When you hear clomipramine, a tricyclic antidepressant originally developed in the 1960s that strongly blocks serotonin reuptake. Also known as Anafranil, it’s one of the few medications approved by the FDA specifically for obsessive-compulsive disorder, not just depression. Unlike newer SSRIs, clomipramine doesn’t just nudge serotonin levels—it slams the brakes on its reabsorption, making it especially potent for stubborn OCD symptoms that don’t respond to other drugs.
Clomipramine works because of how it interacts with the brain’s chemical messengers. It’s a tricyclic antidepressant, a class of drugs that affect serotonin, norepinephrine, and sometimes dopamine. Also known as TCA, this group includes older drugs like amitriptyline and imipramine, but clomipramine stands out for its strong focus on serotonin. That’s why it’s often chosen when SSRIs like fluoxetine or sertraline don’t cut it. But it’s not a first-line choice for everyone—side effects like dry mouth, drowsiness, and weight gain can be tough to manage. And because it affects heart rhythm, doctors check your ECG before and during treatment.
It’s not just for OCD. Clomipramine shows up in treatment plans for panic disorder, chronic pain, and even some cases of depression with severe anxiety. But its real niche is treatment-resistant OCD. Studies show that when patients don’t improve on SSRIs, adding or switching to clomipramine can make a real difference—sometimes the only difference. It’s not magic, though. It takes weeks to kick in, and dosing is tricky. You start low, go slow, and monitor closely.
What makes clomipramine different from newer antidepressants isn’t just its chemistry—it’s its history. It’s been around longer than most SSRIs, and while it’s not as trendy, it’s still one of the most effective tools psychiatrists have for tough cases. If you’ve tried other meds and still struggle with intrusive thoughts or compulsions, clomipramine might be worth discussing. But it’s not a DIY decision. It needs supervision, patience, and regular check-ins.
Below, you’ll find real-world guides on how clomipramine fits into OCD treatment, how it compares to SSRIs, what dosing looks like in practice, and what side effects you’re actually likely to experience. No fluff. Just clear, practical info from people who’ve been there.
Compare Anafranil (clomipramine) with SSRIs, SNRIs, and emerging treatments for OCD and depression. Learn which alternatives work best, their side effects, and how to choose the right option for your needs.
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