Antidepressant Medications Anti-depressant Drugs Antidepressant: imipramine, Tofranil

Antidepressant: imipramine, Tofranil

Generic Name: imipramine
Brand Name(s): Tofranil
Common Use: Antidepressant

Imipramine is a tricyclic antidepressant with general pharmacological properties similar to those of structurally related tricyclic antidepressant drugs such as amitriptyline and doxepin. It possesses anticholinergic properties which are responsible for certain of its side effects.

For the relief of symptoms of depression.
Imipramine may also be useful as temporary adjunctive therapy in reducing enuresis in children aged 5 years and older, after possible organic causes have been excluded by appropriate tests. In patients having daytime symptoms of frequency and urgency, examination should include voiding cystourethrography and cytoscopy, as necessary. The effectiveness of treatment may decrease with continued drug administration.

Imipramine should not be given in conjunction with, or within 14 days of treatment with a MAO inhibitor. Combined therapy of this type could lead to the appearance of serious interactions such as hypertensive crises, hyperactivity, hyperpyrexia, spasticity, severe convulsions or coma and death may occur.

Adverse Side Effects

The following adverse effects have been reported with imipramine or other tricyclic antidepressants.

Frequently: Tremors. Occasionally: drowsiness, fatigue, insomnia, dizziness, headache, paresthesia (numbness, tingling sensation, symptoms suggestive of peripheral neuropathy). Rarely: Epileptic seizures. In isolated cases: Tinnitus, incoordination, ataxia, alterations in EEG patterns, extrapyramidal symptoms, myoclonus, speech disorders. Dry mouth and rarely associated sublingual adenitis, blurred vision, disturbances of accommodation, constipation, perspiration, flushing. Occasionally: Delayed micturition, dilation of the urinary tract. In isolated cases: Mydriasis, glaucoma, paralytic ileus, urinary frequency.

Occasionally: Confusional states (especially in the elderly) with hallucinations, disorientation, delusions, anxiety, agitation, restlessness, nightmares, hypomania, mania, exacerbation of psychosis, decrease in memory, feeling of unreality. In isolated cases: Feeling of weakness, aggressiveness. Nausea, vomiting, anorexia. Rarely: Elevated transaminases. In isolated cases: Diarrhea, bitter taste, stomatitis, epigastric distress, abdominal cramps, black tongue, dysphagia, increased salivation, hepatitis with or without jaundice. Skin rash, urticaria.Increased or decreased libido, impotence.

Frequently: Weight gain.

In isolated cases: Gynecomastia in the male, breast enlargement and galactorrhea in the female, testicular swelling, elevation or depression of blood sugar levels, weight loss, inappropriate antidiuretic hormone (ADH) secretion syndrome. itching, photosensitization (avoid excessive exposure to sunlight), edema (general or of face and tongue), drug fever, obstructive jaundice, nasal congestion, alopecia, cross-sensitivity with desipramine

If treatment is terminated abruptly, withdrawal symptoms, such as gastrointestinal upsets, nervousness, anxiety, and muscle twitching may occur.

Overdose

Children have been reported to be more sensitive than adults to an acute overdosage of imipramine. An acute overdose in infants or young children must be considered serious and potentially fatal.These may vary in severity depending upon factors such as the amount of drug absorbed, the age of the patient and the interval between drug ingestion and the start of treatment. Blood and urine levels of imipramine may not reflect the severity of poisoning; they have chiefly a qualitative rather than quantitative value, and are unreliable indicators in the clinical management of the patient.

Drowsiness, stupor, ataxia, vomiting, cyanosis, restlessness, agitation, delirium, severe perspiration, hyperactive reflexes, muscle rigidity, athetoid movements, convulsions, respiratory depression, hyperpyrexia, hypothermia, mydriasis, and bowel and bladder paralysis may occur.

Therefore, patients who may have ingested an overdosage of imipramine, particularly children, should be hospitalized and kept under close surveillance.

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