Imipramine is a medicine from the class of drugscalled prototypical tricyclic antidepressant (TCA). It is a dibenzazepine-derivative TCA. In non-depressed patients this medicine has no effect on mood or arousal, causes significant sedation.
In depressed patients this medicine induces a positive effect on mood. Imipramine inhibits serotonin and norepinephrine reuptake. The antidepressant effects of Imipramine are caused by an overall increase in serotonergic neurotransmission. Imipramine produces sedative, hypotensive and anticholinergic effects. The last ones are related to such effects as urinary retention
Imipramine can be used in complicated cases of depression and nocturnal enuresis in children. Other indications include chronic and neuropathic pain such as diabetic neuropathy, panic disorders, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD).
For the relief of depression symptoms Imipramine treatment may last at least one week before the actual improvement can be seen.
For the management of enuresis in children Imipramine can be used as an adjunctive treatment during a short period of time. Special tests are required to estimate the treatment results and safety of the medicine. Only doctors can select children for the treatment with Imipramine. Certain criteria exist for choosing children who can benefit from Imipramine treatment. The therapy for enuresis in children may demand using Imipramine with some other medicines.
In the treatment of depression the lowest dose of Imipramine is recommended for all patients. Dosage can be initiated at a low amount of the drug and then increased gradually to achieve the best response.
Usual adult dose for patients with depression are 75 mg per day. The dose can be increased to 150 mg per day. Higher doses are not recommended. To maintain the treatment results the doses between 50 and 150 mg per day are suggested.
For adolescents the use of Imipramine should be approved by a caring doctor. The dose for depression can start from 30-40 mg per day. The dose increase possible for adolescents is up to 100 mg per day.
Initial childhood enuresis dose is 25 mg per day. The treatment is possible in children older than 6 years of age, for whom the treatment is approved by the doctor. The dose can be increased up to 50 mg for children under 12 years of age.
The dose increase up to 75 mg per day is possible in children over 12 years of age.
Side effects from Imipramine can include very common restlessness, agitation, insomnia and rare like tachycardia, myocardial infarction, ECG changes, heart block, blurred vision and some others.
The occurrence of side effects depends on individual response to the treatment, dose of the medicine and some other factors. The properly adjusted dose helps avoid side effects. So, when the side effects occur, it is necessary to consult a doctor about dose changes or other options.