Products
Trimipramine is commercially available in tablet and drop form (Surmontil, generic). It has been approved in many countries since 1962.
Structure and properties
Trimipramine (C20H26N2, Mr= 294.5 g/mol) is present in drugs as trimipramine mesilate or trimipramine maleate, a racemate and white crystalline powder that is sparingly soluble in water. It is structurally closely related to the antidepressant imipramine.
Effects
Trimipramine (ATC N06AA06) has antianxiety, sedative, depressant, antidepressant, antihistamine, anticholinergic, sleep-inducing, and indirect analgesic properties. The effects are based on binding to the corresponding receptor systems.
Indications
For the treatment of depression and chronic pain. Off-label, trimipramine is also used for sleep disorders but is not approved for this purpose.
Dosage
According to the SmPC. The dose is increased gradually and individually. The tablets or drops are taken during or after meals.
Contraindications
- Hypersensitivity
- Concurrent treatment with an MAO inhibitor.
- Prostate enlargement with urinary retention
- Urinary retention
- Narrow-angle glaucoma
- AV block
- After a recent myocardial infarction
For complete precautions, see the drug label.
Interactions
Trimipramine is metabolized by CYP2D6. Treatment must take into account the many potential drug-drug interactions.
Adverse effects
The most common possible adverse effects include dry mouth, fatigue, and dizziness. Other possible side effects include visual disturbances, pupil dilation, drowsiness, tremors, restlessness, sleep disturbances, headache, drowsiness, voiding difficulty, urinary retention, indigestion, constipation, sweating, and flushing. Many of the possible side effects are due to the anticholinergic properties of the drug.
