Clomipramine Dosing: Safe Amounts, Side Effects, and What Works

When you're prescribed clomipramine, a tricyclic antidepressant used primarily for obsessive-compulsive disorder and depression. Also known as Anafranil, it's one of the few medications approved specifically for OCD, not just depression. Getting the dose right matters—too little won’t help, too much can cause serious side effects. Unlike newer SSRIs, clomipramine affects multiple brain chemicals at once, which makes it powerful but trickier to manage.

Most adults start at 25 mg a day, often taken at night to reduce drowsiness. Doctors usually increase the dose slowly—by 25 mg every 3 to 7 days—until they find the sweet spot. For OCD, many people need 100 to 250 mg daily, sometimes even higher under close supervision. But that’s not a one-size-fits-all number. Your weight, age, liver function, and other meds you take all change what’s safe for you. Never jump to a high dose on your own. Clomipramine has a narrow safety window, and overdoses can be life-threatening.

It’s not just about the number on the pill. How you take it, when you take it, and what else you’re on all affect how it works. Mixing clomipramine with serotonin syndrome, a dangerous condition caused by too much serotonin in the brain is a real risk if you’re also taking SSRIs, SNRIs, or even certain herbal supplements. And if you’re on blood pressure meds, medications that lower heart rate or control hypertension, clomipramine can make them work too well—or too poorly. That’s why your pharmacist should always review your full list of meds.

Side effects? They’re common. Dry mouth, dizziness, constipation, weight gain, and blurred vision show up in most people early on. Some feel sleepy; others feel wired. These often fade after a few weeks, but if they don’t, or if you notice heart palpitations or confusion, talk to your doctor. It’s not weakness to need a dose adjustment—it’s smart management.

People often ask if clomipramine is better than Prozac or Zoloft for OCD. It’s not always about better—it’s about what works when others fail. For some, it’s the only thing that cuts through the noise of obsessive thoughts. But it’s not a first-line choice anymore because of the side effects. Still, when other options run out, clomipramine holds its ground.

Below, you’ll find real-world advice from people who’ve walked this path. You’ll see how others managed dosing, handled side effects, and worked with doctors to find balance. No fluff. Just practical, tested insights you can use.