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Imipramine

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Imipramine (sold as Antideprin®, Janimine®, Tofranil®) is an antidepressant medication, a tricyclic antidepressant of the dibenzazepine group, mainly used in the treatment of clinical depression and enuresis.

Imipramine was, in the late 1950s, the first tricyclic antidepressant to be developed (by Ciba-Geigy). Initially, it was tried against psychotic disorders (e.g. schizophrenia), but proved insufficient. During the clinical studies its antidepressant qualities, unsurpassed until today, became evident. Subsequently it was extensively used as standard antidepressant and later served as a prototypical drug for the development of the later released tricyclics. It is not as commonly used today but sometimes used to treat major depression as a second-line treatment. It has also seen limited use in the treatment of migraines, ADD and post concussive syndrome. Imipramine has additional indications for the treatment of panic attacks and chronic pain. In pediatric patients it is relatively frequently used to treat pavor nocturnus and nocturnal enuresis.

Mechanism of Action

Imipramine, a tertiary amine, inhibits the reuptake of serotonin more so than most secondary amine tricyclics, meaning that it blocks the reuptake of neurotransmitters serotonin and noradrenaline almost equally.

Metabolism

Imipramine is converted to desipramine, another TCA, in the body.

Contraindications and Precautions

See Tricyclic antidepressants

Side effects

Some common side effects of the drug include: tremors, dry mouth, blurred vision, constipation, insomnia, drowsiness, perspiration, flushing and weight gain. Agitation, irritability, confusion, and delirium are also possible, particular in the elderly.

Dosage

Overdose

The symptoms and the treatment of an overdose are largely the same as for the other tricyclic antidepressants. Cardinal symptoms are cardial and neurological disturbances. Any intake by children should be considered as serious and potentially fatal.

External links


Monoamine oxidase inhibitors (MAOI):

Reversible Inhibitor of Monoamine oxidase A (RIMA):

Dopamine Reuptake Inhibitor (DARI):

Norepinephrine-dopamine reuptake inhibitors:

Norepinephrine Reuptake Inhibitor (NRI) or (NARI):

Serotonin-Norepinephrine Reuptake Inhibitor (SNRI):

Selective Serotonin Reuptake Inhibitor (SSRI):

Selective Serotonin Reuptake Enhancer (SSRE):

Tricyclic antidepressants (TCA):

Tetracyclic antidepressants:

Noradrenergic and Specific Serotonergic Antidepressant (NaSSA):

 


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