Clomipramine (Anafranil) - Uses, Side Effects, and More

What are the most common side effects of clomipramine?

The most common side effects of clomipramine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Constipation
• Inability to empty your bladder
• Dry mouth
• Drowsiness
• Dizziness
• Confusion
• Blurred vision
• Nausea and vomiting
• Tremor
• Weight gain
• Sexual problems

There may be other side effects of clomipramine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of clomipramine?

While less common, the most serious side effects of clomipramine are described below, along with what to do if they happen.

Severe Allergic Reactions. Clomipramine may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Itching, skin rash, or pale red bumps on the skin called hives
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Shortness of breath, trouble swallowing, or throat tightness
• Swelling in your feet, ankles, or legs
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain
• Dark-colored pee
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Suicidal Thoughts or Actions. Clomipramine or other antidepressants may increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults in the first few months of taking the medicine or when the dose is changed. Depression or other serious mental health conditions are the most important causes of suicidal thoughts or actions. If you or your child is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.

• New or increased thoughts of suicide or death
• Suicide attempt
• New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior

Glaucoma. Clomipramine may increase pressure inside the eye and cause or worsen narrow-angle glaucoma in some people. This can lead to blindness. Ask your healthcare provider if you should have your eyes examined to see if you are at risk. Tell your healthcare provider right away if you have any of the following symptoms.

• Loss of vision
• Eye pain or redness
• Severe headache or vomiting
• Seeing bright, colorful circles around lights (vision halos)

Extremely Elevated Mood (Mania). People with bipolar disorder can have severe high and low moods. The first symptom of bipolar disorder may be depression. People with bipolar disorder who take an antidepressant, such as clomipramine, may have a higher risk of having mania or a manic episode. Call your doctor right away if you have any of the following symptoms of a manic episode.

• Very increased energy
• Significant trouble sleeping
• Racing, fast-paced thoughts
• Reckless behavior
• Unusually grand ideas
• Excessive happiness or irritability
• Talking faster or more than usual

Heart Rhythm Changes. Clomipramine may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take some medicines for other heart rhythm problems. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Clomipramine can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

• Sweating, fever, or flushing
• Confusion
• Feeling agitated or restless
• Seeing or hearing unusual things
• Dizziness
• Fast or racing heartbeat
• Nausea, vomiting, or diarrhea
• Muscle twitching, stiffness, or tremor
• Seizures

Low Sodium Level (Hyponatremia). Clomipramine may cause low sodium levels. Call your healthcare provider if you have any of the following symptoms of a low sodium level.

• Headache
• Drowsiness
• Muscle weakness or cramps
• Nausea, vomiting, or loss of appetite
• Tiredness or sleepiness
• Dizziness
• Weight gain
• Restlessness or irritability
• Change in your mental condition such as hallucinations, confusion, decreased awareness, or alertness
• Seizures

Neuroleptic Malignant Syndrome (NMS). Clomipramine may cause a rare but serious condition called neuroleptic malignant syndrome. Stop taking clomipramine and call your healthcare provider right away if you have any of the following symptoms.

• High fever
• Muscle stiffness or rigidity, where it is hard to move
• Changes in your breathing or heart rate
• Increased sweating
• Confusion

Blood Disorders. Clomipramine may cause blood disorders, such as agranulocytosis, low platelet levels (thrombocytopenia), anemia, and low white blood cell levels (leukopenia). Stop using clomipramine and get help right away if you have any of the following symptoms of blood disorders.

• Fever
• Shortness of breath
• Pale or yellowish skin
• Easy bruising or bleeding
• Frequent infection or sore throat
• Unusual weakness or tiredness
• Dizziness, lightheadedness, or feeling like you are about to pass out
• Headache
• Fast or abnormal heartbeat