What is Imipramine?

Imipramine is a drug that was first synthesized as an antihistamine that was used to relieve the symptoms of allergies like reactions to insect bites or stings, hay fever, hives, and conjunctivitis. Gradually its usage transcended into many forms of problems like for treating motion sickness prevention and also to treat insomnia imipramine is used as a short-term remedy. Over time, in the later years, the antipsychotic effects of chlorpromazine that was a constituent of the drug were discovered and imipramine was then developed and studied for use in patients with schizophrenia as an antipsychotic. Imipramine uses is now not just limited to antihistamine, it is used as antidepressants and even the condition of bed-wetting by blocking the effect of acetylcholine, a natural substance on the bladder. 

Chemistry and Effects of Imipramine in Human Body 

The imipramine hydrochloride or as commonly referred to as imipramine HCl belongs to a group of medicines known as tricyclics or tricyclic antidepressants (TCAs). The tricyclics should only be taken under an expert or professional prescribed suggestion as it is given when no other antidepressants work efficiently and fail to relieve the patient’s depression.   

Chemistry and Working of Imipramine Hydrochloride

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The Molecular Formula Imipramine is C19H24N2 with a molecular weight of 280.4 gram/mol. It also goes by the name of Imidobenzyle, along with Imipramine and very popular as Imipramine Hydrochloride, and Imipramine Monohydrochloride, Imipramine Pamoate, Imizin, Janimine are other synonyms of imipramine. 

  • Tricyclic antidepressants as the name suggests works to relieve the symptoms of depression. Depression is primarily a clinical condition wherein the person may feel less happy and energetic and is always feeling low. The tricyclics work by keeping more serotonin and norepinephrine which are made naturally by our body available more to our brain. These chemicals are thought to affect our moods and keeping them available for the brain helps elevate the mood and thus to some degree relieve depression.

  • The tricyclics imipramine blocks D2 (Dopamine) receptors.

  • Imipramine acts as an anticholinergic, specifically, an antagonist of the muscarinic acetylcholine receptors that can be prescribed for enuresis and for psychosis in elderly patients.

  • Imipramine antagonizes adrenergic receptors, epinephrine, thus sometimes causing orthostatic hypotension and soothing effects in depression. 

  • They are also sometimes used to help people with panic disorder.

Imipramine Tablets and Imipramine Doses

  • Imipramine tablets are available as an Imipramine brand name drug and a generic drug, Tofranil. Other Imipramine brand names are the ANTIDEP tab, DEPSIN tab, DEPSIN PLUS tab, DEPSONIL tab, IMIPRAMINE tab, IMIPRAMINE cap, etc. 

  • Imipramine comes in two forms; it can be taken as a tablet or a capsule,  both forms are to be taken by mouth.

  • It treats two conditions- depression and enuresis (bed-wetting).


For Treatment of Depression

For Treatment of Enuresis

The dose of imipramine will be different for different people as the severity of the depression condition also varies according to the medical history which is specific and individualistic. 

More often given to young children or older kids therefore should be given in smaller doses. 

Usually started on a lower dose so the body gets used to it and then increases gradually as time goes by. 

If the condition is untrusted even after many trials the doctor may start at a low dose and gradually increase the dose.

Prescribed as a single dose and one must not consume more than one tablet or capsule at a time. 

It is given once each day, in the evening. 

Usually, it is prescribed to be taken at bedtime. 

It should be taken one hour before bedtime and if bedwetting occurs in the early night then the dose can also begin in the afternoon. 


How To Take Imipramine Hydrochloride

  • Even if you feel well, do not discontinue the medication without consulting your doctor. 

  • Try to take the imipramine tablets at the same time each day, it becomes easy to familiarize your body with it.

  • Swallow your imipramine tablets or capsules with the help of a glass of water and avoid alcohol intake with it.

  • Continue with the medicine, the benefits will start to appear and symptoms will be relieved after a few weeks.

  • One can take it before or after the food or meal intake.

  • If you abruptly stop the drug, the condition may worsen so talk to a professional.

  • Gradually decline the dosage of the drug and then stop it. 

  • If one misses a dose then avoid taking double doses, continue on with the next dose the next day as usual without panicking. 

Imipramine Uses and Side Effects

Imipramine Uses

  • Main usage in treating depression.

  • The chronic bed-wetting even at a later stage for older kids who have tried all other ways can gain relief from the usage of imipramine.

  • Imipramine uses is different in lower doses and in higher doses, the condition of migraine can be treated by lower doses of imipramine. 

  • It can also be used to treat chronic pain, especially in older people. 

  • Mostly off-label uses include treatment of the condition of obsessive-compulsive disorder (OCD).

Imipramine Side Effect

  • In children, the side effects include- nervousness, tiredness, nausea, vomiting, sleep issues, such as trouble sleeping and nightmares, stomach pain, stomach cramps, and diarrhea.

  • In adolescents and adults, the side effects include- breast swelling in men and women, nausea, dry mouth, blurred vision, trouble urinating, vomiting, constipation and even diarrhea in few patients, muscle stiffness, restlessness, ringing in the ears, shakiness which are manifested in the form of tremors, numbness or tingling of the hands and feet and acute to chronic pain or redness and swelling of arms or legs.

  • In case of after-effects like chest pain, slow or fast or irregular heartbeats, fainting and severe dizziness, seizures, slurred speech, weakness on one side of the body, eye pain, widened pupils, vision changes, hallucinations, loss of coordination, twitching muscles, unexplained fever and unusual agitation/restlessness one must immediately consult the doctor. This can indicate a sign of serotonin syndrome or serotonin toxicity that is a very serious condition due to various interactions of the drug imipramine. 

Conclusion

Imipramine or Imipramine hydrochloride evidently have many uses and are widely used as antidepressants and for treating enuresis. The use and importance of imipramine are known for many years since the early 1950s and it is a very potent chemical drug that is only used as a last resort when all other antidepressants have not relieved the symptoms. The potency of imipramine should not be underestimated and it is not an over-the-counter drug and only to be taken when a professional doctor prescribes it. One must follow all the instructions as the doctor suggests and only under guidance should increase the dosage or stop according to the instructions by the doctor. 

FAQs (Frequently Asked Questions)

Q.1) For How Long Should I Continue the Intake of Imipramine?

Ans.) You'll usually need to keep taking imipramine every day for several weeks and in some cases even some months to treat depression. Few start feeling better after weeks of medication and for some, it takes at least six months after you feel better. You should keep taking it for as long as your doctor asks you to and do not interrupt your system by abruptly stopping the medication or doubling and increasing the dosage of imipramine. 

Q.2) Will I Have Withdrawal Symptoms If I Stop Taking Tofranil (Imipramine)?

Ans.) Imipramine or Tofranil is often started in slow doses so the body gets used to it to start showing effects or benefits it is however not classified as an addiction. Stopping treatment of the imipramine drug abruptly without reducing the dosage prior may cause uncomfortable withdrawal symptoms like nausea, headache, fatigue and easily getting tired, and general malaise. The withdrawal symptoms become severe then you need to immediately consult your doctor, and even if you wish to stop the medication first work out a safety plan with your doctor to taper off your dosage gradually. 

Q.3) When Will One Recover Once After They Start Taking Tofranil (Imipramine)?

Ans.) The recovery of the symptoms depends entirely on the patient's health condition and it is different from one to another so do not compare your healing and recovery process for a condition like depression to others. Some of your symptoms may improve and even show no signs within one or two weeks but it can also take up to 4 to 6 weeks to see any real improvement and tangible changes. Even after the initial stages of feeling better, you will usually have to take Tofranil or any other recommended imipramine brand names for several months or even longer to make sure the benefits will last and you do not have to repeat the intake of medication again.