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Anafranil Side Effects

Generic name: clomipramine

Medically reviewed by Last updated on Dec 13, 2023.

Note: This document contains side effect information about clomipramine. Some dosage forms listed on this page may not apply to the brand name Anafranil.

Applies to clomipramine: oral capsule.


Oral route (Capsule)

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. These risks must be balanced with clinical need. Families and caregivers should closely observe the patient and stay in close contact with the prescriber. This drug is not approved for use in pediatric patients except for those with obsessive compulsive disorder (OCD).

Serious side effects of Anafranil

Along with its needed effects, clomipramine (the active ingredient contained in Anafranil) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking clomipramine:

More common

Less common

Incidence not known

Other side effects of Anafranil

Some side effects of clomipramine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common

For Healthcare Professionals

Applies to clomipramine: oral capsule.


The most commonly reported side effects included dry mouth, dizziness, somnolence, tremor, and constipation.[Ref]


Very common (10% or more): Dry mouth (up to 84%), constipation (up to 47%), nausea (up to 33%), dyspepsia (up to 22%), abdominal pain (up to 13%), diarrhea (up to 13%)

Common (1% to 10%): Abdominal disorders, eructation, esophagitis, flatulence, gastrointestinal disorder, halitosis, tooth disorder, ulcerative stomatitis, vomiting

Uncommon (0.1% to 1%): Blood in stool, colitis, duodenitis, gastric ulcer, gastritis, gastroesophageal reflux, gingivitis, glossitis, hemorrhoids, increased saliva, irritable bowel syndrome, peptic ulcer, rectal hemorrhage, tongue ulceration, tooth caries

Rare (0.01% to 0.1%): Cheilitis, chronic enteritis, discolored feces, gastric dilatation, gingival bleeding

Very rare (less than 0.01%): Paralytic ileus, parotid swelling[Ref]

Nervous system

Very common (10% or more): Dizziness (up to 54%), somnolence (up to 54%), tremor (up to 54%), headache (up to 52%), myoclonus (up to 13%)

Common (1% to 10%): Disturbance in attention, drowsiness, dysgeusia, hypertonia, impaired concentration, memory impairment, migraine, muscle hypertonia, mydriasis, nervousness, paresis, paresthesia, speech disorder, syncope, taste perversion, twitching, vertigo, vestibular disorder

Uncommon (0.1% to 1%): Abnormal coordination, abnormal electroencephalogram (EEG), abnormal gait, ataxia, coma, convulsions, dyskinesia, encephalopathy, extrapyramidal disorder, hyperkinesia, hypokinesia, neuralgia, parosmia, sensory disturbance, stimulation, taste loss

Rare (0.01% to 0.1%): Anticholinergic syndrome, aphasia, apraxia, cerebral hemorrhage, cholinergic syndrome, choreoathetosis, dystonia, generalized spasm, hemiparesis, hyperesthesia, hyperreflexia, hypoesthesia, neuropathy, nystagmus, stupor

Very rare (less than 0.01%): Akathisia, neuroleptic malignant syndrome, peripheral neuropathy, serotonin syndrome, stroke, tardive dyskinesia[Ref]


Very common (10% or more): Ejaculation failure (up to 42%), impotence (up to 20%), micturition disorder (up to 14%), dysmenorrhea (up to 12%)

Common (1% to 10%): Amenorrhea, breast enlargement, breast pain, dysuria, erectile dysfunction, galactorrhea, leukorrhea, menstrual disorder, micturition frequency, nonpuerperal lactation, urinary retention, urinary tract infection, vaginitis

Uncommon (0.1% to 1%): Endometriosis, epididymitis, genital pruritus, hematuria, nocturia, ovarian cyst, perineal pain, polyuria, prostatic disorder, urethral disorder, urinary incontinence, uterine hemorrhage, vaginal hemorrhage

Rare (0.01% to 0.1%): Albuminuria, breast engorgement, cervical dysplasia, endometrial hyperplasia, intestinal obstruction, oral edema, paralytic ileus, pharyngeal edema, premature ejaculation, pyuria, salivary gland enlargement, uterine inflammation, vaginal bleeding, vulvar disorder

Very rare (less than 0.01%): Testicular swelling

Postmarketing reports: Ejaculation delayed[Ref]


Very common (10% or more): Fatigue (up to 39%)

Common (1% to 10%): Asthenia, chills, fever/hyperpyrexia, otitis media, pain, tinnitus

Uncommon (0.1% to 1%): Cyst, deafness, earache, foreign body sensation, hyperacusis, malaise

Rare (0.01% to 0.1%): Dependent edema, labyrinth disorders

Very rare (less than 0.01%): Sudden death[Ref]


Very common (10% or more): Increased sweating/hyperhidrosis (up to 29%)

Common (1% to 10%): Abnormal skin odor, allergic dermatitis, acne, dermatitis, dry skin, photosensitivity reaction, pruritus, rash/skin rash, urticaria

Uncommon (0.1% to 1%): Alopecia, cellulitis, eczema, erythematous rash, maculopapular rash, psoriasis, pustular rash, skin discoloration

Rare (0.01% to 0.1%): Chloasma, folliculitis, hypertrichosis, lupus erythematosus rash, piloerection, seborrhea, skin hypertrophy, skin ulceration

Postmarketing reports: Drug rash with eosinophilia and systemic symptom (DRESS)[Ref]


Hallucinations occurred more frequently in elderly patients and in those with Parkinson's disease.[Ref]

Very common (10% or more): Insomnia (up to 25%), libido change (up to 21%), nervousness (up to 18%)

Common (1% to 10%): Abnormal dreaming, abnormal thinking, aggression, aggressive reaction, agitation, anxiety, confusional state, confusion, delirium, depression/aggravation of depression, depersonalization, disorientation, emotional lability, female orgasmic impotence, hallucinations, irritability, hypomania, libido disorder, mania, nightmares, panic reaction, psychosomatic disorder, restlessness, sleep disorder, withdrawal symptoms, worsening of psychiatric status

Uncommon (0.1% to 1%): Activation of psychotic symptoms, apathy, delusion, euphoria, hostility, hyperagogic hallucinations, manic reaction, paranoia, phobic disorder, psychosis, somnambulism, suicidal ideation, suicide attempt, teeth grinding

Rare (0.01% to 0.1%): Anorgasmy, catalepsy, illusion, impaired impulse control, indecisiveness, mutism, schizophrenic reaction, suicide, withdrawal syndrome

Very rare (less than 0.01%): Suicidal behaviors[Ref]


Very common (10% or more): Anorexia (up to 22%), weight increased (up to 18%), increased appetite (up to 11%)

Common (1% to 10%): Alkaline phosphatase increased, blood sugar changes, decreased appetite, thirst, weight decrease

Uncommon (0.1% to 1%): Dehydration, diabetes mellitus, gout, hypercholesterolemia, hyperglycemia, hyperuricemia, hypokalemia

Rare (0.01% to 0.1%): Fat intolerance[Ref]


Very common (10% or more): Abnormal vision (up to 18%)

Common (1% to 10%): Abnormal lacrimation, accommodation disorder, anisocoria, blepharospasm, blurred vision, conjunctivitis, ocular allergy

Uncommon (0.1% to 1%): Abnormal accommodation, diplopia, eye pain, photophobia, scleritis

Rare (0.01% to 0.1%): Oculogyric crisis, oculomotor nerve paralysis

Very rare (less than 0.01%): Blepharitis, chromatopsia, conjunctival hemorrhage, exophthalmos, glaucoma, keratitis, night blindness, retinal disorders, strabismus, visual field defect

Postmarketing reports: Angle-closure glaucoma[Ref]


Very common (10% or more): Pharyngitis (up to 14%), rhinitis (up to 12%)

Common (1% to 10%): Bronchospasm, coughing, dyspnea, epistaxis, laryngitis, sinusitis, yawning

Uncommon (0.1% to 1%): Bronchitis, dysphonia, hyperventilation, increased sputum, pneumonia

Rare (0.01% to 0.1%): Hemoptysis, hiccup, hypoventilation, laryngismus

Very rare (less than 0.01%): Alveolitis allergic (pneumonitis) with/without eosinophilia[Ref]


Very common (10% or more): Myalgia (up to 13%)

Common (1% to 10%): Arthralgia, back pain, muscle weakness

Uncommon (0.1% to 1%): Arthrosis, leg cramps

Rare (0.01% to 0.1%): Bruising, exostosis, myopathy, myositis, polyarteritis nodosa, torticollis

Frequency not reported: Bone fractures, rhabdomyolysis[Ref]


Common (1% to 10%): Chest pain, clinically irrelevant ECG changes (e.g., T- and ST- wave changes in patients of normal cardiac status), flushing, hot flushes, local edema, orthostatic hypotension, palpitation, postural hypotension, sinus tachycardia, tachycardia

Uncommon (0.1% to 1%): Abnormal ECG, arrhythmia, blood pressure increased, bradycardia, cardiac arrest, extrasystoles, general edema, pallor

Rare (0.01% to 0.1%): Aneurysm, atrial flutter, bundle branch block, cardiac failure, cyanosis, heart block, myocardial infarction, myocardial ischemia, peripheral ischemia, thrombophlebitis, vasospasm, ventricular tachycardia

Very rare (less than 0.01%): Cardiomyopathy, conduction disorder, congestive cardiac failure, edema, hypotension, prolonged PR and QTc (QT/RR) intervals, Torsade de pointes, widening of QRS complex[Ref]


Common (1% to 10%): Anemia, purpura

Uncommon (0.1% to 1%): Lymphadenopathy

Rare (0.01% to 0.1%): Leukemoid reaction, lymphoma-like disorder, marrow depression

Very rare (less than 0.01%): Agranulocytosis, eosinophilia, leukopenia, thrombocytopenia

Frequency not reported: Pancytopenia[Ref]


Common (1% to 10%): Cystitis

Uncommon (0.1% to 1%): Oliguria, renal calculus, renal pain

Rare (0.01% to 0.1%): Glycosuria, pyelonephritis, renal cyst[Ref]


Common (1% to 10%): Transaminases increased

Uncommon (0.1% to 1%): Abnormal hepatic function, hepatitis

Very rare (less than 0.01%): Acute hepatitis, hepatic necrosis, hepatitis with/without jaundice[Ref]


Common (1% to 10%): Allergy

Very rare (less than 0.01%): Anaphylactic reaction, anaphylactoid reaction[Ref]


Uncommon (0.1% to 1%): Hypothyroidism

Rare (0.01% to 0.1%): Goiter, gynecomastia, hyperthyroidism

Very rare (less than 0.01%): Syndrome of inappropriate antidiuretic hormone (SIADH) secretion

Frequency not reported: Blood prolactin increased[Ref]


Uncommon (0.1% to 1%): Increased susceptibility to infection[Ref]


Rare (0.01% to 0.1%): Breast fibroadenosis[Ref]

Frequently asked questions


1. Product Information. Anafranil (clomipramine). Basel Pharmaceuticals. 2001;PROD.

2. Cerner Multum, Inc. UK Summary of Product Characteristics.

3. Cerner Multum, Inc. Australian Product Information.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.