- What is trimipramine, and how does it work (mechanism of action)?
- What brand names are available for trimipramine?
- Is trimipramine available as a generic drug?
- Do I need a prescription for trimipramine?
- What are the side effects of trimipramine?
- What is the dosage for trimipramine?
- Which drugs or supplements interact with trimipramine?
- Is trimipramine safe to take if I'm pregnant or breastfeeding?
- What else should I know about trimipramine?
What is trimipramine, and how does it work (mechanism of action)?
Trimipramine is a tricyclic antidepressant (TCA) in the same family as amitriptyline (Elavil), imipramine (Tofranil), nortriptyline (Pamelor; Aventyl), and desipramine (Norpramin). Trimipramine works by raising the brain's level of norepinephrine (a neurotransmitter) to more normal levels. It also has anti-cholinergic actions (opposing the effects of the neurotransmitter, acetylcholine) which cause many of its side effects. Trimipramine also acts as a sedative. Trimipramine was approved by the FDA in June 1979.
What are the side effects of trimipramine?
Trimipramine may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. The anti-cholinergic effects of trimipramine may cause:
- short-term memory problems,
- impaired attention,
- dry mouth,
- difficulty urinating (especially in men with enlarged prostates),
- blurred vision,
- decreased sweating with increased body temperature,
- sexual dysfunction, and
- worsening of glaucoma.
Older adults are especially sensitive to the anti-cholinergic effects of trimipramine.
Sucking hard candy or chewing gum can help prevent dry mouth.
Trimipramine can increase a person's sensitivity to sunlight; patient's taking trimipramine should wear sunscreen and avoid sun exposure. Since trimipramine can impair the body's ability to sweat and adapt to hot environments, patients should avoid saunas and excessive heat. Trimipramine is used with caution in patients with seizures since it can increase the risk of seizures.
If trimipramine is discontinued abruptly headache, nausea, and general discomfort may occur. Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.
Antidepressants increased the risk of suicidal thinking and behavior in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of trimipramine or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thinking or behavior, and unusual changes in behavior.
Quick GuidePhysical Symptoms of Depression in Pictures
What is the dosage for trimipramine?
The usual starting dose for adults is 50 to 75 mg per day, split into equal, smaller doses (for example, 25 mg three times daily). Doses are gradually increased every 2 to 3 weeks.
Usual doses for long-term therapy may range from 50 to 150 milligrams daily and doses may be increase up to 200 mg per day if needed.
Hospitalized patients may receive up to 300 mg daily. This total daily dosage may be taken once daily at bedtime or spread throughout the day. Beneficial effects may not be seen until treatment at an appropriate dose is given for two to four weeks.
Which drugs or supplements interact with trimipramine?
Trimipramine increases the effects of other medications and drugs that slow the brain's processes, such as alcohol, barbiturates, benzodiazepines, for example, diazepam (Valium) or lorazepam (Ativan), zolpidem (Ambien) and narcotics. Reserpine, given to patients taking TCAs, can cause a stimulatory effect. Trimipramine and other TCAs should not be used with monoamine oxidase inhibiting drugs for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). High fever, convulsions and even death can occur when these drugs are used together. Trimipramine affects heart rhythm. Therefore, trimipramine should not be administered with amiodarone (Cordarone), sotalol (Betapace), quinidine, procainamide, and other drugs that also affect heart rhythm.
Is trimipramine safe to take if I'm pregnant or breastfeeding?
Safe use of trimipramine during pregnancy has not been established; therefore, if it is to be administered to pregnant patients or women of childbearing potential, the benefits must be weighed against the potential hazards to the fetus.
Safe use of trimipramine during lactation has not been established; therefore, if it is to be administered to nursing mothers, the benefits must be weighed against the potential hazards to the child.
What else should I know about trimipramine?
What preparations of trimipramine are available?
Capsules: 25, 50, and 100 mg
How should I keep trimipramine stored?
Capsules should be stored at room temperature, approximately 25 C (77 F).
Reference: FDA Prescribing Information
Quick GuidePhysical Symptoms of Depression in Pictures
Trimipramine (Surmontil) is a tricyclic antidepressant drug prescribed for the treatment of major depression. Side effects, drug interactions, and patient warnings should be reviewed prior to taking this medication.
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amitriptylineAmitriptyline (Endep [Elavil - this brand name drug is no longer available in the U.S.])is an antidepressant medication. In patients with depression, abnormal levels of brain chemicals called neurotransmitters may relate to their depression. Amitriptyline elevates mood by raising the level of neurotransmitters in brain tissue. Amitriptyline is also a sedative, and is useful in the treatment of insomnia, restlessness, and nervousness. It has also been found to be helpful in the treatment of fibromyalgia and symptoms related to chronic pain. It is extremely important to be aware of the drug interactions related to amitriptyline, effects on pregnancy and nursing mothers, as well as common side effects on the user.
Anticholinergic or antispasmodic (generic name) drugs include prescription medications used to treat a variety of medical conditions like:
- muscle spasms,
- breathing problems,
- movement disorders,
- motion sickness,
- and gastrointestinal cramps.
Examples of anticholinergic (antispasmodic) drugs include:
- Parkinson's disease medications,
- Benadryl, antipsychotics,
- and Levsin.
Examples of anticholinergic drugs for overactive bladder include:
- and Sanctura.
Examples of anticholinergic antidepressant medications include:
- and Norpranmin.
Examples of anticholinergic muscle relaxants include:
- and Norflex.
Anticholinergic motion sickness medications include:
- and respiratory medications.
Anticholinergic drug side effects, drug interactions, storage, dosing, and pregnancy and safety information should be reviewed prior to taking any medication.
Depression medications or antidepressants are drugs prescribed for treating depression. There are several types of drug classes of antidepressants including
- tricyclic antidepressants (TCAs),
- selective serotonin reuptake inhibitors (SSRIs),
- serotonin norepinephrine reuptake inhibitors (SNRIs), and
- monoamine oxidase inhibitors (MAOIs).
Side effects depend on the medication prescribed. Drug interactions, warnings and precautions, and pregnancy and breastfeeding safety should be reviewed prior to taking any medication.
DepressionDepression 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).
Depression in ChildrenChildhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Depression in the ElderlyDepression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants, psychotherapy, or electroconvulsive therapy.
desipramineDesipramine (Norpramin) is a medication prescribed for the treatment of depression. Off label uses include the treatment of anxiety, ADHD, cataplexy, chronic itching, bulimia, neuropathic pain, panic attacks, and depression caused by a traumatic brain injury. Side effects, drug interactions, warnings and precautions, and patient information should be reviewed prior to taking any medication.
Drug InteractionsDrug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.
imipramineImipramine (Tofranil, Tofranil-PM) is an antidepressant medication prescribed for the treatment of depression, bedwetting, and chronic pain. Side effects, drug interactions, pregnancy safety, and precautions should be reviewed prior to taking this medication.
nortriptylineNortriptyline (Pamelor, Aventyl) belongs to the drug class called tricyclic antidepressants (TCAs) and is used for treating depression. Off-label (non-FDA approved) use of nortriptyline (Pamelor, Aventyl) include attention deficit hyperactivity disorder (ADHD) in adults, children and adolescents, adjunctive therapy for chronic pain conditions. Side effects, warnings and precautions, drug interactions, and other drug information should be reviewed prior to taking this drug.