Imipramine: Uses And Side Effects Of This Antidepressant
The first tricyclic antidepressant in history was imipramine, which appeared in 1951. Although this and other tricyclics were the most used drugs to treat depression for many decades, little by little they were replaced by other more effective medications, although imipramine It is still used in certain disorders, not just depressive disorders.
In this article we will analyze in detail The most important therapeutic uses and side effects of imipramine We will also describe the key pharmacological properties of this medication and explain in which cases its consumption is contraindicated.
Imipramine is a antidepressant medication of the tricyclic class, to which clomipramine, amitriptyline, doxepin, nortriptyline or desipramine also belong. Imipramine was the first of these drugs to be developed; The initial purpose was its use as a sedative in cases of schizophrenia and as an antihistamine.
Tricyclic antidepressants were for a long time the pharmacological treatment of choice in cases of depression. However, they have currently been relegated to the background due to the emergence of selective serotonin reuptake inhibitors (SSRIs) and other medications with higher degrees of specificity and tolerability.
The effects of imipramine are very broad, so it acts on different neurotransmitters; This explains both its therapeutic properties and the adverse reactions associated with its consumption. They are especially relevant agonist effects on serotonin and norepinephrine which take place through the inhibition of its reuptake.
Although imipramine has been marketed under different generic names, the best known of all is “Tofranil” since this brand was the one that popularized the product and continues to be sold in many countries today.
Imipramine, like other medications in the tricyclic class, is primarily used to treat symptoms on the depression spectrum. Research suggests that it is especially useful in cases in which depression is associated with anxiety-type symptoms particularly psychomotor agitation.
In this sense, imipramine is sometimes prescribed to people with disorders such as major depression, dysthymia (chronic, mild depression with marked anxiety), bipolar disorder, panic disorder and agoraphobia. It has also been applied in cases of attention deficit hyperactivity disorder, better known by the abbreviation “ADHD.”
The use of imipramine in the nocturnal enuresis treatment Its effectiveness in this disorder is due to the fact that this drug reduces the proportion of slow wave sleep phases, and it is in these when episodes of involuntary urination normally take place.
Adverse reactions and side effects
The most common adverse reactions associated with imipramine treatment include: drowsiness, feelings of dizziness, tachycardia, dry mouth, urinary retention and orthostatic hypotension (sudden decrease in blood pressure). Changes also occur in brain electrical activity, such as those related to sleep.
Other signs that affect the central nervous system and that have a somewhat lower frequency are anxiety, agitation, insomnia, nightmares, headaches, confusion or the appearance of tremors, seizures and other motor symptoms related mainly to the extrapyramidal system.
Imipramine also causes other physiological side effects Among these we find cardiovascular alterations (hypertension, palpitations, dysrhythmias…), blurred vision, nausea, vomiting, increased appetite, gastrointestinal discomfort (such as cramps), constipation, jaundice and pupillary dilation or mydriasis.
Overdose of imipramine or other tricyclic antidepressants causes blurred vision, mydriasis, confusion, drowsiness, and increased heart rate. The toxic dose is easier for children to achieve, and sometimes death may occur due to cardiac arrest if the alterations are not resolved quickly.
Even compared to other tricyclic antidepressants, imipramine has very intense pharmacological potency. Because of this and its interaction with receptors for multiple types of neurotransmitter, the use of imipramine should be avoided in numerous and varied circumstances.
This drug is contraindicated in people with a history of disorders such as alcoholism, hyperthyroidism, diabetes glaucoma, kidney and liver problems, epilepsy and particularly alterations of the cardiac system.
The consumption of imipramine is also not recommended if you are simultaneously taking drugs of different types, including barbiturates, monoamine oxidase enzyme inhibitors (MAOIs), SSRIs, lithium, methylphenidate, anticholinergics or buspirone, the medication choice for generalized anxiety disorder.
Currently the use of imipramine is somewhat discouraged due to its pharmacological profile, difficult to tolerate for many people and very unspecific regarding its effects on relevant neurotransmitters. However, it must also be taken into account that SSRIs and other modern antidepressants also cause significant adverse reactions.
