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Anafranil (Clomipraminum, Clomipramine) - tricyclic antidepressant, an inhibitor of the reuptake of norepinephrine and serotonin. Anafranil effect on depressive symptoms in general, including especially in its typical manifestations such as a psychomotor retardation, depressed mood, and anxiety. The clinical effect is usually observed within 2-3 weeks of treatment. In addition, Anafranil has a specific (distinct from its antidepressant effect) effects in obsessive-compulsive disorders. Action Anafranil in chronic pain syndromes, both due and not due to medical illness, probably associated with the transmission of nerve impulse relief mediated by serotonin and noradrenaline.
Pregnancy and breast-feeding:
Experience with Anafranil in pregnancy is limited. As known to the individual reports of a possible association between tricyclic antidepressants and impaired fetal development, Anafranil should be avoided during pregnancy except in cases where the expected effect of the treatment of the mother certainly outweighs the potential risk to the fetus.
In cases where the tricyclic antidepressants used in pregnancy up until the birth, the newborn within the first few hours or days of developing the syndrome, which is manifested by shortness of breath, lethargy, colic, irritability, hypotension or hypertension, tremor, cramps or spastic phenomena. In order to avoid the development of this syndrome Anafranil should be possible to gradually canceled at least 7 weeks before the expected birth.
Since the drug active substance is excreted in breast milk, you should either stop breast-feeding or phased Anafranil.
During treatment requires regular Anafranil determination of cellular composition of the blood and liver function.
Before starting therapy should be corrected hypokalemia.
Dosage regimen and mode of administration of the drug is determined individually, taking into account the patient's condition. The goal of treatment is to achieve an optimal effect when using the lowest possible doses and their gentle increase. It should be particularly careful when increasing the dose in elderly patients and adolescents, who are generally more sensitive to the drug Anafranil than patients of intermediate age groups.
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Depression, obsessive-compulsive syndromes and phobias
The initial daily dose is 75 mg; Anafranil prescribed medication 25 mg 2-3 times a day or Anafranil SR 75 mg 1 time a day (preferably in the evening). Then, during the first week of treatment, the dose was gradually increased, for example, at 25 mg every several days (depending on tolerance), to achieve the daily dose is 100-150 mg. In severe cases, the daily dose may be increased to a maximum of 250 mg. Once improvement is reached, the patient is transferred to a maintenance dose, 50-100 mg of component (Table 2-4. Anafranil drug or Table 1. Anafranila CP preparation).
Panic attacks, agoraphobia
Anafranil initial dose of the drug is 10 mg / day. Then, depending on the tolerability Anafranil drug, the dose was increased to achieve the desired effect. Anafranil daily dose of the drug varies greatly and can range from 25 to 100 mg. If necessary, may increase the dose to 150 mg / day. It is recommended not to stop the treatment for at least 6 months, decreasing slowly during the time a maintenance dose of the drug.
Cataplexy, accompanying narcolepsy
Anafranil daily dose of the drug is 25-75 mg.
Chronic pain syndromes
The mode set individually. Anafranil daily dose of the drug varies greatly and can range from 10 mg to 150 mg. It should take into account the concomitant analgesic drugs and the possibility of reducing the use of the latter.
Elderly patients. The initial dose is 10 mg / day. Then slowly, over about 10 days, the daily dose is increased to an optimal level, which is 30-50 mg.
Children and adolescents
The initial dose is 25 mg / day. During the first 2 weeks gradually increase the dose, based on tolerability to achieve a daily dose of 100 mg, or the calculated rate of 3 mg / kg - depending on whether the dose is less. Over the next few weeks, the dose is gradually increased to continue to achieve a daily dose of 200 mg, or the calculated rate of 3 mg / kg - depending on whether the dose is less.
The initial daily dose of the drug Anafranil for children aged 5-8 years is 20-30 mg; for children aged 9-12 years - 25-50 mg; for children over 12 years - 25-75 mg. The use of higher doses indicated for patients who have completely no clinical effect after 1 week of treatment. Typically all the daily dose administered in one portion after dinner, but in those cases where the incontinent noted in the early hours of the night, the dose of the drug administered before Anafranil -. After 16 hours to achieve the desired effect of the treatment should be continued for 1-3 months, gradually reducing the dose of the drug Anafranil.
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