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Anafranil Side Effects

Generic Name: clomipramine

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

In Summary

Common side effects of Anafranil include: constipation, dizziness, drowsiness, dyspepsia, ejaculatory disorder, fatigue, headache, insomnia, myoclonus, nausea, nervousness, paresthesia, tremor, urination disorder, visual disturbance, weight gain, anorexia, diaphoresis, and xerostomia. Other side effects include: anxiety, fever, hot flash, hypertonia, memory impairment, muscle twitching, non-puerperal lactation, orthostatic hypotension, pruritus, skin rash, sleep disorder, tachycardia, tinnitus, vomiting, flushing, and taste disorder. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to clomipramine: oral capsule, oral tablet

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
  • Bladder pain
  • bloody or cloudy urine
  • blurred vision
  • body aches or pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • confusion
  • difficult, burning, or painful urination
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • excessive muscle tone
  • fear or nervousness
  • feeling sad or empty
  • fever
  • hearing changes
  • irritability
  • lower back or side pain
  • muscle stiffness, tension, or tightness
  • poor concentration
  • rhythmic movement of muscles
  • sneezing
  • tightness of the chest
  • trouble breathing
  • unusual tiredness or weakness
  • voice changes
Less common
  • Anger that is hard to control
  • breast enlargement
  • burning feeling while urinating
  • changes in vision
  • chills
  • decrease in the frequency of urination
  • difficulty in passing urine (dribbling)
  • difficulty in speaking
  • dry mouth
  • fast, irregular, pounding, or racing heartbeat or pulse
  • headache, severe and throbbing
  • hyperventilation
  • irregular heartbeats
  • irritability
  • nausea or vomiting
  • numbness, tingling, pain, or weakness in the hands or feet
  • pain during sexual intercourse
  • panic attacks
  • paranoia
  • rapidly changing moods
  • restlessness
  • shaking
  • swelling of the face, fingers, feet, or lower legs

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
  • Blistering, crusting, irritation, itching, or reddening of the skin
  • change in taste
  • constipation
  • cracked, dry, or scaly skin
  • change in interest in sexual intercourse
  • diarrhea
  • dry skin
  • heartburn
  • hives or welts, skin rash
  • inability to have or keep an erection
  • increased interest in sexual intercourse
  • joint pain
  • pimples
  • redness of the face, neck, arms, and occasionally, upper chest
  • shakiness in the legs, arms, hands, or feet
  • stomach discomfort, upset, or pain
  • swelling
  • swollen joints
  • trembling or shaking of the hands or feet
Less common
  • Absent, missed, or irregular menstrual periods
  • breast pain
  • sores, ulcers, or white spots on the lips or tongue or inside the mouth

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]


1. "Product Information. Anafranil (clomipramine)." Basel Pharmaceuticals, Summit, NJ.

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Some side effects of Anafranil may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.