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Anafranil

Generic Anafranil is a tricyclic antidepressant. Generic Anafranil is used to treat symptoms of obsessive-compulsive disorder (recurrent thoughts or feelings and repetitive actions). Generic Anafranil works by affecting chemicals in the brain that may become unbalanced.

Other names for this medication:

Similar Products:
Anafranil SR, Clopran, Doxepin, Cymbalta, Elavil

 

Also known as:  Clomipramine.

Description

Generic Anafranil is used to treat symptoms of obsessive-compulsive disorder (recurrent thoughts or feelings and repetitive actions).

Generic Anafranil is a tricyclic antidepressant.

Anafranil is also known as Clomipramine, Clonil, Clofranil, Clopram, Clopran, Clopress, Equinorm, Hydiphen.

Generic Anafranil works by affecting chemicals in the brain that may become unbalanced.

Generic name of Generic Anafranil is Clomipramine.

Brand name of Generic Anafranil is Anafranil.

Dosage

Take Generic Anafranil orally.

Do not take Generic Anafranil in large amounts.

Take Generic Anafranil with food.

Take Generic Anafranil up to 4 weeks.

The dosage of tablets depends on the disease and its prescribed treatment.

If you want to achieve most effective results do not stop taking Generic Anafranil suddenly.

Overdose

If you overdose Generic Anafranil and you don't feel good you should visit your doctor or health care provider immediately. Symptoms of Generic Anafranil overdosage: uneven heart rate, extreme drowsiness, confusion, agitation, vomiting, blurred vision, sweating, muscle stiffness, increased or decreased urination, swelling, shortness of breath, blue lips or fingernails, feeling light-headed, fainting, seizure.

Storage

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Anafranil are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Generic Anafranil if you are allergic to Generic Anafranil components.

Do not take Generic Anafranil if you're pregnant or you plan to have a baby, or you are a nursing mother.

Do not take Generic Anafranil if you had recent heart attack.

Do not take Generic Anafranil if you use MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam) or tranylcypromine (Parnate) within the past 14 days.

Be careful with Generic Anafranil if you have heart disease or a history of heart attack, bipolar disorder, schizophrenia or other mental illness, kidney or liver disease, overactive thyroid or adrenal gland tumor, glaucoma, problems with urination.

Avoid using other medicines that make you sleepy while using Generic Anafranil.

Avoid drinking grapefruit juice and eating grapefruit while using Generic Anafranil.

Avoid exposure to sunlight or artificial UV rays while using Generic Anafranil.

Be careful if you drive or do anything that requires you to be awake and alert while using Generic Anafranil.

Avoid alcohol.

Do not stop taking Generic Anafranil suddenly.

anafranil with alcohol

An isocratic high-performance liquid chromatography (HPLC) method with column switching and ultraviolet (UV) detection is described for quantitative analysis of the new antipsychotic drug ziprasidone. After centrifugation of serum or plasma samples and addition of fluperlapine as internal standard, the samples were injected into the HPLC system. On-line sample clean-up was conducted on a column (10 x 4.0 mm ID) filled with silica C8 material (20-microm particle size) using 8% (vol/vol) acetonitrile in deionized water as eluent. Ziprasidone was eluted and separated on ODS Hypersil C18 material (5 microm; column size 250 x 4.6 mm ID) using acetonitrile-water-tetramethylethylendiamine (50:49.6:0.4, vol/vol/vol). The UV detector was set at 254 nm. Ziprasidone was separated within 20 minutes. The limit of quantification was 10 ng/mL. At therapeutic concentrations, the interassay reproducibility (coefficient of variation) of quality control samples was below 10%. The method was found to be robust and stable. More than 100 serum samples could be analyzed without changing the clean-up column and more than 300 samples using the same analytic column. Among multiple drugs tested for interference, only the tricyclic antidepressants trimipramine and clomipramine were found to exhibit retention times similar to that of ziprasidone. The method was applied to analyze ziprasidone concentrations in blood serum of 67 patients treated with 40 to 280 mg ziprasidone per day for at least 7 days (median 120 mg). The median steady-state serum concentration of ziprasidone was 76 ng/mL, and the 25th and 75th percentile were 43 to 131 ng/mL, respectively. Forty to 130 ng/mL may be considered the recommended target plasma concentration range. HPLC with column switching and UV detection as described here is suitable for therapeutic drug monitoring of ziprasidone.

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Thirty-eight patients with primary obsessive-compulsive disorder participated in a 10-week, double-blind, placebo-controlled trial of the potent, selective serotonin reuptake inhibitor fluvoxamine. Fluvoxamine was significantly better than placebo on two of three measures of improvement in obsessive-compulsive symptoms. The authors also compared studies of the serotonergic agents fluvoxamine, sertraline, fluoxetine, and clomipramine and found that a greater effect size was associated with less serotonergic specificity and that some ability to affect other neurotransmitter systems may be a necessary but not sufficient requirement for antiobsessional activity. These data lend only partial support to a serotonin hypothesis of obsessive-compulsive disorder.

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A population-based case-control study was conducted within a large Dutch primary care database over the period 1996-2005. Cases with endoscopy-confirmed RE were identified and matched with up to 10 controls on gender, age, GP practice, and calendar time. Exposure to TCAs was assessed in the year prior to diagnosis and categorized as current (last prescription covered or ended within one month prior to the index date), past, and no use. The relative risk of RE was estimated by odds ratios (OR) with 95% confidence intervals (95% CI) using multivariate conditional logistic regression analysis.

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The present study (1) reports on the synthesis of two hybrid silica monoliths functionalized with aminopropyl or cyanopropyl groups by the sol-gel process; (2) evaluates these monoliths as selective stationary phase for microextraction by packed sorbent (MEPS) to determine drugs in plasma samples via liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the multiple reactions monitoring (MRM) mode; and (3) discusses important factors related to the optimization of MEPS efficiency as well as the carryover effect. The prepared hybrid silica monoliths consisted of a uniform, porous, and continuous silica monolithic network. The structure of the aminopropyl hybrid silica monolith was more compact than the structure of the cyanopropyl hybrid silica monolith. The Fourier-transform infrared spectroscopy (FTIR) spectra of the hybrid silica monoliths displayed readily identifiable peaks, characteristic of the cyanopropyl and aminopropyl groups. Compared with the aminopropyl hybrid silica phase, the cyanopropyl hybrid silica phase exhibited higher binding capacity for most of the target drugs. The developed method afforded adequate linearity at concentrations ranging from the lower limit of quantification (0.05-1.00 ng mL(-1)) to the upper limit of quantification (40-10,500 ng mL(-1)); the coefficients of determination (r(2)) were higher than 0.9955. The precision of the method presented coefficients of variation (CV) lower than 14%; the relative standard error (RSE) of the accuracy ranged from -12% to 14%. The developed method allowed for simultaneous analysis of five antipsychotics (olanzapine, quetiapine, clozapine, haloperidol, and chlorpromazine) in combination with seven antidepressants (mirtazapine, paroxetine, citalopram, sertraline, imipramine, clomipramine, fluoxetine), two anticonvulsants (carbamazepine and lamotrigine), and two anxiolytics (diazepam and clonazepam) in plasma samples from schizophrenic patients, which should be valuable for therapeutic drug monitoring purposes.

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Despite the effectiveness of clomipramine and selective serotonin reuptake inhibitors (SSRIs) in the treatment of obsessive-compulsive disorder (OCD), 40% to 60% of patients who receive an adequate treatment with these agents have significant persisting symptoms. Newer atypical antipsychotic drugs showed efficacy as augmenting agents in patients with OCD resistant to serotonin reuptake inhibitors (SRIs). The objective of this study was to evaluate the efficacy and safety of amisulpiride augmentation in treatment resistant OCD. A total of 20 patients diagnosed with OCD according to DSM-IV criteria and having a history of resistance to treatment with SRIs were included in the study. Amisulpiride 200 mg/day was added to ongoing SRI treatment and titrated up to 600 mg/day in flexible doses. The mean amisulpiride dose was 325 +/- 106 mg/day. The patients were assessed with the Yale-Brown obsessive-compulsive scale (Y-BOCS) at baseline and at week 12 of amisulpiride treatment. Side effects were monitored by the UKU side effect rating scale. The reduction in Y-BOCS scores between the baseline (26.7 +/- 6.3) and the end of the treatment (12.5 +/- 2.8) was statistically significant (p=0.0001). The most commonly observed side effects included weight gain (14 patients, 70%), mild sedation (13 patients, 65%) and asthenia (7 patients, 35%). This study has several limitations and, hence, the results are preliminary and require confirmation in a randomized controlled trial. In conclusion, this study suggests that amisulpiride may be a promising option as an augmentation strategy in treatment resistant OCD.

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With the aim of identifying predictors of treatment response, plasma levels of tryptophan (Trp) and tyrosine (Tyr) pretreatment and during treatment, and their ratios in plasma to the sum of the other large neutral amino acids (LNAA), were determined in 26 inpatients with major depression. The subjects were treated double-blind on a fixed-dose schedule for 4 weeks with the monoamine oxidase (MAO) inhibitor moclobemide. The study took place at 4 clinical centers. Endogenous and nonendogenous depressives were comparable in all biochemical variables and were therefore analysed together. The levels of plasma Trp/LNAA were decreased pretreatment and during treatment in the depressives compared with healthy controls. No significant correlation between plasma amino acid levels or ratios, or plasma moclobemide level, and clinical improvement was found, and there were no indications of a specific plasma amino acid profile associating with a favourable clinical response. Endogenous depressives showed significantly greater improvement than nonendogenous depressives; however, neither subgroup showed significant correlations between biochemical and clinical variables. The findings are at variance with a series of studies, which showed significant correlations between plasma amino acid ratios and clinical improvement on a variety of antidepressant treatments.

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These findings are consistent with other data suggesting that 5-HT3 receptors do not play a major role in the prolactin response to 5-HT challenge in human subjects, but may mediate nausea associated with enhanced 5-HT neurotransmission.

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We recently observed a 45-year-old patient with a history of psychiatric illness who presented with severe hyperthermia (rectal temperature above 41 degrees C) with intense rhabdomyolysis and liver cytolysis during tetrabenazine therapy for neuroleptic tardive dyskinesia. In addition to tetrabenazine, this patient took lorazepam and two antidepressant drugs: clomipramine, a potent serotonin-reuptake inhibitor, and mianserin. Hyperthermia responded to parenteral sodium dantrolene and oral bromocriptine administration. The significant role of tetrabenazine (a central nervous system dopamine-depleting drug) and the contribution of antidepressants to the mechanism of this neuroleptic malignant syndrome - like hyperthermia are discussed.

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Twenty-five Sprague Dawley rats (250 to 300 gm. each) were equally divided into 5 groups based on experimental agent; normal saline, clomipramine, sertraline, paroxetine, and fluoxetine. The hypogastric nerve was electrically stimulated and the intraluminal pressure of the vas deferens was measured, both pretreatment and 30 minutes after intravenous injection of four different doses (0.1 to 20 x the therapeutic dose) of each agent. Variations of responses relative to the time after administration of each agent (at 10- and 20-fold concentration) were also observed.

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All suspected adverse drug reactions in women and reported from January 1986 until August 1996 to the Netherlands Pharmacovigilance Foundation, a spontaneous adverse drug reaction reporting programme, were analysed. Adverse drug reaction (ADR) reporting odds ratios, defined as the ratio of the exposure odds among reported cases of non-puerperal lactation to the exposure odds of reported other ADRs, were calculated adjusted for age and year of reporting.

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In 2 out of 3 cases of retrograde ejaculation treatment with clomipramine hydrochloride resulted in normal ejaculation and conception. The 3rd patient was only partially helped by the drug. The mechanisms of ejaculation, the causes of retrograde ejaculation, the management of the condition and the relevant pharmacological features of the tricyclic anti-depressants are discussed.

anafranil medicine

Neuropathic mice exhibited an increased spontaneous rubbing÷scratching of the ipsilateral vibrissal pad, together with enhanced responses to cooling (acetone) and the chemical irritants (formalin, capsaicin). Clomipramine and tramadol produced an antihyperalgesic effect on most of these nociceptive responses, but tramadol was ineffective on capsaicin-induced hyperalgesia.

anafranil drug insert

Alterations in arginine vasopressin regulation and secretion have been proposed as one possible biochemical abnormality in patients with obsessive-compulsive disorder. In golden hamsters, arginine vasopressin microinjections into the anterior hypothalamus trigger robust grooming and flank marking, a stereotyped scent marking behaviors. The intensity and repetition of the behaviors induced by arginine vasopressin is somewhat reminiscent of Obsessive Compulsive Disorder in humans. The present experiments were carried out to test whether pharmacological agents used to alleviate obsessive compulsive disorder could inhibit arginine vasopressin-induced flank marking and grooming.

anafranil ocd medication

This study examines the predicting factors for absenteeism in depressed patients. Using a 'cross-sectional' design, we observed 345 patients diagnosed with major depressive disorders as assessed by the Diagnostic and Statistical Manual for Mental Disorders, third edition revised (DSM-III-R) criteria and Hamilton Depression Rating Scale (HAM-D) [12] score higher than 12. The treatment group (n = 268) were treated with antidepressants (n = 98 with fluoxetine and n = 170 with tricyclics [amitriptyline, clomipramine]) for at least one week and the non treated group (n = 67) had not received antidepressants for at least one month. Sociodemographic, clinical and therapeutic data was collected. The primary endpoint was absenteeism from work. Logistic regression analysis of these data was used to identify potential predictive variables. The rate of absenteeism from work was greater in non treated (70.2%) compared to treated patients (39.8% for fluoxetine group and 57.7% for tricyclics group). The risk of absenteeism for patients treated with tricyclics was 2.45 times greater than for patients treated with fluoxetine (odds-ratio = 2.45, CI 95% = 1.1-4.7). For all patients, the strongest predictors of absenteeism from work were symptom severity (odds-ratio = 44.4, CI 95% = 7.9-250) followed by past history of depression (odds-ratio = 6.85, CI 95% = 2.6-18.4) and past history of absenteeism (odds-ratio = 6.51, CI 95% = 2.0-204). In conclusion, the risk of absenteeism from work increases with depression severity and is higher with tricyclics compared to fluoxetine.

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Serotonin significantly decreased serotonergic activity in major cerebral arteries and striatum without affecting it in hippocampus. This reduction was blocked by previous injection of WAY-100635 in DRN. Local administration of 8-OH-DPAT or clomipramine elicited an effect similar to that of serotonin, whereas that of WAY-100635 did not modify serotonergic activity in either of the tissues. Electrical stimulation of DRN significantly increased serotonergic activity in major cerebral arteries and striatum but not in hippocampus.

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In one study (De Carufel 2006) behavioral therapy (BT) was significantly better than waiting list for duration of intercourse (MD (mean difference) 407.90 seconds, 95% CI 302.42 to 513.38), and couples' sexual satisfaction (MD -26.10, CI -50.48 to -1.72). BT was also significantly better for a new functional-sexological treatment (FS) (MD 412.00 seconds, 95% CI 305.88 to 518.12), change over time in subjective perception of duration of intercourse (Women: MD 2.88, 95% CI 2.06 to 3.70; Men: MD 2.52, CI 1.65 to 3.39) and couples' sexual satisfaction (MD -25.10, 95% CI -47.95 to -2.25), versus waiting list.One study (Li 2006) showed that the combination of chlorpromazine and BT was superior than chlorpromazine alone for IELT (MD 1.11, 95% CI 0.82 to 1.40), SAS (Self-rating Anxiety Scale) (MD -8.72, 95% CI -11.09 to -6.35) and for some CIPE (Chinese Index Premature Ejaculation) questions ('anxiety in sexual activity', 'partner sexual satisfaction', 'patient sexual satisfaction', 'control ejaculatory reflex' and 'ejaculatory latency') ('Analysis 1.2').One study (Yuan 2008) showed that citalopram significantly improved IELT (RR (risk ratio) 0.52, 95% CI 0.34 to 0.78) and the number of couples satisfied with their sex life after treatment (RR 0.60, 95% CI 0.39 to 0.93), versus BT.In the last study (Abdel-Hamid 2001), 31 patients received 1 of 4 drugs administered on an as-needed basis 35 hours before anticipated coitus (clomipramine, sertraline, paroxetine, sildenafil), or were instructed to use the pause-squeeze technique. The study consisted of five four-week periods of treatment, separated by two-week washout periods. Anxiety score and ejaculation latency time were measured before treatment, after each treatment and during washout periods. Sexual satisfaction scores were measured after each treatment. However the available data from the article were not sufficient to be included, and the related database was not available anymore, according to the main author.

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In a comparative study of three treatment regimens in patients with obsessive-compulsive or phobic manifestations, the most favourable therapeutic findings were seen in the clomipramine (Anafranil, Geigy Pharmaceuticals) plus behaviour therapy group and the least favourable therapeutic findings in the clomipramine plus simulated behaviour therapy group. The findings that a combination of behaviour therapy and clomipramine results in more favourable therapeutic changes than either of the two treatments alone is in line with reported studies in the literature.

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Twenty-three premature ejaculators (PEs) and 11 control subjects were administered 25 mg of clomipramine in a double-blind, placebo-controlled, crossover design study. During 2-week trials, subjects took either the drug or the placebo 4 to 6 hours prior to sexual activity. Daily diary data revealed that, for both groups, orgasmic latency was significantly increased when taking the clomipramine. For the PEs, the average increase in orgasmic latency during intercourse was from less than 1 minute to more than 3.5 minutes. Subjects also participated in two laboratory sessions while on the drug and placebo. During these lab sessions they were exposed to erotic videos with and without the addition of vibrotactile stimulation to the penis. Results from the laboratory data support those from the diaries. Specifically, PEs were significantly less likely to reach orgasm during the lab sessions while on the clomipramine than while on the placebo. Further, they reported a significantly greater sense of control over their orgasm while on the drug. The results of this study, along with previous research, strongly support the value of low doses of clomipramine in the treatment of premature ejaculation, specifically when taken on an as-needed basis as little as 4 hours prior to sexual activity. It is important to note, however, that the beneficial effects of the drug were not uniform across clinical subjects. In this study, those PEs with the shortest orgasmic latencies while on the placebo were the least likely to substantially improve while on the drug. Additional research is necessary to determine whether changes in the timing and dosage of the clomipramine administration can extend the benefits of the drug to those with the shortest latencies.

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The potent CYP1A2 inhibitor fluvoxamine has recently been shown also to be an effective inhibitor of the CYP2C19-mediated metabolism of the antimalarial drug proguanil in vivo. The purpose of the present study was to confirm this interaction in vitro.

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Obsessions or compulsions that cause personal distress or social dysfunction affect about 1% of men and 2% of women. About half of people with obsessive compulsive disorder (OCD) have an episodic course, whereas the other half have continuous problems. Up to half of people show improvement of symptoms over time.

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Patients with multiple sclerosis show higher prevalence of psychiatric disorders compared to general population, that are hardly managed by pharmacotherapy. In the present report a female patient, 44 years old, with diagnosis (according to DSM-IV) of 340 multiple sclerosis, 296.32 major depressive disorder, recurrent, moderate, 292.84 antidepressant-induced mood disorder, with manic features, is described. In this patient depressive symptoms did not respond to a number of drugs, including tricyclic antidepressants, selective serotonine re-uptake inhibitors hand lithium. Moreover, she had hypomanic and manic episodes induced by two different antidepressant, hydroxy-tryptophan and clorimipramine. Until today, only amisulpride (50 mg/die for four months, then 50 mg every two days for two months) has shown a significant effect on depressive symptomatology, moreover, this drug has not induced the occurrence of manic symptoms.

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Medication management of obsessive-compulsive disorder (OCD) has consisted of monotherapy with either clomipramine (CMI) or selective serotonin reuptake inhibitors (SSRIs) such as fluvoxamine, paroxetine, or sertraline. Frequently, OCD patients receiving monotherapy experience low treatment response rates and problematic side effects that may result in discontinuation or noncompliance. This open-label case series presents 7 patients (6 male, 1 female) ages 9 to 23 years with OCD who were effectively treated with combination of CMI plus an SSRI. Treatment effects persisted through 5 to 22 months of follow-up from onset of combination therapy. The drug combination was effective in the 2 patients with OCD and no mood/anxiety comorbidity. Side effects appeared in 5 of 7 patients; cardiovascular side effects were the most common adverse effects. Two patients had prolongation of QTc intervals and 2 developed tachycardia while taking CMI and SSRI combinations. Other risks might include serotonin syndrome, manic switch, insomnia, and possibly headaches, EPS, and sexual dysfunction. Recommendations are made to monitor electrocardiograms, CMI blood concentrations, and vital signs in all cases because SSRIs can increase the blood levels of CMI and/or its active metabolite, desmethylclomipramine (DCMI). CMI could also potentially increase SSRI absorption and/or protein binding. The use of CMI and SSRI combination therapy was found to be more effective compared with their monotherapy in all 7 cases.

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Polymorphisms in genes coding for drug metabolizing enzymes, such as the cytochrome P450 enzymes CYP2C19 and CYP2D6, can lead to therapy failure and side effects. In earlier studies, the novel variant CYP2C19*17 increased metabolism of several CYP2C19 substrates. The objective of this study was to evaluate the impact of CYP2C19*17 on the metabolism of amitriptyline (AT), citalopram (CIT), and clomipramine (CLOM). Six-hundred and seventy-eight patients were included in this study, based on availability of DNA and serum levels of parent drug and main metabolite. We investigated the relationship between CYP2C19 genotypes and metabolic parameters, including serum levels corrected for dose and metabolic ratio (MR). The CYP2C19*17 allele was significantly associated with decreased MR for CIT (CYP2C19*1/*17 mean MR=2.3, compared with CYP2C19*1/*1 mean MR=2.8) and AT (CYP2C19*17/*17 mean MR=0.8, compared with CYP2C19*1/*1 mean MR=3.7 in the CYP2D6*1/*1 subgroup). Furthermore, significant association of CYP2D6 genotype with AT, CIT, and CLOM metabolism was observed. No clear correlation was found between CYP2C19 genotype and CLOM metabolism. This study confirms the increased activity of the CYP2C19*17 allele and shows increased metabolism of drugs that are metabolized by CYP2C19, including AT and CIT. However, the clinical relevance of CYP2C19*17 is probably limited for AT, CIT, and CLOM.

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We used the Structured Interview for DSM-III Personality Disorders to diagnose DSM-III personality disorders systematically in 55 patients with obsessive-compulsive disorder in the active-treatment cell of a controlled trial of clomipramine hydrochloride. Patients with a cluster A personality disorder had significantly higher obsessive-compulsive disorder severity scores at baseline, and the number of personality disorders was strongly related to baseline severity of obsessive-compulsive disorder symptoms. At the conclusion of the 12-week study, we found no significant difference in treatment outcome with clomipramine between those patients with at least one personality disorder and those with no personality disorders. However, the presence of schizotypal, borderline, and avoidant personality disorders, along with total number of personality disorders, did predict poorer treatment outcome. These variables were strongly related to having at least one cluster A personality disorder diagnosis, which was also a strong predictor of poorer outcome. Implications of these findings are discussed.

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Twenty patients diagnosed with OCD according to DSM-IV TR criteria and having a history of resistance to standard pharmacological treatment were included in the study. Aripiprazole was added to ongoing SSRI or clomipramine treatment with a starting dose of 5 mg/day and titrated up to a maximum of 20 mg/day (mean dose 12.62 mg ± 4.25). Efficacy was assessed with the Yale-Brown obsessive compulsive scale (Y-BOCS) and the Clinical Global Improvement-severity scale (CGI-S) at baseline and at week 12 of Aripiprazole augmentation. Side effects were monitored by the Udvalg for Kliniske Undersogelser (UKU) side effect rating scale.

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anafranil 40 mg 2015-01-16

This article reviews all available studies reported in the literature or presented at national or international meetings on the efficacy of serotonin selective reuptake inhibitors and less selective serotonin uptake inhibitors in buy anafranil panic disorder. The research data lags behind-rather than leads-experience in everyday clinical practice. The emerging data suggest that serotonin uptake inhibitors are superior to placebo and better tolerated than most of the older alternatives. As a result they are now becoming first-choice treatments in panic disorder.

anafranil 75 mg 2016-10-16

Due to the generally poor buy anafranil prognosis previously reported for patients with obsessive-compulsive disorder (OCD), this report systematically assessed the outcome of patients who had had access to new psychopharmacologic treatments to determine whether there had been any long-term gains and if there were any predictors of outcome.

anafranil 600 mg 2017-07-08

In a tertiary care center, comorbidity between OCD and bipolar disorder is a significant clinical problem affecting a large number of patients and has a substantial impact on the clinical characteristics and treatment outcome of both buy anafranil disorders.

anafranil dosage information 2017-12-03

A sleep deprivation/chlorimipramine therapy was compared to chlorimipramine therapy in endogenous depression buy anafranil . In the sleep deprivation/chlorimipramine group a quick and long-lasting remission of depressive symptoms could be demonstrated. In the chlorimipramine group a marked prolonged onset of action was seen.

anafranil with alcohol 2016-05-11

OCD in dogs does not appear to be associated with lack of training, lack of household stimulation, or social confinement. In cats, OCD may be associated with environmental and social stress. Obsessive-compulsive disorder appears at the time of social maturity and may have sporadic and heritable forms. With appropriate treatment (consistent behavior modification and treatment with clomipramine), frequency and intensity of clinical signs in most dogs and cats may decrease by > 50%. Success appears to depend on client understanding and compliance and the reasonable expectation that OCD cannot be cured, but can be well controlled. buy anafranil

anafranil drug class 2015-05-27

On striatal synaptosomal preparations, using a double labelling test, numerous antidepressant drugs demonstrated an inhibitory effect on [3H]DA uptake at the same high concentrations producing a [14C]DA release. This releasing effect was also shared buy anafranil by non-antidepressant agents and was observed on synaptosomes preloaded with [3H]5HT. The imipramine-induced release of DA was not modified by increasing concentration of K+, by decreasing concentration of Na+, by deleting Ca2+ from the incubation medium, or by blocking the catecholamine uptake systems with nomifensine or cocaine. The imipramine effect was reversible and was possibly initiated by a transient physico-chemical modification of the synaptosomal membrane. It was concluded that the DA uptake carrier is probably not involved in the effect of these drugs.

anafranil pill 2017-09-25

A fatal toxicity index (deaths per million National Health Service prescriptions) was calculated for antidepressant drugs on sale during the years 1975-84 in England, Wales, and Scotland. The tricyclic drugs introduced before 1970 had a higher index than the mean for all the drugs studied (p less than 0.001). In this group the toxicity of amitriptyline, dibenzepin, desipramine, and dothiepin was significantly higher, while that of clomipramine, imipramine, iprindole, protriptyline, and trimipramine was lower. The monoamine oxidase inhibitors had intermediate toxicity, and the antidepressants introduced since 1973, considered as a group, had significantly lower toxicity than the mean (p less than 0.001). Of these newer drugs, maprotiline had a fatal toxicity index similar to that of the older buy anafranil tricyclic antidepressants, while the other newly introduced drugs had lower toxicity indices, with those for mianserin, nomifensine, trazodone, and viloxazine reaching significance. Provided that these drugs are equally effective clinically, serious consideration should be given to prescribing antidepressants with a lower fatal toxicity.

anafranil 25mg tab 2015-01-30

Shared obsessions could represent the continuum concept of obsessions and delusions, buy anafranil and their relationship needs to be evaluated in greater detail.

anafranil pills 2015-11-13

Nine male Lewis rats received 30 mg/kg clomipramine from neonatal day 8 to day 21 (depressed group), while 13 control Lewis rats were buy anafranil left untouched (control group). On day 150, ligatures were placed around the 2nd upper molars in both groups, i.e. the contralateral molar of the intra-group control. On day 190, the rats were killed and the maxillae were defleshed. The distance between the cemento-enamel junction and the alveolar bone crest was measured by a blinded examiner using standardized digital photographs.

anafranil 50 mg 2016-04-28

This study was conducted to confirm an interindividual variability in pharmacokinetic parameters of clomipramine in a large population of cats and to identify potential covariables that would explain the presence of such pharmacokinetic variability after a single dose of Clomicalm. Clomipramine hydrochloride was administered orally according to a weight-dose chart from 0.32 buy anafranil to 0.61 mg/kg, to 76 cats and five blood samples were then taken by direct venipuncture at 1, 3, 6, 12, and 24 h. Plasma concentrations of clomipramine and desmethylclomipramine (DCMP) were measured by LC-MS/MS. The Standard Two-Stage technique was used to assess differences and detect correlations between pharmacokinetic parameter estimates and individual covariables. A large interindividual variability in all pharmacokinetic parameters (CV% 64-124) was detected. Statistically significant gender-related differences were detected in MR and Cl/F, where female cats had a higher mean MR (0.53) and faster Cl/F (0.36 L/h.kg) than males (0.36 and 0.21 L/h.kg, respectively). No correlation could be found between clomipramine AUC0-24 h or DCMP AUC0-24 h and sedation scores. Further feline studies are required to assess these findings after multiple dosing of clomipramine and DCMP to allow clinical extrapolation.

anafranil dose range 2016-07-05

Although their problem is often as disabling as in chronic schizophrenia, most cases of obsessive-compulsive disorder have become eminently treatable by the behavioural approach of live exposure with response prevention. Treatment takes from 1 to 6 months depending on the severity of the problem, and may need an overall mean therapist time of +/- 8 hours time per patient. Most psychiatrists can learn to apply the treatment quite quickly, and most patients can be treated on an outpatient basis. About 25% of patients refuse or do not complete behavioural treatment. Improvement has endured over the 5-year follow-ups available. Occasional cases need brief booster period during followup. In exposure treatment the sufferer is persuaded to come into prolonged contact with discomfiting cues that bring on the rituals, without ritualising, so that the ensuing anxiety and urge to ritualise can subside to the point of habituation. The contact should be for at least an hour daily, and should gradually involve all ritual-evoking cues. The patient should record all exposure tasks done in a daily self-exposure diary. The therapist does not need to do the exposure with the patient, his role being to educate the patient in what to do and to monitor and praise progress. Therapist-accompanied exposure is largely redundant. Where family members are involved in the rituals they need to be coopted, with the patient's agreement, as exposure buy anafranil cotherapists and taught in role rehearsal with the patient to withhold requests for reassurance. Antidepressant drugs are a useful adjuvant to exposure therapy when the patient's obsessive-compulsive problem is complicated by dysphoria.

anafranil 250 mg 2017-10-18

Sexual dysfunction (SD) is common in type 2 diabetic men, but few subjects are diagnosed and treated. The prevalence of diabetes mellitus is increasing worldwide. It is expected that the number of subjects suffering from SD increases in the near future. Most studies of SD in diabetic men have focused on erectile dysfunction. There is a dearth of studies in the area of the other forms of SD. SD has consequences on the psychological well-being and reproductive function. They can be the first symptom of comorbidities or a treatment side effect. Erectile dysfunction is increasingly being recognised as an early marker of organic incipient systemic disease. Evaluation for any SD includes buy anafranil a complete medical history, detailed sexual history, physical examination, psychosocial assessment and, sometimes, complementary studies. Initial treatment of any SD should eliminate any modifiable factor that may lead to or aggravate the dysfunction. Phosphodiesterase type 5 inhibitors are the preferred therapy for most men with organic erectile dysfunction who do not have a specific contraindication to their use. Pharmacological treatment of premature ejaculation includes on-demand or daily dosing of certain selective serotonin reuptake inhibitors or clomipramine and on-demand topical local anaesthetics. Delayed ejaculation and anejaculation due to vascular or neuropathic damage are usually irreversible. The issue of infertility in patients with anejaculation or retrograde ejaculation seeking to have children should be addressed. No study specifically conducted in diabetic men on the treatment of hypoactive sexual desire disorder, apart from that occurring in the context of hypogonadism, has been published.

anafranil drug insert 2017-02-03

Mean difference in mean arterial pressure between Intralipid- and saline solution-treated groups was 21.1 mm Hg (95% confidence interval [CI] 13.5 to 28.7 mm Hg) and 19.5 mm Hg (95% CI 10.5 to 28.9 mm Hg) at 5 and 15 minutes, respectively. Mean difference in mean arterial pressure between Intralipid- and bicarbonate-treated groups was 19.4 mm Hg (95% CI 18.8 to 27.0 mm Hg) and 11.5 mm Hg (95% CI 2.5 to 20.5 mm Hg) at 5 and 15 minutes. The rate of change in mean arterial pressure was greatest in the Intralipid-treated group at 3 minutes (6.2 mm Hg/min [95% CI 3.8 to 8.6 mm Hg/min] Intralipid versus -0.25 mm Hg/min [95% CI -1.9 to 1.4 mm Hg/min] saline solution) and 5 minutes (4.4 mm Hg/min [95% CI 3.0 to 5.9 mm Hg/min] Intralipid versus 0.06 mm Hg/min [95% CI -0.9 to 1.1 mm Hg/min] saline solution). In the second phase of the experiment spontaneous circulation was maintained in all Intralipid-treated rabbits (n=4). All animals in the bicarbonate-treated group developed pulseless electrical activity and proved refractory to resuscitation at 10 minutes (n buy anafranil =4, P=.023).

anafranil ocd reviews 2017-07-17

Since the discovery that clomipramine was effective in the treatment of obsessive-compulsive disorder (OCD), trials of several different medications for OCD have been published. The question of which agent, if any, is the medication of choice in OCD is of real clinical concern. Published buy anafranil clinical trials were collected using computerized search on MedLine and PsychLit. Trials that met predetermined criteria were included in a meta-analysis. Analyses of variance were used to compare the specific effect sizes of different medications in OCD. In placebo-controlled trials, serotonin reuptake inhibitor (SRI) type had a significant effect on medication effect size, with clomipramine more effective than fluoxetine. Although this finding did not alter when trials were restricted to those with large numbers of subjects (n > 50), the analysis was based on a very limited number of studies. The fact that so few placebo-controlled studies have been done in OCD compromises the findings of this meta-analysis. It would be premature to extrapolate the results to clinical practice, where clomipramine and certain selective SRIs are currently and justifiably used as first-line agents. Nevertheless, the current study supports previous work suggesting that increased serotonergic specificity is not necessarily correlated with greater efficacy in the treatment of OCD. Further head-to-head comparison studies are necessary to confirm or refute this preliminary impression.

anafranil 125 mg 2016-10-30

Clomipramine, a tricyclic antidepressant, has been used in the treatment of obsessive neurosis successfully. In the course of treatment with this medication, sexual disorders in the form of decreased libido and impotence were noticed in three patients whose cases are reported. These disturbances occurred in the first week and lasted during the course of treatment. Upon withdrawal of the medication, the side effects disappeared. These side effects seem to be more common than is usually thought. The physician should be alerted to them as they can be a source of noncompliance. Lanoxin Dosage Iv

anafranil 100 mg 2015-10-04

Painful diabetic neuropathy is a common, difficult-to-manage complication of diabetes. We report two case of intractable painful diabetic neuropathy which occurred after the rapid lowering of blood sugar level. Although pregabalin, antidepressants, opioid analgetics and Singulair Tablet 5mg various nerve block did not improve their pain, clomipramine dramatically reduced their pain.

anafranil drug interactions 2017-11-15

ATP is a potential marker of cell vialibility and growth. The content of ATP and 3H-valine incorporation into proteins were measured and the morphometry was performed after antidepressant treatment of astrocytes cultured in vitro with or without dibutyryl 3'5'-cyclic adenosine monophosphate (dB-cAMP). Antidepressants were added into the culture medium (for 24 h) at a final concentration of 10(-4)M (imipramine, amitriptyline, clomipramine, doxepine, mianserin) or 10(-5)M (maprotiline). It was shown that all antidepressants except maprotiline and imipramine increased ATP level and decreased 3H-valine incorporation into astrocytes. All drugs except clomipramine and maprotiline, diminished cell area and perimeter of astrocytes. The addition of dB-cAMP to cultures caused an increase Ilosone Dosage of astrocyte form factor. It can be concluded that antidepressants have a significant effect on energy metabolism and differentiation of astrocytes cultured in vitro.

anafranil overdose 2015-07-13

The SNRIs may represent Famvir 250 Mg a valid alternative to the SSRIs, particularly in specific cases. Double-blind, placebo-controlled studies are, however, needed to confirm the positive findings reported by several studies with venlafaxine.

anafranil ocd dose 2017-10-12

The cardiovascular effects and toxicity of tricyclic antidepressants (TCAs) have been well documented in medical literature. The most common manifestation of such effects is slowing of intraventricular conduction, manifested by prolonged PR, QRS and QT intervals on the standard electrocardiogram (ECG) and postural hypotension. In contrast to TCAs, selective serotonin reuptake inhibitors (SSRIs), including fluoxetine and citalopram, are considered to cause less effect on cardiac impulse conduction. In addition, these compounds induced significantly less anticholinergic, antihistaminergic and cardiotoxic side-effects than TCAs. However, there is an Risperdal Tablets increasing number of case reports on dysrhythmias, like atrial fibrillation or bradycardia and syncope associated with fluoxetine and another SSRI treatment and overdose. Although such reports have not been common, they do raise concerns. In cardiac tissues isolated from canine, rabbit, rat and guinea pig hearts we have found that fluoxetine and citalopram inhibited cardiac Na+ and Ca2+ channels. These direct cardiac electrophysiological effects were similar to those of observed for tricyclic antidepressants clomipramine and imipramine. The inhibition of cardiac Ca2+ and Na+ channels by fluoxetine may explain most cardiac side-effects observed occasionally with the drug and mild but significant bradycardia reported during chronic treatment. Our results suggest that fluoxetine and citalopram may have antiarrhythmic (class I + IV type), as well as proarrhythmic properties (due to impairment of atrioventricular or intraventricular conduction and shortening of repolarization). Taking all these into consideration, in depressed patients having also severe cardiac disorders, ECG control may be suggested during fluoxetine and probable another SSRI therapy. The primary goal of this review is to compare these direct cardiac effects of fluoxetine and citalopram to those of previously reported for TCAs. This paper also summarizes the recently observed effects of fluoxetine apparently not related to the blockage of 5-HT transporter based on literature.

anafranil tablet 2017-09-04

Developments in the neurosciences, neuropharmacology Cardura Dosage Range and in cognitive/behavioural therapy have helped in providing effective treatment for OCD. That OCD can be treated successfully is likely to lead to greater public demands on clinicians for diagnosis and treatment. It is thus hoped that the quality of life for sufferers will improve and the secretiveness and shame they now feel about their illness will no longer occur.

anafranil buy online 2017-11-29

Tourette's syndrome (TS) is a chronic neuropsychiatric disorder characterized by multiform motor and phonic tics. Conditions that are commonly associated with TS include attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). Medications used to treat tics include haloperidol, pimozide, and clonidine. Symptoms of ADHD may respond to clonidine or desipramine. Specific serotonin uptake inhibitors, such as fluoxetine or clomipramine, are used in the treatment of OCD symptoms. The decision to use medication and the monitoring of its impact require careful assessment of the Omnicef O Tablet child's overall development and not only the presence of tic symptoms.

anafranil generic name 2017-10-28

25 patients with therapy-resistant depressive syndromes of various origins were treated by the infusion of high Hydiphen doses, a very effective thymoleptic drug with no dissociation between its drive increasing and spirit raising actions. Voltaren Gel 60g The results yielded by this treatment varied from good to very good in respect of endogenic depressions, in which the mood was observed to change at doses between 150 and 425 mg/d, depending on the severity of the depression. The results of this treatment were less satisfactory in the case of reactive and bran-organically induced depressions.

anafranil therapeutic dose 2016-03-04

The tricyclic and related antidepressants reduce monoamine uptake at the synapses, block the Bactrim 250 Mg presynaptic receptors and, after chronic administration, act upon the synthesis of the monoamines and the sensitivity of the post-synaptic receptors. The NA and 5-HT synapses are influenced to different degrees by the antidepressants: for example, desipramine has a preponderance of activity at NA synapses and clomipramine at 5-HT synapses. By combining these findings and by highlighting one or other of these properties, it is possible to come to diametrically opposite conclusions upon the effect of the antidepressants upon monoamine performance (activation or inhibition) and to develop many models of the mechanisms of antidepressant action. The authors describe some of these and stress the model which is at the basis of the studies being carried out at the Department of Psychiatry of the University of Geneva.

anafranil 20 mg 2015-07-31

Obsessive-compulsive disorder (OCD) is a chronic illness that affects 2-3% of Americans during their lifetime. It is characterized by recurrent obtrusive thoughts (obsessions) that compel patients to perform repetitive behaviors that can be excessively time consuming and cause marked distress. More than 40 controlled trials have been published on the treatment of OCD. Of drugs available to treat the disorder, serotonin reuptake inhibitors (SRIs) are most studied. With SRIs, symptoms improve in 22-62% of patients, but complete remission is rare. An agent is often selected based on side effects and patient tolerance, since SRIs are all equally effective. If no response is seen with average dosages, dosages should be increased to the maximum within 4-8 weeks from starting treatment. In patients with partial response, the dosage should be increased to the maximum by 5-9 weeks. Before determining the effectiveness of therapy, a trial of 8-13 weeks is necessary.

anafranil online 2015-07-30

The obsessive-compulsive disorder has only recently been recognized as a specific pathological entity in children, despite the fact that the first descriptions of pediatric manifestations date back to the beginning of this century (P. Janet, 1903) with further reports having been published regularly since that time. The first assessment of the complete epidemiologic, clinical and functional repercussions of the obsessive-compulsive disorder was reported by the Pediatric Psychiatric Group of the NIMH (Pr Judith Rapoport); of their various publications, one is well known in France: The Child who Couldn't Stop Washing (17). Among possible reasons for this delayed recognition are the special conditions for diagnosis and the frequent underestimation of its importance by the family, and sometimes by doctors. This underassessment could be due to confusion between the normal developmental rituals which are frequently seen between the ages of 3 and 5 years, and which do not cause any particular handicaps, and a more severe symptomatology which interferes with normal academic and social adaptation, presenting a substantially worse long-term prognosis. Having recognized the disorder, questions have arisen as to its possible linkage with the form seen in adults. There are numerous convergent argument suggesting a certain long-term persistence of this disorder throughout development and later life: 1) the relative stability of the incidence and prevalence of the disorder; 2) phenomenologic and developmental similarities; 3) most recently, comparable efficacy of treatments for pediatric and adult obsessive-compulsive disorder, whether by the behavioral modification approaches or by pharmacologic treatment, notably with the serotonin re-uptake inhibitors (clomipramine, fluoxetine, fluvoxamine).(ABSTRACT TRUNCATED AT 250 WORDS)

anafranil 30 mg 2017-02-11

Twenty-nine (53%) of the 55 patients and none of the 22 control subjects had a positive result in the B-HUT. With Clom-HUT, the proportion of patients who experienced a positive response increased to 80% (n = 44), although this happened to only one control subject. Prolactin and cortisol plasma levels increased significantly in the positive Clom-HUT patient group only.

anafranil generic 2015-03-01

Twenty four in-patients with an endogenous or non endogenous depressive syndrome (9 and 15, respectively) were treated in hospital for 21 days with various dosages regimens of clomipramine. Plasma concentrations of clomipramine and demethylclomipramine were determined once a week in blood samples. Therapeutic effects were assessed with Hamilton Rating Scale. At day 21, optimal therapeutic effect was observed when the sum of clomipramine and demethylclomipramine plasma levels was situated between 200-400 ng/ml.

anafranil 10mg dosage 2017-10-13

Animal models of drug-seeking suggest that exposure to cues associated with self-administered drugs and drug primes might precipitate relapse via activation of central dopaminergic substrates.

anafranil missed dose 2016-02-15

This is a retrospective study to add to the existing body of clinical information regarding male sexual side effects associated with antidepressants. From the chart review, thirty-four out of eighty male patients were identified to have reported loss of libido, erectile difficulty, anorgasmia, and delayed ejaculation while receiving pharmacotherapy of selective serotonin reuptake blockers (fluoxetine, paroxetine, and sertraline); tricyclic antidepressants (nortriptyline, imipramine, amitriptyline, desipramine, and clomipramine); and a monoamine oxidase inhibitor (phenelzine).