Anafranil, common uses
The active ingredient in Anfranil, clomipramine hydrochloride, is an antiobsessional drug that belongs to the class of pharmacologic agents known as tricyclic antidepressants.
Clomipramine is presumed to influence obsessive and compulsive behaviors through its effects on serotonergic neuronal transmission. The actual neurochemical mechanism is unknown, but clomipramine´s capacity to inhibit the reuptake of serotanin is thought to be important.
Anafranil is indicated for the treatment of obsessions and compulsions in patients with Obsessive-Compulsive Disorder (OCD).
Anafranil comes as a tablet, containing 25 mg. clomiramine, to take by mouth.
Treatment with clomipramine should be initiated at a dosage of 25 mg daily and gradually increased, as tolerated, to approximately 100 mg during the first 2 weeks. During initial titration, clomipramine should be given in divided doses with meals to reduce gastrointestinal side effects. Thereafter, the dosage may be increased gradually over the next several weeks up to a maximum of 250 mg daily. After titration, the total daily dose may be given once daily at bedtime to minimize daytime sedation.
Although the efficacy of clomipramine after 10 weeks has not been documented in controlled trials, patients have been continued in therapy for up to 1 year without loss of benefit. However, dosage adjustments should be made to maintain the patient on the lowest effective dosage, and patients should be periodically reassessed to determine the need for treatment.
If you miss a dose, take it as soon as remembered if it is within an hour or so. If you do not remember until later, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.
Caution should be used in administering clomipramine to patients with a history of seizures or other predisposing factors, e.g., brain damage of varying etiology, alcoholism, and concomitant use with other drugs that lower the seizure threshold.
Patients should be aware of the risk of taking clomipramine while engaging in activities in which sudden loss of consciousness could result in serious injury to the patient or others, e.g., the operation of complex machinery, driving, swimming, climbing.
Since depression is a commonly associated feature of O.D. the risk of suicide must be considered.
As with closely related tricyclic antiepressents, concurrent administration of clomipramine with electroconvulsive therapy may increase the risks.
Prior to elective surgery with general anesthetics, therapy with clomipramine hydrochloride should be discontinued for as long as is clinically feasible, and the anesthetist should be advised.
A variety of withdrawal symptoms have been reported in association with abrupt discontinuation of clomipramine, including dizziness, nausea, vomiting, headache, malaise, sleep disturbance hyperthermia, and irritability. In addition, such patients may experience a worsening of psychiatric status.
Clomipramine has been found in human milk. Because of the potential for adverse reactions, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
The safety and effectiveness of clomipramine in pediatric patients below the age of 10 have not been established, nor has clomipramine been systematically studied in older patients.
The risks of using clomipramine in combination with other drugs have not been systematically evaluated. Given the primary CNS effects of clomipramine, caution is advised in using it conncomitantly with other CNS-active drugs. Clomipramine should not be used with MAO inhibitors.
Possible side effects
The most commonly observed adverse events associated with the use of clomipramine are;
dry mouth, constipation, nausea, dyspepsia, and anorexia; somnolence, tremor dizziness, nervousness, and myoclonus;
changed libido, ejaculatory failure, and miciturition disorder; fatigue, sweating, weight gain and visual changes.
If you notice other effects not listed above, contact your doctor.
If overdose of clomipramine is suspected, contact your local poison control center or emergency room immediately. Deaths may occur from overdosage with this class of drugs. Critical manifestations of overdose include cardiac dysrhythmias, severe hypotension, convulsions, and CNS depression including coma.
Keep Anafranil in a tightly closed container and out of reach of children. Store Anafranil at room temperature and away from excess heat and moisture (not in the bathroom).
The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, or other healthcare professional. It should not be construed to indicate that use of clomipramine is safe, appropriate, or effective for you.
Consult your health care professional before you