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Trimipramine

    DEA Class;  Rx

    Common Brand Names; Surmontil, Trimip, Tripramine

    • Antidepressants, TCAs

    Tertiary amine tricyclic antidepressant (TCA), considerable sedative and anxiolytic effects
    FDA-approved to treat major depression in adult patients; especially useful for those with co-existing sleep disturbances or anxiety
    Boxed warning for use in pediatric patients and young adults due to risk for suicidality

    Indicated for the treatment of major depression.

    Hypersensitivity

    Severe cardiovascular disorder

    Narrow angle glaucoma

    Any drugs or conditions that prolong QT interval

    Acute recovery post-MI

    • Sedation (less than amitriptyline, but greater than imipramine)
    • Fatigue
    • Dry mouth
    • Constipation
    • Blurred vision
    • Weakness
    • Lethargy
    • Headache
    • Agitation
    • Insomnia
    • Nausea/vomiting
    • Anxiety
    • Sweating
    • Confusion
    • EPS
    • Dizziness
    • Tinnitus
    • Paresthesia
    • Orthostatic hypotension
    • ECG changes
    • Tachycardia
    • Incr LFTs
    • Sexual dysfunction
    • Rash
    • Seizure (rare)
    • Agranulocytosis, thrombocytopenia, eosinophilia, leukopenia (rare)
    • SIADH (rare)

    BPH, urinary/GI retention, increases IOP, hyperthyroidism, open-angle glaucoma, seizure disorder, brain tumor, respiratory impairment

    Clinical worsening and suicide ideation may occur despite medication

    Risk of anticholinergic side-effects

    Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

    Pregnancy Category: C

    Lactation: avoid

    Adults

    200 mg/day PO in outpatients; 300 mg/day PO in hospitalized patients.

    Elderly

    100 mg/day PO.

    Adolescents

    100 mg/day PO.

    Children

    Safety and efficacy have not been established. 

    Trimipramine maleate

    capsule

    • 25mg
    • 50mg
    • 100mg