Imipramine - instructions for use, doses, side effects, contraindications

Antidepressant from the group of tricyclic compounds. Has psychostimulant, antidepressant and sedative effect. The effect of the drug is associated with the stimulation of serotonergic and adrenergic structures of the brain. It blocks predominantly reverse neuronal seizure of serotonin. Has anticholinergic, adrenoblocking and antihistamine action.

Pharmacokinetics:

After oral administration, fasted to 77% is absorbed in the gastrointestinal tract. The maximum concentration in the blood plasma is achieved in 1-2 hours and 30-60 minutes after intramuscular injection. The connection with plasma proteins is 95%.

Penetrates through the blood-brain and placental barrier, enters the breast milk.

Metabolism in the liver with the formation of the active metabolite demethylimipramine.

The half-life is 21 hours. Elimination of the kidneys in the unchanged form and form of metabolites. With feces - in the form of metabolites.

Indications:

It is used for the treatment of reactive, endogenous and organic depression, with involutional and latent forms of depression, depressive states in schizophrenia and psychopathies, depressive syndrome in the elderly, obsessive-compulsive syndrome, phobias and panic conditions, enuresis in patients over 6 years.

ICD-10

V.F50-F59.F50.0 Anorexia nervosa

V.F10-F19.F13.9 Mental and behavioral disorders caused by the use of sedatives and hypnotics - mental disorder and behavioral disorder, unspecified

V.F10-F19.F11.8 Mental and behavioral disorders caused by the use of opioids - other mental disorders and behavioral disorders

V.F20-F29.F25 Schizoaffective disorder

V.F30-F39.F32 Depressive episode

V.F40-F48.F40.0 Agoraphobia

V.F40-F48.F41.0 Panic disorder [episodic paroxysmal anxiety]

V.F40-F48.F41.1 Generalized anxiety disorder

V.F40-F48.F42 Obsessive-compulsive disorder

V.F40-F48.F43.0 Acute stress reaction

V.F40-F48.F43.2 Disorder of adaptive reactions

V.F50-F59.F50.2 Nervous bulimia

V.F50-F59.F51.1 Drowsiness [hypersomnia] inorganic etiology

V.F90-F98.F98.0 Enuresis of inorganic nature

Contraindications:

Simultaneous administration of MAO inhibitors, individual intolerance, children under 6 years of age.

Carefully:

Spasmophilia, epilepsy, conduction disturbances and excitability of the myocardium, circulatory insufficiency, prostate disease, urinary disorders, glaucoma.

Pregnancy and lactation:

Recommendations for FDA - Category C. Contraindicated in pregnancy and lactation.

Dosing and Administration:

Use in children

6-8 years: 25 mg per day;

9-12 years old: 25-50 mg per day;

Older than 12 years: 50-75 mg per day.

The highest daily dose: not more than 2.5 mg / kg.

Adults

Inside for 150-250 mg per day, maintenance dose - 50 mg per day.

Intramuscular: 25 mg 3 times per day in combination with oral administration of 25 mg.

The highest daily dose: 250 mg.

The highest single dose: 150 mg.

Side effects:

Central and peripheral nervous system: nightmarish dreams, confusion, hallucinations, headache, "a sensation of a lump in the throat", tremor, syncope.

Respiratory system: shortness of breath.

The cardiovascular system: tachycardia, stenocardia.

Hemopoietic system: leukopenia, thrombocytopenia, agranulocytosis, thrombocytopenic purpura, eosinophilia.

Digestive system: anorexia, dry mouth, constipation, flatulence.

Musculoskeletal system: myalgia, back pain.

Dermatological reactions: rarely - photosensitivity.

Sense organs: noise in ears.

Allergic reactions.

Overdose:

Increased side effects.

Treatment is symptomatic, with severe anticholinergic symptoms - the introduction of cholinesterase inhibitors.

Interaction:

Tricyclic antidepressants can not be administered together with non-selective MAO inhibitors. The interval between taking these drugs should be at least 2 weeks.

Special instructions:

During treatment, patients are forbidden to drink alcohol and manage transport, work with moving mechanisms.

Instructions

Imipramine (Imipraminum)