Anafranil Is a Tricyclic Antidepressant Used to Treat OCD

Anafranil (Clomipramine) is a prescription tricyclic antidepressant (TCA) primarily used to treat obsessive-compulsive disorder (OCD) in patients aged 10 and older.

If you or someone you know has been prescribed Anafranil — or is considering it — this guide covers everything you need to know: what it's used for, how it's taken, who should avoid it, and how much it costs in 2026.

What Is Anafranil?

Anafranil is the brand name for Clomipramine Hydrochloride. Here are the basics:

• Generic name: Clomipramine Hydrochloride
• Drug class: Tricyclic antidepressant (TCA)
• Manufacturers: Multiple generic manufacturers including Mallinckrodt and Taro (brand Anafranil is largely discontinued in the US)
• FDA approval: Approved for OCD in patients aged 10 and older
• Controlled substance: No — Anafranil is not a controlled substance and has no DEA schedule
• Available forms: Oral capsules in 25 mg, 50 mg, and 75 mg strengths

Clomipramine is the most serotonin-selective of all tricyclic antidepressants, which is believed to explain why it works so well for OCD when other antidepressants may not. For more on how it works, see our guide on Anafranil's mechanism of action.

What Is Anafranil Used For?

FDA-Approved Use

Anafranil is FDA-approved for one condition:

• Obsessive-Compulsive Disorder (OCD) — in patients aged 10 and older. It's considered one of the most effective medications for OCD, sometimes working when SSRIs have not provided adequate relief.

Off-Label Uses

Doctors also prescribe Clomipramine off-label for several other conditions:

• Major depressive disorder (MDD)
• Anxiety disorders
• Panic disorder
• Insomnia
• Chronic pain
• Premature ejaculation
• Treatment-resistant depression

Off-label use means the FDA hasn't specifically approved the drug for that condition, but there's medical evidence supporting its use and doctors are legally allowed to prescribe it.

How Is Anafranil Taken?

Anafranil is taken orally as a capsule. Your doctor will typically follow this dosing schedule:

For Adults

• Starting dose: 25 mg once daily
• Titration: Increase by 25 mg every 4-7 days during the first 2 weeks, aiming for approximately 100 mg/day
• Target dose: 100-250 mg per day
• Maximum dose: 250 mg per day

For Children (Ages 10+)

• Starting dose: 25 mg daily
• Maximum dose: 3 mg/kg/day or 200 mg/day, whichever is less

Important Dosing Notes

• Take with food to reduce stomach upset
• During the initial titration period, take in divided doses with meals
• After titration, your doctor may switch you to a single bedtime dose to help with drowsiness
• Never stop Anafranil suddenly — always taper under your doctor's supervision to avoid withdrawal symptoms

Who Should Not Take Anafranil?

Anafranil is not safe for everyone. You should not take Anafranil if you:

• Have taken a monoamine oxidase inhibitor (MAOI) within the past 14 days — this combination can cause seizures, coma, or death
• Are currently taking Linezolid or intravenous Methylene Blue
• Are in the acute recovery period after a heart attack
• Have a known allergy to Clomipramine or other tricyclic antidepressants

Use with extra caution if you:

• Have a history of seizures or epilepsy
• Have heart disease or cardiac rhythm abnormalities
• Have liver or kidney problems
• Are pregnant (Category C) or breastfeeding (not recommended)
• Are elderly (increased sensitivity to side effects)

Tell your doctor about all medications and supplements you take before starting Anafranil. It has significant drug interactions that need to be reviewed.

What Are the Side Effects?

Common side effects include drowsiness, dry mouth, constipation, dizziness, tremor, weight gain, and sexual dysfunction. Serious side effects — though less common — include seizures, serotonin syndrome, heart rhythm changes, and suicidal thoughts in young patients.

For a complete breakdown, read our guide on Anafranil side effects: what to expect and when to call your doctor.

How Much Does Anafranil Cost?

Cost varies significantly depending on whether you have insurance and whether you use discount programs:

• Brand Anafranil: Approximately $2,400/month — but it's largely discontinued in the US market
• Generic Clomipramine (retail): About $600 for 60 capsules (50 mg) without insurance
• Generic with discount cards: $15-$40 per month using GoodRx, SingleCare, or other discount programs
• With insurance: Generic Clomipramine is typically covered as a Tier 2 generic with copays ranging from $10-$30/month

Some insurance plans may require prior authorization or step therapy (trying an SSRI first) before approving Clomipramine. If cost is a barrier, check out our guide on how to save money on Anafranil.

Patient assistance programs are also available through NeedyMeds, RxAssist, and Prescription Hope (which offers medications for a flat $70/month).

Current Availability

Anafranil has experienced intermittent supply disruptions since 2020. Availability varies by strength and location. If you're having trouble finding it, Medfinder can help you locate a pharmacy with Anafranil in stock near you.

Final Thoughts

Anafranil (Clomipramine) remains one of the most effective medications available for OCD, especially for patients who haven't responded well to SSRIs like Fluoxetine, Sertraline, or Fluvoxamine. It's been around for decades, is well-studied, and — as a generic — can be very affordable with the right discount card.

If you're considering Anafranil, talk to your doctor about whether it's right for your situation. And if you need help finding it or affording it, Medfinder is here to help.