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Imipramine – Usages, Side effects, Risk factors, Precautions
Here in this post, we are discussing the “Imipramine”. You can read usages, side effects, Risk factors, and warning information. Keep visiting Psychology Roots.
About Imipramine
Imipramine is an antidepressant TCAs.
Brand name
Imipramine is available with the following brand name.
● Tofranil
● Tofranil- PM
Forms of Imipramine
Imipramine is available in the following form
- Tablet
- Capsule
Tablet
Imipramine tablets are available in the following doses
- 10mg
- 25mg
- 50mg
Capsule
Imipramine capsules are available in the following doses
- 75mg
- 100mg
- 125mg
- 150mg
Disorder to treat
It is used for the treatment of the following disorder
● Depression
Depression
Adults
● Initially, 75mg orally per day is given.
● It may increase to 150 mg per day gradually
● It should not exceed 200 mg per day
● It may give in divided doses or single doses at bedtime.
● Maintenance dose: 50-100 mg orally per day.
Children
● 1.5 mg/kg/day PO divided q8hr; may increase every 3-4 days by 1 mg/kg; not to exceed 5 mg/kg/day
Adolescents
● 30-40 mg per day orally is given in a divided dose every day or divided every 8hr.
● It should not exceed to 100 mg per day.
Older Adults
● 5-50 mg orally daily at bedtimes.
● It may increase weekly.
● It should not exceed to 100 mg per day.
Adverse effects
There are the following side effects of Clomipramine:
- Fatigue
- Weakness
- Constipation
- Sedation
- Blurred vision
- Lethargy
- Insomnia
- Anxiety
- Dry mouth
- Vomiting
- Agitation
- Headache
- Nausea
- Sweating
- Rash
- ECG changes, orthostatic hypotension, tachycardia
- Increased LFTs
- Sexual dysfunction
- Eosinophilia
- Seizures
- Thrombocytopenia
- Confusion, extrapyramidal symptoms (EPS), dizziness, paresthesia, tinnitus
- Agranulocytosis
- SIADH
- Leukopenia
Warnings
Following are the warnings that must know while using Imipramine
- In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 yr of age) taking antidepressants for major depressive disorders and other psychiatric illnesses.
- This increase was not seen in patients aged >24 years. A slight decrease in suicidal thinking was seen in adults >65 years.
- In children and young adults, risks must be weighed against the benefits of taking antidepressants.
- Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies. This should be done during the initial 1-2 months of therapy and dosage adjustments.
- The patient’s family should communicate any abrupt changes in behavior to the healthcare provider.
- Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy.
- This drug is not approved for use in pediatric patients.
Contraindications
There are the following contraindications of Clomipramine
- Hypersensitivity.
- Acute recovery post-MI
Cautions
- BPH, urinary/GI retention, hyperthyroidism, seizure disorder, brain tumour, respiratory impairment.
- Risk of anticholinergic side effects
- Risk of mydriasis; may trigger angle closure attack in patients with angle-closure glaucoma with anatomically narrow angles without a patent iridectomy.
- Clinical worsening and suicidal ideation may occur despite medication
- Potentially life-threatening serotonin syndrome reported when coadministered with drugs that impair serotonin metabolism (in particular, MAOIs, including non-psychiatric MAOIs, such as linezolid and IV methylene blue)
- May cause sedation and impair physical or mental abilities.
- Do not discontinue abruptly for prolonged high dosage.
- May cause bone marrow suppression.
- May cause orthostatic hypotension.
Pregnancy
Lactation
It is distributed in breast milk.
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