Anafranil (Clomipramine)

depressants Photo courtesy of Ark Behavioral HealthOpens in new window

Anafranil is an antidepressant medication used primarily to treat obsessive-compulsive disorder. It is also used in treating depression and other medical and psychiatric conditions. Its generic name is clomipramine.


Anafranil is a tricyclic antidepressant, a class of drugs with a three-ring chemical structure. Its primary use is the treatment of the obsessions and compulsions of obsessive-compulsive disorder when these symptoms greatly disrupt an individual’s daily activities.

Anafranil is also used in panic disorder, pain management, sleep problems like narcolepsy (uncontrollable attacks during deep sleep), and anorexia nervosa. It is also helpful in reducing other compulsive behaviors such as hair pulling, nail biting, Tourette’s syndrome (tics and vocalizations), and childhood autism.

The first tricyclic, imipramine (trade name: Tofranil), was to decrease depressive symptoms, presumably by increasing serotonin in the brain. Because Anafranil significantly increases serotonin levels in the brain, it is most effective in reducing compulsions.

Precautions and Side Effects

SeizuresOpens in new window are the most important risk associated with Anafranil. The risk of seizure increases with larger doses and after abrupt discontinuation of it. Care must be taken in the use of Anafranil in those with a history of epilepsy or condition associated with seizures, such as brain damage or alcoholism.

Anafranil may worsen glaucoma and adversely affect heart rhythm in those with cardiac disease. Because some studies associate antidepressants with increased suicidal thoughts in children and adults up to age 24, the use of Anafranil should be carefully monitored. The safety of Anafranil use during pregnancy has not been fully determined. However, it is known that tricyclic antidepressants pass into breast milk and may cause sedation and depress breathing in nursing infants.

Anafranil may cause several side effects. Like other tricyclic antidepressants its side effect may initially be more pronounced but decrease with continued treatment. Common side effects are headache, confusion, nervousness, restlessness, sleep difficulties, numbness, tingling sensations, tremors, nausea, loss of appetite, constipation, blurred vision, difficulty urinating, menstrual pain, impotence, decreased sex drive, fatigue, and weight gain.

See also:
  1. Marina, Giuseppe, Umberto Albert, and Filippo Bogetto. “Obsessive-Compulsive Disorder Resistant to Pharmacological Treatent.” In Obsessive-Compulsive Disorder Research, edited by B. E. Ling, pp. 171 – 199. Hauppauge, NY: Nova Science Publishers, 2005.
  2. Preston, John D., John H. O’Neal, and Mary C. Talaga. Handbook of Clinical Psychopharmacology for Therapists, 7th ed. Oakland, CA: New Harbinger, 2013.
  3. Simpson, H. Blair, and Michael R. Liebowitz, “Combining Pharmacotherapy and Cognitive-Behavioral Therapy in the Treatment of OCD. “In Concepts and Controversies in Obsessive-Compulsive Disorder, edited by Jonathan Abramowitz and Arthur C. Houts, pp. 359 – 376. New York, NY: Springer Science, 2005.
  4. Stahl, Stephen M. Antidepressants. New York: Cambridge University Press, 2009.