Trimipramine

What is Trimipramine

Trimipramine is an oral tertiary amine tricyclic antidepressant (TCA). This drug is considered one of the most sedating TCAs.

Trimipramine is FDA-approved to treat major depression in adult patients. The drug is not FDA-approved for use for treating depression in pediatric patients; suggestions for adolescent dosing are provided in manufacturer labels.

Trimipramine is noted for its favorable effect on sleep measures in depressed patients with co-existing sleep disturbances.

It is also beneficial to adult patients with depression accompanied by anxiety.

Trimipramine was approved by the FDA in 1979.

The FDA requires a boxed warning detailing the increased risk of suicidality in children, adolescents, and young adults in product labels. A Patient Medication Guide (MedGuide) should accompany all prescriptions for antidepressants.

Brand Name

Surmontil

Indications

  • depression

Side Effects

  1. abdominal pain
  2. agitation
  3. agranulocytosis
  4. alopecia
  5. anorexia
  6. anxiety
  7. appetite stimulation
  8. ataxia
  9. blurred vision
  10. breast enlargement
  11. confusion
  12. constipation
  13. cycloplegia
  14. delirium
  15. depression
  16. diabetes mellitus
  17. diarrhea
  18. dizziness
  19. drowsiness
  20. dysarthria
  21. dysgeusia
  22. dyskinesia
  23. dyspepsia
  24. dystonic reaction
  25. edema
  26. EEG changes
  27. ejaculation dysfunction
  28. elevated hepatic enzymes
  29. eosinophilia
  30. erythema
  31. fatigue
  32. fever
  33. flushing
  34. galactorrhea
  35. glossitis
  36. goiter
  37. gynecomastia
  38. hallucinations
  39. headache
  40. heart failure
  41. hepatic failure
  42. hepatitis
  43. hyperhidrosis
  44. hypertension
  45. hyperthermia
  46. hyperthyroidism
  47. hyponatremia
  48. hypothyroidism
  49. ileus
  50. impotence (erectile dysfunction)
  51. increased urinary frequency
  52. insomnia
  53. jaundice
  54. leukopenia
  55. libido decrease
  56. mania
  57. memory impairment
  58. mydriasis
  59. myocardial infarction
  60. nausea
  61. neuroleptic malignant syndrome
  62. nightmares
  63. ocular hypertension
  64. ocular pain
  65. orthostatic hypotension
  66. palpitations
  67. paresthesias
  68. parotitis
  69. peripheral neuropathy
  70. petechiae
  71. photosensitivity
  72. PR prolongation
  73. pruritus
  74. pseudoparkinsonism
  75. psychosis
  76. purpura
  77. pyrosis (heartburn)
  78. QT prolongation
  79. rash
  80. restlessness
  81. seizures
  82. serotonin syndrome
  83. SIADH
  84. sinus tachycardia
  85. stomatitis
  86. stroke
  87. suicidal ideation
  88. testicular swelling
  89. thrombocytopenia
  90. tinnitus
  91. tongue discoloration
  92. tremor
  93. urinary retention
  94. urticaria
  95. ventricular tachycardia
  96. vomiting
  97. weakness
  98. weight gain
  99. withdrawal
  100. xerophthalmia
  101. xerostomia
  102. yawning

Monitoring Parameters

  • blood pressure
  • ECG
  • heart rate
  • LFTs
  • serum trimipramine concentrations
  • thyroid function tests (TFTs)

Contraindications

  • abrupt discontinuation
  • acute myocardial infarction
  • agranulocytosis
  • alcoholism
  • anticholinergic medications
  • bipolar disorder
  • bradycardia
  • breast-feeding
  • carbamazepine hypersensitivity
  • cardiac arrhythmias
  • cardiac disease
  • children
  • closed-angle glaucoma
  • coadministration with other CNS depressants
  • congenital heart disease
  • contact lenses
  • coronary artery disease
  • diabetes mellitus
  • driving or operating machinery
  • electroconvulsive therapy (ECT)
  • ethanol ingestion
  • females
  • geriatric
  • heart failure
  • hepatic disease
  • hypertension
  • hyperthyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothyroidism
  • ileus
  • increased intraocular pressure
  • leukopenia
  • long QT syndrome
  • malnutrition
  • mania
  • MAOI therapy
  • myocardial infarction
  • neonates
  • pheochromocytoma
  • pregnancy
  • prostatic hypertrophy
  • QT prolongation
  • radiographic contrast administration
  • schizophrenia
  • seizure disorder
  • seizures
  • suicidal ideation
  • sunlight (UV) exposure
  • surgery
  • tobacco smoking
  • tricyclic antidepressant hypersensitivity
  • urinary retention

Interactions

  • Abarelix
  • Abiraterone
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acetazolamide
  • Acetylcholine Chloride
  • Acrivastine; Pseudoephedrine
  • Albendazole
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  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
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  • Brompheniramine; Pseudoephedrine
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  • Chlordiazepoxide; Clidinium
  • Chloroquine
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  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
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  • Dextromethorphan; Guaifenesin
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  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
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  • food
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  • Hydrocodone; Pseudoephedrine
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