Anafranil® [Clomipramine]

Brand Novartis

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Clinical Pharmacology

Anafranil CP - a tricyclic antidepressant, a norepinephrine and serotonin reuptake inhibitor. The therapeutic effect of Anafranil CP is believed to be due to its ability to inhibit reverse neuronal uptake of norepinephrine (NA) and serotonin (5-HT), released into the synaptic cleft, with the most important inhibition of serotonin reuptake. Anafranil CP, in addition, has a wide range of other pharmacological actions: alpha1-adrenolytic, anticholinergic, antihistamine and antiserotoninergic (blockade of 5-HT receptors).

Anafranil SR acts on depressive syndrome in general, incl. especially its typical manifestations such as psychomotor inhibition, depressed mood and anxiety. The clinical effect is usually observed after 2-3 weeks of treatment. In addition, Anafranil CP has a specific (different from its antidepressant effect) effect in obsessive-compulsive disorders. The action of Anafranil CP in chronic pain syndromes, both caused and not caused by somatic diseases, is probably due to the relief of transmission of nerve impulses mediated by serotonin and noradrenaline.

Indications

Adults:
- treatment of depressive states of various etiologies occurring with different symptoms: endogenous, reactive, neurotic, organic, masked, involutional forms of depression; depression in patients with schizophrenia and psychopathy; depressive syndromes that occur in old age, caused by chronic pain syndrome or chronic somatic diseases; depressive mood disorders of a reactive, neurotic, or psychopathic nature;
- obsessive-compulsive syndromes;
- chronic pain syndrome;
- phobias and panic attacks;
- cataplexy associated with narcolepsy.
Children and teenagers:
- obsessive-compulsive syndromes;
- nocturnal enuresis (only in patients over the age of 5 years and subject to the exclusion of organic causes of the disease).

Composition

1 tablet contains clomipramine hydrochloride 75 mg

Clomipramine is marketed under different brands and generic names, and comes in different dosage forms:

Brand name	Manufacturer	Country	Dosage form
Anafranil CP	Novartis	Switzerland	pills
Anafranil	Novartis	Switzerland	pills

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Dosage and Administration

Doses of the drug are selected individually, taking into account the patient's condition. The goal of treatment is to achieve an optimal effect against the background of using the smallest possible doses of the drug, as well as to carefully increase them, especially in elderly patients and adolescents who are generally more sensitive to Anafranil CP than patients in intermediate age groups. The initial daily dose is 75 mg (25 mg 2-3 p / day)

Adverse reactions

Other: following sudden withdrawal or rapid reduction of the dose of Anafranil CP, the following symptoms often occur: nausea, vomiting, abdominal pain, diarrhea, insomnia, headache, irritability, anxiety. The observed adverse events are usually mild and transient, pass during the continuation of treatment or after reducing the dose of Anafranil SR. They do not always correlate with the concentration of the active substance of the drug in the blood plasma or its dose. Some adverse events, such as general weakness, sleep disturbances, anxiety, anxiety, constipation, dry mouth, are often difficult to distinguish from manifestations of depression. In the event of the development of serious side effects from the nervous system or mental status of Anafranil, SR should be canceled. The elderly are particularly sensitive to the effect of Anafranil CP on the nervous system, the cardiovascular system, the effect of the drug on mental status, as well as the anticholinergic effect of Anafranil CP.

Contraindications

- hypersensitivity to clomipramine and other components of the drug, cross-hypersensitivity to tricyclic antidepressants from the group of dibenzazepine;
- simultaneous use of MAO inhibitors, as well as a period of less than 14 days before and after their use;
- simultaneous use of selective inhibitors of MAO type A of reversible action (such as moclobemide);
- recent myocardial infarction;
- congenital long QT syndrome.

Do not recommend the use of the drug during pregnancy and during breastfeeding.
The drug is not recommended for use in children under the age of 5 years.

Special instructions

It is known that tricyclic antidepressants reduce the threshold of convulsive readiness, therefore Anafranil SR should be used with extreme caution in patients with epilepsy. Patients who develop drowsiness and other disorders of the central nervous system (including blurred vision) against the background of Anafranil SR, should not drive a car, operate machinery, or engage in other activities requiring increased attention and quick response.