Tuesday, October 13, 2015

Clofranil use and side effects

Clofranil is a brand of Clomipramine. It is prescribed for obsessive compulsive disorder and depressive disorder. Main side effects are drowsiness, feeling faintish, dry mouth and constipation. This is a TCA class antidepressant with more serotonergic actions than other TCA antidepressants. More serotonergic action makes this medication more similar to SSRI (Selective serotonin reuptake inhibitors) class medication and it is more effective in OCD (Obsessive compulsive disorder).

Clofranil 50mg tablets

Uses of Clofranil

This medication is an antidepressant. It is primarily used for mental health problems such as depression and obsessive compulsive disorder. Compared to other antidepressants in this class, this medication is more effective in OCD or obsessive compulsive disorder.

This medication is useful in treating OCD (Obsessive compulsive disorder)

Obsessive compulsive disorder is a mental health problem associated with repeated thoughts or actions that are resisted.  A common example is excessive hand washing in a patient with repetitive belief that his/her hands are contaminated by germs. Usually excessive means around more than 10 times of washing hands per session. Usually the compulsion or act starts once the patient gets the thought that his hands are dirty.  

In fact, in current psychiatry practice it is used as a medication for OCD than depression. Most doctors use it as a second line treatment option for OCD, due to its unfavorable side effects profile. But according to this author's experience this medication helps patients who are resistant to SSRI medications.

What are the common side effects of Clofranil?

  1. Drowsiness
  2. Dry mouth
  3. Constipation
  4. Increased heart rate
  5. Feeling faintish
  6. Confusion
  7. Nausea
  8. Headache
  9. Yawning
  10. Blurred vision
  11. Sexual dysfunction

Since this is a TCA (Tricyclic antidepressant) class medication, drowsiness and dry mouth is common. Usually SSRI medications do not cause such side effects.

Due to side effect of drowsiness, it will affect driving and ability to operate machinery.
Sexual dysfunction includes erectile dysfunction in males and reduced sexual desire in females.

What are the dangerous side effects?

  1. Urine retention
  2. Glaucoma or increased eye pressure
  3. Heart block
  4. Mania

Since this medication can cause serious heart problems (heart block) it is toxic when taken overdose. Therefore, it is prescribed carefully for highly suicidal patients. This medication can cause manic shift in patients with bipolar affective disorder. Urine retention can be a troublesome side effect in elderly patients.

What are rare but documented side effects of Clofranil?

  1. Breast enlargement
  2. Increased appetite with increased body weight
  3. Getting low sodium in the blood (Hyponatremia)
  4. Hallucinations
  5. Epileptic Seizures
  6. Flushing
  7. Impaired memory
  8. Muscle weakness

Things you need to discuss with your doctor?

Before getting the prescription, you need to inform your doctor if you have following medical/psychiatric conditions.

  1. Any heart disease or Hypertension
  2. Liver disease
  3. Kidney disease
  4. Bipolar affective disorder
  5. Diabetes mellitus
  6. Schizophrenia
  7. Eye problems
  8. Prostate problems in males (History of urinary retention)
  9. Long standing constipation
  10. History of all the medications you are on including street drugs

Compared to newer anti-depressants this medication is safe in pregnancy and breast feeding. It is due to availability of large amount of safety information.

How Clofranil is taken?

This medication is available as 50mg and 25mg tablets. Usual dose range is 50mg per day to 250mg per day. It should be taken with a full glass of water and should not be crushed before ingesting.


Clofranil is a TCA class antidepressant medication usually prescribed for OCD (Obsessive compulsive disorder) and depression. Common side effects are drowsiness and dry mouth.

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