Anafranil vs. Luvox for Obsessive-Compulsive Disorder: Important Differences and Potential Risks.

Key takeaways

Clomipramine (Anafranil) and fluvoxamine (Luvox) are both used to treat obsessive-compulsive disorder (OCD), but they belong to different medication classes. Clomipramine is a tricyclic antidepressant (TCA), while fluvoxamine is a selective serotonin reuptake inhibitor (SSRI). Clomipramine can be used in children as young as 10 years old, whereas fluvoxamine can be used in children as young as 8 years old. Clomipramine often causes side effects like dry mouth, sleepiness, and weight gain, while fluvoxamine commonly causes nausea, sleep problems, and headache. Fluvoxamine is considered a first-choice treatment for OCD, but clomipramine is not due to its higher risk of side effects. Additionally, fluvoxamine has a higher risk of medication interactions compared to clomipramine. Both medications are available in generic forms, making them more affordable options.

Clomipramine

(Anafranil)

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Fluvoxamine

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Summary for Anafranil

Prescription only

Clomipramine (Anafranil) is a tricyclic antidepressant used to treat obsessive-compulsive disorder (OCD). It can be used by children as young as 10 years old. The medication is taken by mouth and your dosage might increase over several weeks. Clomipramine (Anafranil) isn't a first-choice medication because of the high risk for side effects such as dry mouth, sleepiness, weight gain, and headaches.

Indications for Anafranil

Obsessive-compulsive disorder (OCD)

Pros and Cons for Anafranil

Pros

Can help lessen unwanted thoughts and compulsions for people with OCD
Can be used in children as young as 10 years old
Dose can be adjusted by your provider based on your response
Available as a lower-cost generic

Cons

More likely to cause bothersome side effects compared with other medications for OCD
Can affect sex drive or sexual performance for men
Unknown if long-term use (more than 10 weeks) is safe
Careful use in people with certain medical conditions (e.g., overactive thyroid or glaucoma)

Common Side Effects for Anafranil

Dry mouth (63-84%)
Sleepiness (46-54%)
Dizziness (41-54%)
Tremor (33-54%)
Headache (28-52%)
Constipation (22-47%)
Sexual problems in males (6-42%)
Tiredness (35-39%)
Nausea (9-33%)
Sweating more (9-29%)
Trouble sleeping (11-25%)

Warnings for Anafranil

Suicidal thoughts or behavior
Mania
Serotonin syndrome
Seizures
Dizziness and falls
Eye problems (Angle-closure glaucoma)
Low sodium levels
Serious skin reactions

Summary for Luvox

Prescription only

Fluvoxamine maleate is an SSRI, or a selective serotonin reuptake inhibitor. It's approved to treat obsessive-compulsive disorder (OCD) in people ages 8 years and up. Fluvoxamine comes as immediate-release tablets taken by mouth once or twice a day. For adults, it also comes as extended-release capsules taken once a day. Your specific dosage depends on which form you're taking. Side effects include nausea, sleepiness or trouble sleeping, and headache. Fluvoxamine is a generic medication; the brand name Luvox is no longer available.

Indications for Luvox

Obsessive-compulsive disorder (OCD)

Pros and Cons for Luvox

Pros

A first-choice treatment option for OCD
Immediate-release tablets approved for children as young as 8 years old

Cons

Can cause a lot of side effects, like sleepiness, nausea, diarrhea, and dry mouth
Can interact with many medications, such as triptan migraine medications, antidepressants, and benzodiazepines