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Clomipramine (Anafranil) is a tricyclic antidepressant used to treat obsessive-compulsive disorder (OCD) by reducing obsessive thoughts and compulsive behaviors.
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Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Clomipramine is a tricyclic antidepressant (TCA) that inhibits the reuptake of serotonin and, to a lesser extent, norepinephrine. It is specifically approved for the treatment of obsessive-compulsive disorder (OCD), helping to reduce the frequency and severity of obsessions and compulsions. Dosing typically starts at 25 mg daily and is gradually titrated up to a usual maintenance dose of 100-250 mg daily, given in divided doses with meals to reduce gastrointestinal side effects. Common side effects include dry mouth, constipation, drowsiness, dizziness, weight gain, and sexual dysfunction. Like other TCAs, clomipramine carries a boxed warning for increased risk of suicidal thinking and behavior in children, adolescents, and young adults. It can also prolong the QT interval and should be used cautiously with other serotonergic drugs due to the risk of serotonin syndrome; it should not be combined with MAO inhibitors.
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Clomipramine (Anafranil) is a tricyclic antidepressant specifically approved to treat obsessive-compulsive disorder (OCD), helping reduce the frequency and severity of obsessions and compulsions.
Boxed Warning: Antidepressants including clomipramine may increase the risk of suicidal thinking and behavior in children, adolescents, and young adults, especially during the first months of treatment. Patients should be monitored closely for worsening depression or unusual behavior changes.
Common side effects include dry mouth, constipation, drowsiness, dizziness, weight gain, and sexual dysfunction. Clomipramine can prolong the QT interval and should not be combined with MAO inhibitors due to the risk of serotonin syndrome.