Verified
The first week brought a dry mouth and I felt sleepy by late afternoon. By the sixth week, I was spending much less time repeating checking routines before leaving home.
Aug 24, 2026
Anafranil
Quality products
24/7 Support
Fast delivery
Delivery
from 4 days
Active ingredient
Clomipramine
Anafranil is a clomipramine-based tricyclic antidepressant for people with obsessive-compulsive disorder and selected mood or anxiety-related conditions. By strengthening serotonin signalling in the brain, it can gradually reduce intrusive thoughts, compulsive urges, and depressive symptoms.
Description
Anafranil is a tricyclic antidepressant used in the treatment of obsessive-compulsive disorder and selected mood or anxiety-related conditions. Anafranil contains clomipramine hydrochloride, an antidepressant from the tricyclic antidepressant, or TCA, class.
Composition
Anafranil contains clomipramine hydrochloride, an antidepressant from the tricyclic antidepressant, or TCA, class. TCAs affect several brain chemicals and body systems, which explains both their clinical benefits and their wider side-effect profile.
Dosage and usage
Anafranil is supplied as tablets for oral use. The prescribed dose is usually introduced gradually, because starting too quickly can intensify nausea, dizziness, sedation, or palpitations.
- Swallow the tablet with water at the scheduled time.
- Take doses consistently each day.
- If drowsiness occurs, the prescriber may choose an evening schedule.
- Do not stop suddenly after regular use.
- Do not double a later dose to make up for a missed one.
A missed dose should be taken when remembered unless the next scheduled dose is close. In that situation, skip the forgotten dose and return to the normal schedule. Taking two doses together can increase the risk of severe drowsiness, confusion, heart-rhythm changes, and seizures.
Keep a simple record of the first few weeks: sleep, bowel habit, anxiety level, pulse awareness, and any compulsive behaviours. These details help a prescriber distinguish temporary adjustment effects from a dose that needs changing.
How it works
Clomipramine blocks the reuptake of serotonin and, to a lesser extent, norepinephrine. Reuptake is the process by which nerve cells reclaim a chemical messenger after releasing it. By slowing this process, Anafranil leaves more serotonin available between nerve cells.
This is relevant in OCD because serotonin pathways help regulate intrusive thoughts, threat perception, repetitive rituals, and emotional control. The medicine changes signalling patterns over repeated doses rather than creating an immediate change in mood or anxiety.
Anafranil also has anticholinergic activity. This means it can affect acetylcholine receptors, leading to dry mouth, constipation, blurred vision, difficulty passing urine, and a faster heartbeat in some people.
Indications
Anafranil is most strongly associated with obsessive-compulsive disorder. Doctors may also use clomipramine in carefully selected situations outside its primary indication, when clinical assessment supports it.
- Obsessive-compulsive disorder: may reduce the intensity and frequency of obsessions and compulsions.
- Depression: may be considered when a TCA is clinically suitable.
- Panic disorder and phobias: may help some patients with persistent panic symptoms or disabling anxiety.
- Narcolepsy with cataplexy: specialist use may target sudden loss of muscle tone associated with emotion.
- Enuresis: some TCAs have been used in selected children, though this needs close medical direction because of cardiac and overdose risks.
- Trichotillomania or premature ejaculation: these are off-label uses and require an individual treatment plan.
For OCD, NICE guidance places psychological therapy and serotonin-focused medicines at the centre of care, with clomipramine remaining an option when clinical circumstances justify it. [1]
For OCD, improvement is often first noticed as a little more space between an intrusive thought and the urge to perform a ritual. Full symptom relief may take longer.
Comparison
Anafranil has a broader receptor profile than selective serotonin reuptake inhibitors, or SSRIs. That can be useful in treatment-resistant OCD, yet it also produces more anticholinergic and cardiovascular effects for many patients.
| Feature | Anafranil | SSRIs such as fluoxetine |
|---|---|---|
| Drug class | Tricyclic antidepressant | Selective serotonin reuptake inhibitor |
| Main action | Raises serotonin and norepinephrine; affects other receptors | Mainly raises serotonin |
| Typical limitation | Dry mouth, constipation, sedation, cardiac concerns | Nausea, sexual effects, sleep changes |
Doctors may select an SSRI first because it is often easier to tolerate and safer in overdose. Anafranil may be considered when OCD symptoms remain severe, when prior serotonin-focused treatment has not given enough benefit, or when a clinician considers its pharmacology a better fit.
A Cochrane review found clomipramine can reduce OCD symptoms, while also confirming that adverse effects may limit its use compared with newer antidepressants. [3]
Contraindications
- epilepsy or a history of seizures;
- bipolar disorder or past mania;
- heart disease, fainting episodes, or known QT-interval prolongation;
- glaucoma;
- urinary retention or significant prostate symptoms;
- severe constipation or bowel obstruction;
- liver disease;
- older age, due to falls, confusion, and anticholinergic effects;
- pregnancy or breastfeeding, where treatment requires individual risk assessment.
Avoid Anafranil during MAOI treatment and for the required washout interval before switching between these medicines. Combining them can trigger severe serotonin toxicity, dangerous blood-pressure changes, fever, agitation, or seizures.
When this is not for you
Anafranil is not for you if you have a known allergy to clomipramine or another tricyclic antidepressant, have recently had a heart attack, or are taking a monoamine oxidase inhibitor, known as an MAOI.
Clomipramine can impair alertness. Driving, operating machinery, and tasks requiring rapid reactions may be unsafe until the individual effect is clear.
Side effects
Side effects are most common during dose initiation or after an increase. They do not affect everyone, and some become less troublesome after the first weeks.
Common effects
Commonly reported effects include:
- dry mouth;
- constipation;
- nausea or stomach discomfort;
- sleepiness or fatigue;
- dizziness, especially on standing;
- sweating;
- tremor;
- blurred vision;
- increased appetite or weight change;
- reduced libido, delayed orgasm, or erectile difficulty.
Orthostatic dizziness means blood pressure falls when standing. Rise slowly from bed or from a chair, especially during the first days of treatment.
Urgent symptoms
Seek urgent medical assessment for fainting, a fast or irregular heartbeat, a seizure, severe confusion, high fever with muscle rigidity, eye pain with sudden visual halos, or thoughts of self-harm. Serotonin syndrome can occur when clomipramine is combined with other serotonin-raising medicines. Symptoms can include agitation, sweating, diarrhoea, tremor, fever, and muscle stiffness.
The FDA highlights seizure risk, cardiac effects, and the need to monitor worsening mood or suicidal thinking, especially during treatment changes. [2]
Dry mouth is more than an annoyance. Frequent sips of water, sugar-free gum, and careful dental hygiene can reduce discomfort and lower the risk of dental decay during long-term treatment.
Common mistakes
- Stopping as soon as symptoms ease: OCD and depression commonly relapse when treatment is withdrawn abruptly.
- Taking an extra tablet after a missed dose: this can raise the risk of sedation, confusion, seizures, and cardiac symptoms.
- Mixing it with alcohol to sleep: alcohol can worsen sedation, dizziness, and impaired judgement.
- Ignoring constipation for weeks: severe constipation can become medically significant with anticholinergic medicines.
- Starting another antidepressant without a washout plan: serotonin toxicity and interaction risks can be serious.
- Expecting immediate OCD relief: intrusive thoughts may begin to ease gradually, while compulsions often take longer to shift.
Sleep changes can occur before mood improves.
What doctors say
In clinical practice, doctors often view Anafranil as a valuable option for OCD with persistent, function-limiting symptoms. It is not usually chosen casually, because its benefits need to be balanced against dry mouth, constipation, sedation, sexual side effects, seizure risk, and cardiac considerations.
MOHAP, the UAE Ministry of Health and Prevention, supports the wider goal of structured mental-health care. For Anafranil, the practical point is consistent follow-up rather than changing the regimen independently.
Frequently asked questions
How long does Anafranil take to work?
Anafranil may cause sleepiness or dry mouth within days, but its therapeutic effect takes longer. Some people notice early improvement in anxiety or sleep after a few weeks, while OCD symptoms may require several weeks of consistent treatment before meaningful change appears. The FDA prescribing information from 2013 describes clinical response as a gradual process rather than an immediate effect.
Is Anafranil addictive?
Anafranil is not considered addictive in the way that benzodiazepines, opioids, or stimulants can be. It does not usually produce drug-seeking behaviour or a craving-driven pattern of use. Physical adaptation can still occur, which is why sudden discontinuation may cause withdrawal symptoms and treatment is usually tapered. NICE guidance from 2005 supports planned medication review rather than abrupt stopping.
Can Anafranil affect sleep?
Yes. Anafranil can make some people sleepy, while others experience vivid dreams, restless sleep, or initial insomnia. The prescribed timing may be adjusted according to the individual pattern of drowsiness or sleep disruption. The FDA label from 2013 lists somnolence and sleep-related effects among reported adverse reactions.
Can Anafranil cause weight gain?
Weight gain can occur during longer treatment, though it is not inevitable. Increased appetite, reduced activity from sedation, and changes in eating patterns can all contribute. Tracking weight trends and appetite gives the prescriber useful information before the problem becomes difficult to manage. A Cochrane review published in 2013 identified tolerability as a key factor when comparing clomipramine with other OCD treatments.
Can Anafranil be used with alcohol?
Alcohol can increase drowsiness, dizziness, slowed reactions, and impaired coordination caused by Anafranil. It may also worsen depression, anxiety, sleep quality, and impulsive behaviour. Avoiding alcohol is the safer approach while taking clomipramine, especially during initiation or dose adjustments. WHO mental-health materials published in 2023 recognise alcohol use as a factor that can complicate mental-health treatment.
Does Anafranil help intrusive thoughts?
Anafranil can reduce the intensity and frequency of intrusive thoughts in OCD by increasing serotonin availability. The change is usually gradual, and the medicine is often more useful when paired with exposure and response prevention therapy. OCD treatment plans are tailored because compulsions, avoidance, depression, and panic symptoms do not improve at the same pace. NICE’s OCD guideline, issued in 2005 and maintained as a reference standard, supports combined and stepped-care approaches.
Do you offer anonymous delivery?
Your order will be securely packed and shipped within 24 hours. This is exactly what your package will look like (images of an actual item sent). It has the size and look of a regular private letter (9.4x4.3x0.3 in. or 24x11x0.7 cm) and its contents cannot be seen.
Comparison
Abilify
10mg
15mg
20mg
5mg
Anafranil Current
25mg
50mg
75mg
10mg
Paroxetine
20mg
Prozac
10mg
20mg
40mg
60mg
Zoloft
100mg
50mg
25mg
Anafranil: Reviews and Experiences
3.8
Based on 4 reviews
Verified
I had nausea for several days after the dose was adjusted, then it settled. I slept more deeply, although getting up quickly in the morning made me light-headed.
Aug 31, 2026
Verified
My intrusive thoughts were quieter, but constipation became frustrating. Changing my meals and following the treatment plan helped, yet the dry mouth never fully disappeared.
Sep 11, 2026
Verified
It did not feel dramatic. I gradually had more concentration at work and less mental looping at night. I still needed follow-up because of tiredness.
Sep 22, 2026
Sources
- National Institute for Health and Care Excellence (2005). Obsessive-compulsive disorder and body dysmorphic disorder: treatment.
- U.S. Food and Drug Administration (2013). Anafranil (clomipramine hydrochloride) capsules: safety and adverse reactions information.
- Cochrane (2013). Clomipramine versus other antidepressive agents for obsessive-compulsive disorder.
