How opipramol works
Opipramol is a tricyclic antidepressant and has a calming, anxiety-relieving and slightly mood-lifting effect.
Unlike conventional antidepressants, however, this effect is not based on inhibiting the reuptake of neurotransmitters in the brain (such as serotonin or norepinephrine). Instead, strong binding to specific binding sites in the brain (including sigma-1 receptors) has been demonstrated. However, the effect of opipramol has not yet been fully clarified.
By occupying additional binding sites in various regions of the central nervous system, it also leads to a number of typical side effects. For example, opipramol has a sedative effect, especially at the beginning of treatment.
Uptake, breakdown and excretion of opipramol
The active substance reaches maximum concentration in the blood about three hours after ingestion. It is largely metabolized in the liver and half of it is excreted after six to nine hours, with excretion occurring mainly via the kidneys.
When is opipramol used?
Generalized anxiety disorder is characterized by persistent anxiety that is not related to a specific situation or object. Somatoform disorders are physical complaints for which no organic cause can be found.
Outside of these indications approved by the drug authorities, the active ingredient is still used to treat other mental disorders (off-label use).
The duration of treatment depends on the symptoms and is determined by the treating physician. In general, an average treatment duration of one to two months is recommended. In individual cases, however, the duration of opipramol therapy may vary greatly from this.
How opipramol is used
The most common form of opipramol in Germany is tablets. However, there are also coated tablets and drops. In Austria and Switzerland, only Opipramol coated tablets are currently available.
Like some other psychiatric drugs, opipramol must be taken regularly for at least two weeks before it is possible to tell whether the drug is actually helping as desired.
Discontinuing opipramol
If the treating physician wants to discontinue opipramol, he or she will gradually reduce the dose – physicians refer to this as “tapering.” Abrupt discontinuation of the therapy can cause undesirable discontinuation symptoms.
What are the side effects of opipramol?
Side effects such as fatigue, dry mouth and low blood pressure occur frequently (i.e. in one in ten to one in a hundred patients), usually at the start of treatment with opipramol.
Side effects typical of psychotropic drugs (weight gain, increase in liver enzyme levels, skin reactions) occur only occasionally with opipramol, i.e. in one in one hundred to one in one thousand patients treated.
What should be considered when taking opipramol?
Contraindications and precautions
Opipramol is contraindicated in:
- acute urinary retention
- hypersensitivity to the active substance or tricyclic antidepressants
- conduction disorders in the heart (e.g., AV block)
Opipramol should be used with caution in:
- Enlargement of the prostate
- Cardiac arrhythmia
- Seizure readiness
- Blood formation disorders
- Narrow-angle glaucoma (form of glaucoma)
Age Limitation
Experience on the efficacy and safety of opipramol in children and adolescents is limited; therefore, use of opipramol under 18 years of age is not recommended.
Drug interactions
Therapy with opipramol generally does not preclude additional treatment with other psychotropic drugs. However, if centrally depressant drugs (tranquilizers, sleeping pills) or drugs that increase serotonin levels (such as certain antidepressants like serotonin reuptake inhibitors) are additionally administered, there may be a mutual enhancement of effects.
Medications that affect heart rhythm (including beta-blockers, antihistamines, certain antibiotics, antimalarials) should be given during treatment with opipramol only if absolutely necessary.
Pregnancy and lactation
Opipramol and alcohol
Central dullness is one of the most prominent side effects of opipramol. Alcohol can exacerbate these. Even small amounts of alcohol are capable of causing drowsiness and dizziness.
Avoid drinking alcohol during treatment with opipramol.
How to get medicines with opipramol
As a centrally active substance, the active ingredient opipramol requires a prescription in Germany, Austria, and Switzerland in any dosage form and is only available in pharmacies.
Further interesting information
The original classification of opipramol as a tricyclic antidepressant is increasingly being abandoned. Instead, it is increasingly referred to as a mood-enhancing anxiety reliever.
Due to the development of more selective antidepressants for the treatment of depression, opipramol is increasingly used only for generalized anxiety disorders and similar complaints.
The active ingredient opipramol is mainly used in Germany and some other European and African countries. The active ingredient is not approved in the United States.
