Imipramine: uses and side effects of this antidepressant

This tricyclic Antidepressant has been widely used in the treatment of nocturnal enuresis.

The first tricyclic antidepressant in history was imipramine, which appeared in 1951. Although this and other tricyclics were the most widely used drugs to treat depression for many decades, they were gradually replaced by other more effective drugs, although imipramine is still used in certain disorders, not only of the depressive type.

In this article we will discuss in detail the therapeutic uses and the most important side effects of imipramine.. We will also describe the key pharmacological properties of this drug and explain in which cases its use is contraindicated.

What is imipramine?

Imipramine is a antidepressant drug of the class of tricyclicsto 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 now been overshadowed by the emergence of selective serotonin reuptake inhibitors (SSRIs) and other drugs with greater specificity and tolerability.

The effects of imipramine are very broad, so that it acts on different neurotransmitters; this explains both its therapeutic properties and the adverse reactions associated with its use. Particularly relevant are its agonist effects on serotonin and norepinephrinewhich occur through the inhibition of their 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 it is still sold in many countries today.

Therapeutic uses of this drug

Imipramine, like the other drugs in the tricyclic class, is used primarily to treat symptoms of the depression spectrum. Research suggests that it is especially useful in cases in which depression is associated with anxiety-like symptoms, particularly psychomotor agitation.particularly psychomotor agitation.

In this regard, 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 treatment of nocturnal enuresis is also relatively common. treatment of nocturnal enuresis. Its efficacy 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.

Adverse reactions most commonly associated with treatment with imipramine include drowsiness, sensations of dizziness, tachycardia, dry mouth, urinary retention, and hypokalemia.Urinary retention and orthostatic hypotension (sudden drop in blood pressure). There are also changes in brain electrical activity, such as those related to sleep.

Other signs affecting the central nervous system that have a somewhat lower frequency are anxiety, agitation, insomnia, nightmares, headaches, confusion or the occurrence of tremors, convulsions and other motor symptoms mainly related to the extrapyramidal system.

Imipramine also causes other physiological side effects. These include cardiovascular disturbances (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. Toxic doses are more easily reached by children, and occasionally death by cardiac arrest may occur if the disturbances are not promptly if the alterations are not resolved quickly.

Contraindications and precautions

Even compared to other tricyclic antidepressants, imipramine has a very strong pharmacological potency. Because of this and its interaction with multiple neurotransmitter receptors, the use of imipramine should be avoided in many different circumstances.

This drug is contraindicated in individuals with a history of disorders such as alcoholism, hyperthyroidism, diabetes, glaucoma, glaucoma, diabetes, hyperthyroidism, diabetes, glaucoma, and other neurotransmitter problems.glaucoma, kidney and liver problems, epilepsy and particularly cardiac disorders.

It is also not recommended to take imipramine if you are simultaneously taking drugs of different types, including barbiturates, monoamine oxidase enzyme inhibitors (MAOIs), SSRIs, lithium, methylphenidate, anticholinergics or buspirone, the drug of choice for generalized anxiety disorder.

At present, the use of imipramine is to some extent discouraged because of its pharmacological profile, which is difficult for many people to tolerate.It is difficult for many people to tolerate and very unspecific in terms of its effects on relevant neurotransmitters. However, it should also be noted that SSRIs and other modern antidepressants also cause significant adverse reactions.