Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Imipramine is an antidepressant medication
of the tricyclic class. Medications in this class are often referred to as
tricyclic antidepressants or TCAs. Depression is defined as an all-pervasive
sense of sadness and gloom. In patients with depression, abnormal levels of
chemicals in the brain (called neurotransmitters) may be the cause of their
depression. These neurotransmitters are chemicals that the nerves in the brain
use to communicate with each other. Imipramine is believed to elevate mood by
raising the levels of neurotransmitters in the brain. Imipramine was first
synthesized in the late 1940s and was approved by the FDA for depression in 1959
and for enuresis in 1973. PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 10, 25 and 50 mg. Capsule: 75, 100, 125 and 150
mg.
STORAGE: Imipramine should be stored below 86 F (30 C) in a tight,
light resistant container.
PRESCRIBED FOR: Imipramine is FDA approved for treating depression and
enuresis (bedwetting). It is sometimes used off-label to treat chronic pain in
combination with other pain medications.
DOSING: The dose range for treating
depression is 75 to 300 mg daily. It may be given as a single dose or in divided
doses. The recommended dose for enuresis is 10 to 75 mg daily at bedtime.
DRUG INTERACTIONS: Other medications and drugs that slow the brain's
processes, such as alcohol, barbiturates, benzodiazepines, for example,
lorazepam (Ativan), diazepam (Valium), temazepam (Restoril), oxazepam (Serax),
clonazepam (Klonopin), zolpidem (Ambien), and narcotics, may add to the effect
of imipramine on the brain.
Reserpine, given to patients taking TCAs, can cause
agitation and anxiety. Imipramine and other TCAs should not be used with
monoamine oxidase inhibiting drugs, for example, isocarboxazid (Marplan),
phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane),
since high fever, convulsions and even death can occur.
Concurrent use of
cimetidine (Tagamet) can increase imipramine blood levels by reducing
elimination of imipramine from the body and possibly lead to imipramine- related
side effects. Other drugs which share this effect include propafenone (Rythmol),
flecainide (Tonocard), quinidine (Quinidex, Quinaglute), methylphenidate
(Ritalin), and fluoxetine (Prozac).
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Overactive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
ADHD afflicts approximately 3 percent to 5 percent of school-age children and an estimated 60 percent of those maintain the disorder into adulthood. Symptoms of adult ADHD include chronic lateness, anxiety, low self esteem, employment problems, difficulty controlling anger, impulsiveness, poor organization skills, procrastination, chronic boredom among others.
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder characterized by the symptoms hyperactivity, impulsivity, and inattention. Treatment for ADHD may involve behavioral therapy and psychostimulant or antidepressant medication.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common treatment methods include therapy and medications.
Narcolepsy, a chronic disease of the central nervous system causes have not been fully determined. Some theories include abnormalities in hypocretin neurons in the brain or an autoimmune disorder. Symptoms of narcolepsy include excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, disturbed nocturnal sleep, and automatic behavior. Diagnosis of narcolepsy is based on a clinical evaluation, specific questionnaires, sleep logs or diaries, and the results of sleep laboratory tests. Treatments of narcolepsy symptoms include medication and lifestyle changes.
There are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence, and overflow incontinence. Urinary incontinence in men may be caused by prostate or nerve problems. Treatment depends upon the type and severity of the UI and the patient's lifestyle.
Urinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection, surgery, medication, bladder stone, constipation, cystocele, rectocele, or urethral stricture. Symptoms include discomfort and pain. Treatment depends upon the cause of urinary retention.
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
People who have bladder spasms, the sensation occurs suddenly and often severely. A spasm itself is the sudden, involuntary squeezing of a muscle. A bladder spasm, or "detrusor contraction," occurs when the bladder muscle squeezes suddenly without warning, causing an urgent need to release urine. The spasm can force urine from the bladder, causing leakage. When this happens, the condition is called urge incontinence or overactive bladder.
Urinary incontinence in children (enuresis) is twice as common in boys as in girls and may occur during the daytime or nighttime. Nighttime urinary incontinence is also called bedwetting and sleepwetting. The cause of nighttime incontinence in children is unknown. Daytime incontinence in children may be caused by an overactive bladder. Though many children overcome urinary incontinence naturally, it may be necessary to treat incontinence with medications, bladder training and moisture alarms, which wake the child when he or she begins to urinate.
Bedwetting, or nocturnal enuresis, is the accidental passage of urine while asleep. There are two types of bedwetting: primary and secondary. Primary enuresis is bedwetting since infancy, and secondary enuresis is bedwetting after being consistently dry for at least six months.
A nerve problem might affect your bladder control if the nerves that are supposed to carry messages between the brain and the bladder do not work properly. Such problems include urine retention, poor control of sphincter muscles, and overactive bladder. Treatment depends upon the cause of the nerve damage and resulting type of bladder control problem.
An overactive bladder is a condition that results
from sudden, involuntary contraction of the muscle in the wall of the urinary
bladder. Overactive bladder causes a sudden and unstoppable need to urinate
(urinary urgency), even though the bladder may only contain a small amount of urine.
Overactive bladder is also referred to as urge incontinence
and is a form of urinary incontinence (unintentional loss of urine). Another common type of urinary incontinence is called stress incontinence, which is caused by anatomic weakness in the structures that prevent the bladder from leaking. In general, urinary incontinence is more common in women compared to men.
Although it can happen at any age, overactive bladder is especially common in older adults. Overactive bladder affects an estimated one in 11 adults in the United States. Overactive bladder, however, should not be considered a normal part of aging.
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