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

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