Imipramine belongs to the group of tricyclic antidepressants and is a dibenzazepine-derivative TCA. This medicine is indicated for the treatment of various mood conditions like depression and as temporary adjunctive therapy in reducing enuresis in children aged 6 years and older.
Other indications are attention-deficit/hyperactivity disorder ADHD, bulimia nervosa, eating disorders, major depressive disorder, neuropathic pain, panic attacks, anxiety and agoraphobia.
Imipramine can be applied in patients with symptoms of panic disorders, acute depressive episodes in bipolar disorder and schizophrenia. It can be used for symptomatic treatment of postherpetic neuralgia.
Unlabeled indications of treatment are: chronic and neuropathic pain such as diabetic neuropathy, and post-traumatic stress disorder (PTSD).
In all indications either structural or unlabeled the medicine should be taken only with a prescription of a doctor.
The off-label indication of Imipramine in patients with no signs of depression often has a goal to produce sedation.
Patients with symptoms of depression benefit from the treatment as soon as increase of serotonergic neurotransmission occurs due to the actions of Imipramine.
Imipramine is a potent inhibitor of serotonin and norepinephrine reuptake. It also blocks histamine H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for its sedative, hypotensive and anticholinergic effects. Urinary retention and sedation are due to the direct actions of Imipramine on serotonin reuptake and its anticholinergic effects.
When regularly used, Imipramine can be effective as a prophylaxis of migraine headaches.
The onset of action is observed usually as soon as 2-4 weeks after the medicine is started. The individual response to the treatment differs in patients.
Food can be used with this medicine. Still patients should avoid tea and coffee, and must not use alcohol. Imipramine is for oral administration.
Dose choice for adults and children is made with accordance to various factors.
Adult patients usually receive 1 tablet of Imipramine 25mg up to three times a day with the dose increase to 150-200mg. The increments of the dose should be steady to achieve the result and maintain it during the period of treatment.
Other dose adjustments are possible. Still the doses of 100 mg taken 3 times a day must be regulated and supervised by a caring doctor in clinical conditions.
Adult patients over the age of 60 usually respond to lower doses of this medicine. They are recommended to start with 10mg daily, gradually increasing to 30-50mg.
Children are prescribed Imipramine only for nocturnal enuresis. The medicine should be given right before bedtime. The medicine dose for children should not exceed 75 mg daily.
Contraindicating cases are: hypersensitivity to any of the excipients in the tablets of Imipramine, allergic reactions to any component, serious cardiac arrhythmias, recent myocardial infarction, liver or kidney disease.
Before starting treatment it is advisable to inform a doctor about all other medicines you use. Your doctor may adjust special tests before you begin the treatment.