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Imipramine

Adrenergic Uptake Inhibitors
CATEGORIES

Adrenergic Uptake Inhibitors, Antidepressive Agents, Tricyclic


ALIASES

Imipramin-neuraxpharm, Imipramine, Tofranil, Tofranil Dolorgiet, Tofranil mite, Tofranil®, Imipramin Dak, Imipramine, Imipramine Hydrochloride, Imipramine Pamoate, Imiprex, Pramin, Tofranil, Tofranil-pm


SUBSTANCES

imipramine, imipramine hydrochloride


ENVIRONMENTAL CONCERN: MODERATE
Imipramine, the prototypical tricyclic antidepressant (TCA), is a dibenzazepine-derivative TCA. TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, imipramine does not affect mood or arousal, but may cause sedation. In depressed individuals, imipramine exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Tertiary amine TCAs, such as imipramine and amitriptyline, are more potent inhibitors of serotonin reuptake than secondary amine TCAs, such as nortriptyline and desipramine. TCAs also down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission. TCAs also block histamine H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively. Imipramine has less sedative and anticholinergic effects than the tertiary amine TCAs, amitriptyline and clomipramine. See toxicity section below for a complete listing of side effects. Imipramine may be used to treat depression and nocturnal enuresis in children. Unlabeled indications include chronic and neuropathic pain (including diabetic neuropathy), panic disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD).

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MODERATE
The medicine is now withdrawn from use in Sweden. The data on hazard and risk are based on previous environmental information on Fass.se.

REFERENCES

  1. Stockholms läns landsting. Miljöklassificerade läkemedel 2014–2015. Stockholm; 2014.