and should not be given to patients with a history of seizure disorder. It should be given with caution to patients on haloperidol or phenobarbital. Clomipramine can precipitate mania in patients with Bipolar Disorder. 

Adverse Reactions: Possible common side effects may include dry mouth, drowsiness, tremor, dizziness, constipation, and ejaculatory failure. There is a relatively high incidence of male sexual dysfunction (ejaculatory failure ) (42%).  It may also cause weight gain and decreased libido. Dosing should begin low and progress slowly to minimize potential side effects.

Dosing Range: The starting dose is 25 mg per day given at bedtime. Dose increases should be slow, on an as tolerated basis, up to about 100 mg per day during the first two weeks. The maximum daily dosage is 250 mg per day in adults. In children, the dose usually should not exceed 200 mg or 3 mg per kilogram per day. 

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© 2000 Red Oak Psychiatry Associates, P.A.    Updated 11/26/2007