Anafranil

• Anafranil is used to treat-
• Obsessive Compulsive Disorder (OCD)
• Major Depressive Disorder (MDD)

Depression.

Clomipramine Hydrochloride is an original tricyclic antidepressant, a member of the dibenzazepine group of compounds. It is presumed to influence obsessive and compulsive behaviors through it's effects on serotonergic neuronal transmission. The actual neurochemical mechanism is unknown but it has the capacity to inhibit the reuptake of serotonin (5-HT) which is thought to be important (like obsessions, compulsion) thus hampers social acquaintance.

Initial dose is 25 mg at bed time about a week, gradual increase of dose should not be exceeded more than 150 mg per day in adult and 75 mg per day in elderly patient. Dose can be given as divided form to reduce gastrointestinal disturbances. Not recommended for children.

Medicines for depression, particularly-

MAOIs e.g. tranylcypromine, phenelzine, moclobemide;

SSRIs e.g. fluoxetine (or have taken within the last 3 weeks), fluvoxamine, paroxetine, sertraline;

SNaRIs e.g. venlafaxine; tricyclic and tetracyclic antidepressants e.g. amitriptyline, dothiepin, maprotiline

Diuretics, also known as ‘water tablets’, e.g. bendroflumethiazide, furosemide

Anaesthetics, used for the temporary loss of bodily sensation

Blood pressure lowering agents (Beta blockers), Anti-coagulants etc.

Patients who have shown hypersensitivity to Clomipramine Hydrochloride or hypersensitivity to other tricyclic antidepressants belonging to the dibenzazepine group

Patient with acute recovery phase following a myocardial infarction

Should not be used in with MAO (Monoamine Oxidase) inhibitors within 14 days

The most frequent side effects are gastrointestinal disturbances, Headache, dizziness, nausea, constipation, dry mouth, increased sweating, shaking hands, tremor, difficulty in passing urine, problems with their eyes, feeling tired or sleepy, sexual disturbance, restlessness.

No adequate well-controlled studies of safety for pregnancy. Limited data suggest that clomipramine is likely to be excreted in human breast milk. Although it has known risk of damage to fetus.

• Talk to your doctor or pharmacist before taking Anafranil if you:
• have ever had suicidal thoughts
• suffer from epilepsy (fits)
• have had a head injury or have suffered brain damage
• are going to have electric shock therapy (ECT)
• have other problems with your heart

have been told you have a low level of potassium in your blood (hypokalaemia). The doctor will need to treat this before you start taking clomipramine

• have kidney disease
• suffer from schizophrenia or other mental health conditions
• have a blood disorder
• have an overactive thyroid gland
• have had severe constipation for a long time

have a tumour (cancer) of the adrenal gland (such as phaeochromocytoma or neuroblastoma)

• liver disease
• have low blood pressure
• wear contact lenses

It has been reported that adults can experience dryness of mouth, dilated pupils, coma, convulsions. Tachycardia/ cardiac arrhythmia, respiratory depression and alteration in blood pressure are noted.

Do not store above 30°C. Keep away from light and out of the reach of children.