Name: Imipramine (Tofranil)
Class: Psychopharmacological Agents (Tricyclic Antidepressant)
Mechanism: Blocks NE and 5HT uptake. Also prominent muscarinic blockade. Possible mechs include down-reg. of brain a2 and 5HT2 receptors or decreased number of b brain receptors.
Absorption: Dist.: Metabolism.:
Excretion, t½:
Toxicity/S.E.s: Sedation, postural hypotension, excess sweating, marked decrease in REM sleep. Block antihypertensive effects of guanethidine. Enhance effects of some sympathomimetics. Can be extremely toxic when combined w/MAO inhibs (but can also be done safely). Potentiates effects of alcohol and other CNS depressants. Overdoses ® coma, seizures, hypotension, depressed resp., arrhythmias.
Utility: Treat endogenous depression, enuresis, chronic pain, panic rxns, phobic anxiety.
Special Features: TCAs preferred over MAOIs for initial treatment of endogenous depression. Severely depressed patients should never be given more than a 1 week supply of a TCA (danger of overdose).