Trimipramine

Registered South African indications:

• Depression
• Obsessive compulsive neurosis

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Breastfeeding
• Severe hepatic impairment
• Recent myocardial infarction
• Any degree of heart block or other cardiac arrhythmias
• Mania

Cautions

• Pregnancy
• Renal impairment
• Elderly
• History of suicide-related events, or a significant degree of suicidal ideation 
• Closed angle glaucoma
• Prostatic hypertrophy
• Epilepsy
• Galactose intolerance
• Lapp lactase deficiency 
• Glucose-galactose malabsorption 

Forms avail. in SA and covered in this monograph: tab, cap

Depression
Obsessive compulsive neurosis - severe

• Oral (tab, cap): 25-125mg, dly

Therapeutic response usually takes 2-3 weeks

If given at night it can induce sleep and can help the patient to return to a normal sleep pattern and at the same time reduce daytime drowsiness

Patients with recurrent depression may require maintenance therapy for up to one year or longer

Not established for use in children

Pregnancy

• FDA Pregnancy Category C

Breastfeeding

• Contraindicated

Renal Impairment

• Caution; no information available

Hepatic Impairment

• Severe: Contraindicated

Elderly

• Caution; dose adjustment recommended

Central Nervous System Disorders

• Drowsiness
• Tremor
• Hypomania
• Seizures 
• Peripheral neuropathy
• Mania 
• Paranoid delusions
• Irritability
• Insomnia
• Agitation (neonates)
• Suicidal ideation 
• Suicidal behaviours

Cardiovascular Disorders

• Cardiac arrhythmias 
• Severe hypotension
• Tachycardia
• Postural hypotension

Respiratory Disorders

• Respiratory depression (neonates)

Gastrointestinal Disorders

• Dry mouth
• Constipation

Hepatobiliary Disorders

•  Cholestatic jaundice

Genitourinary Disorders

• Hesitancy of micturition
• Sexual dysfunction

Endocrine and Metabolic Disorders

• Sweating
• Excessive perspiration

Musculoskeletal Disorders

• Increased risk of bone fractures

Skin and Subcutaneous Tissue Disorders

• Rash

Immune, Blood and Lymphatic System Disorders

• Depression of bone marrow
• Agranulocytosis

Sensory Disorders

• Disturbance of accommodation

• Alcohol
• Anaesthetics 
• Monoamine oxidase inhibitors
• Guanethidine
• Debrisoquine
• Bethanidine 
• Clonidine
• Antihypertensives
• Sympathomimetics
• Barbiturates
• Hyperthyroid agents

• Hepatic function
• Vital signs

Specific cases may require

• Blood glucose
• Weight
• ECG

Trimipramine is a tricyclic antidepressant with antihistaminic and sedative actions. The mechanism of action is by blockade of the amine transport system of the membrane of the adrenergic nerve terminal.

Tablet 25mg

• Tydamine (Pharmacare)

Capsule 50mg

• Tydamine (Pharmacare)