When you hear clomipramine, a tricyclic antidepressant originally developed in the 1960s to treat depression but now widely used for obsessive-compulsive disorder. Also known as Anafranil, it works by boosting serotonin and norepinephrine in the brain—two chemicals that help regulate mood, anxiety, and compulsive behaviors. Unlike newer SSRIs like sertraline or fluoxetine, clomipramine hits multiple neurotransmitters at once, which makes it stronger but also more likely to cause side effects.
It’s not just for depression. The FDA approved clomipramine for obsessive-compulsive disorder, a condition where intrusive thoughts lead to repetitive behaviors. Also known as OCD, this disorder often doesn’t respond well to first-line treatments, making clomipramine a go-to when other meds fail. Many patients report a drop in compulsions after 4–8 weeks, though it can take longer. Doctors often start low—25 mg a day—and slowly increase to avoid dizziness, dry mouth, or heart rhythm changes.
Clomipramine also shows up in off-label use for panic disorder, chronic pain, and even bedwetting in kids. But it’s not a casual pill. Because it affects your heart’s electrical signals, people with existing heart conditions need careful monitoring. It also interacts badly with MAOIs, certain antidepressants, and even some over-the-counter cold meds. If you’re taking sertraline, a common SSRI often compared to clomipramine for OCD and depression. Also known as Daxid, it’s safer but less potent, mixing it with clomipramine can lead to serotonin syndrome—a rare but dangerous spike in brain serotonin levels.
What sets clomipramine apart isn’t just its power—it’s its history. It’s one of the few antidepressants proven to work when everything else fails. But that strength comes with trade-offs: weight gain, constipation, blurred vision, and fatigue are common. Some people quit because of the side effects. Others stick with it because their OCD or depression simply won’t budge without it.
You won’t find this drug in every pharmacy’s top shelf. It’s not flashy, it’s not new, and it doesn’t get marketed like the latest SSRIs. But in clinics and hospitals, it’s still a trusted tool. If you’re considering it, talk to your doctor about your full medication list, your heart health, and what you’re hoping to fix. This isn’t a pill to trial lightly.
The posts below dive into real-world details: how dose splitting affects clomipramine’s peak levels, how it compares to other antidepressants like sertraline, and what drug interactions to watch out for. You’ll see how it fits into broader treatment plans, why some patients respond better than others, and what to do if side effects get too heavy. This isn’t theory—it’s what people actually experience.
