According to the Anxiety and Depression Association of America (ADAA), more than 2.2 million American adults (approximately 1% of the US population) are affected by obsessive-compulsive disorder (OCD). The disorder is characterized by persistent and mostly unwanted obsessions and compulsions. If left untreated, it can greatly affect someone’s normal life.
Anafranil, the brand name for Clomipramine, is one of the highly recommended remedies for OCD, and other similar conditions, such as severe depressive disorders, panic disorder, and severe pain. It is classified under tricyclic antidepressants (TCA). It is also known to lower suicide risks in senior citizens (aged over 65 years). Discovered in 1964 by Ciba-Geigy, a Swiss pharmaceutical, Anafranil (Clomipramine) is listed among the World Health Organization’s (WHO) list of essential medicines. It is approved by the FDA for the treatment of OCD in adults and children aged ten years and above.
Anafranil is a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by blocking the reuptake of the neurotransmitters into the neurons by barring their interaction with their respective transporters. This increases their concentration within the synaptic cleft leading to enhanced transmission of serotonin and noradrenaline. The drug is also known to contain anticholinergic, antiadrenergic, antiserotonergic, antihistamine and antidopaminergic properties.
Usage and Effects
Just like any other medicines, it is advisable and necessary that you read and understand the pharmacist’s instructions, as well as the label. The drug should be taken orally, with or without food as per the doctor’s prescription. In the initial stages of treatment, a low dose may be prescribed and increased with time as the body responds. This is cautionary to avoid possible side effects like stomach upsets. Upon reaching the most ideal dose, you can then take the daily dose (not exceeding 250mg and 200mg for adults and children, respectively). It should ideally be administered at bedtime to avoid drowsiness during the day, or according to the doctor’s prescription.
A dosage may vary depending on the medical condition, and how the body responds to the treatment. It is important to stick to the prescription; an increase in dose will not expedite healing and may lead to serious side effects like seizures. It is recommended that the medicine be taken at the same time every day to effective healing for enhanced efficiency.
Don’t stop treatment even if the condition improves. Abrupt discontinuation is especially discouraged as it might worsen the condition. Possible side effects of that may include dizziness, vomiting, irritability and nausea. To avoid that, gradual reduction of dosage is encouraged, but must be guided by the doctor.
Precautions and Doctor’s Consultation
There are some severe side effects that must be reported the doctor immediately they are experienced. They include change in moods, enlarged or painful breasts, painful or irregular menses, increased production of breast milk, stiffness of muscles, low libido, tremors, troubled urination, uncontrolled movements of the tongue, lips and face, severe stomachache, and yellowing skin or eyes.
The use of Clomipramine may cause serotonin syndrome, especially if you are using other serotonin enhancing drugs. It is therefore important that you disclose to the doctor all the medication you are taking. Severe allergic reactions, though possible, are rare. You should however report symptoms of rashes, severe dizziness, fever, troubled breathing, among others. Note that this list is not conclusive. Always consult your physician in case you detect any changes in your body when taking this medicine.
You must inform your doctor if you are allergic to Clomipramine or other TCAs like Nortriptyline. Disclose your medical history, such as blood problems, eating disorders, glaucoma (personal or family), heart problems, intestinal problems, liver-related complications, mental/mood problems, kidney problems, reaction to medication, drug and alcohol abuse, tremors, among others. This drug may affect the rhythm of your heart, a condition known as QT prolongation, whose risk may increase based on other conditions or medications.
Children involved in active sports should be instructed to take Anafranil with caution as it may increase risks of heart complications. Pregnant and breastfeeding mothers shouldn’t take this medicine unless it is deemed really necessary. This should however be guided by the prescribing physician or pharmacist.
Anafranil Clomipramine may interact with the following drugs: Anticholinergics, some high blood pressure drugs like Reserpine, drugs that may lead to bleeding or bruising, and anti-platelets like Aspirin. MAO inhibitors shouldn’t be taken with this medicament because the resulting interaction can be severe and even fatal. Only take these inhibitors two weeks before or after taking Anafranil. Always consult your doctor prior to medication. Avoid drugs that lead to increased serotonin, especially other SSRIs to avoid serotonin toxicity.
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Other drugs to be avoided include those that may cause QT prolongation, HIV protease inhibitors, phenothiazines, and some anti-seizure medications. Always inform your doctor if you are taking any substance, or drugs that may result in drowsiness. The surest way to avoid serious interaction is to clearly read and understand the label instructions, and adhere to a doctor’s prescription. Don’t hesitate to notify the physician whenever you experience any side effects after using Clomipramine. While some symptoms may appear minor, they may turn out to be severe.
Overdoes, Under-dose and Missed Doses
Serious overdose of Anafranil Clomipramine may cause one to pass out, or grasp for breath. Such cases should be reported immediately as they require urgent medical attention. Missed doses should be taken as soon as you remember but can be skipped before resuming normal dosage if you remember late. Compensation for missed dosage is discouraged.
There are some common side effects that may occur as a result of using this medication. They include drowsiness, dizziness, stomach upset, constipation, blurred vision, exhaustion, and sweating. It is also possible that symptoms of anxiety may worsen during the initial stages of treatment. Don’t hesitate to contact your doctor in case of persistent or worsened side effects. Some adverse effects can be controlled. Consume food rich in fiber to avoid constipation and drink a lot of water.