Anafranil

What is it?

A TCAD containing clomipramine hydrochloride, available as capsules, syrup and in ampoules for injection. There are three strengths: yellow/caramel (10mg), orange/caramel (25mg), grey/caramel (50mg) all marked Geigy. Also, ANAFRANIL SR sustained release pink capsules containing 75mg, marked Geigy and GD.

Medical Uses

Depression, phobic and obsessional states.

Dosage

Adults, capsules for depression, 10mg each day gradually increasing to 30-150mg (maximum 250mg) in divided doses or as a single dose at bedtime. Obsession and phobia, 25mg at first increasing to 100-150mg daily. Elderly, 10mg each day at first increasing to a maximum of 75mg.

Special Care

Elderly (reduce dose), psychoses or suicidal tendencies. Persons with heart and circulatory disease, liver disorders, overactive thyroid gland (hyperthyroidism), epilepsy, diabetes, constipation, urine retention, glaucoma, tumour of the adrenal glands. Blood tests and monitoring of liver and heart function are advisable during therapy.

Avoid Use

Children, pregnancy, breastfeeding, patients with heart block, heart rhythm disorders, weak heart, mania, serious liver disease.

Possible Drug and Food Interactions

Maois or within 14 days of their use, other antidepressant drugs, neuroleptics, anticholinergic drugs, alcohol, adrenaline, noradrenaline (or anaesthetics containing these), quinidine, carbamazepine, phenytoin, antihypertensive drugs, thyroid drugs, barbiturates, cimetidine, sympathomimetics, oestrogens.

Known Side Effects

Gastro-intestinal disturbances such as constipation, blurred vision, dry mouth, anxiety, ringing in ears (tinnitus), drowsiness, insomnia, urine retention, sweating, tremor, raised heartbeat rate, arrhythmias, conduction defects, palpitations, weight gain or loss. Also, low blood pressure on rising upright, blood changes, allergic skin reactions, abnormal breast enlargement and milk production (gynaecomastia and galactorrhoea), alterations in blood sugar, jaundice, loss of libido and impotence may occur. Occasionally, symptoms of schizophrenia and mania may be activated, particularly in elderly persons.