Trimipramine
Mechanism :
Trimipramine is an antidepressant with an anxiety-reducing sedative component to its action. The mode of action on the central nervous system is not known. However, unlike amphetamine-type compounds it does not act primarily by stimulation of the central nervous system. It does not act by inhibition of the monoamine oxidase system.
Indication :
- Depression
- Nocturnal enuresis
Contraindications :
Trimipramine is contraindicated in patients who have shown prior hypersensitivity to it and in acute porphyria, hepatic impairment and cardiovascular disease.
Dosing :
>12 years:
50 mg initially. Max: 100 mg/day.
Adverse Effect :
Mainly anticholinergic effects, sedation, postural hypotension, tremor, sweating, arrhythmia, increased appetite and weight gain, sexual dysfunction and lowered seizure threshold.
Interaction :
MAOIs: Hyperpyretic crises, severe convulsions, and deaths have occurred in patients receiving tricyclic antidepressant and monoamine oxidase inhibiting drugs simultaneously
OCPs, Calcium Channel Blockers, Cimetidine, Phenothiazines, SSRIs: Plasma concentration of trimipramine increased.
Rifampicin, Anti-Coagulants: Decreased plasma concentration of trimipramine.
Sedatives, hypotensives, drugs that prolong QT interval: Increased effects of these drugs.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
Dose adjustment guidelines are not available. Use cautiously. Dose reduction may be needed.