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Surmontil (Trimipramine Maleate) - Summary

 
 



BOX WARNING

Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Surmontil or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Surmontil is not approved for use in pediatric patients. (See Warnings: Clinical Worsening and Suicide Risk, Precautions: Information for Patients, and Precautions: Pediatric Use)

 

SURMONTIL SUMMARY

Surmontil is an antidepressant with an anxiety-reducing sedative component to its action.

Surmontil is indicated for the relief of symptoms of depression. Endogenous depression is more likely to be alleviated than other depressive states. In studies with neurotic outpatients, the drug appeared to be equivalent to amitriptyline in the less-depressed patients but somewhat less effective than amitriptyline in the more severely depressed patients. In hospitalized depressed patients, trimipramine and imipramine were equally effective in relieving depression.


See all Surmontil indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Surmontil (Trimipramine)

Could laughing gas be used to treat severe depression?
Source: Depression News From Medical News Today [2014.12.10]
A small pilot study suggests treatment with nitrous oxide or laughing gas may help patients with severe depression whose illness is not responding to conventional therapies.

Malnutrition in U.S. - greatest cost linked to seniors, depression, COPD, coronary artery disease and dementia
Source: Depression News From Medical News Today [2014.12.10]
Even in food-abundant industrialized countries like the U.S., an alarming number of people, particularly seniors, are in a state of diseased-associated malnutrition1.

A Guide to Treating Depression
Source: Medscape Internal Medicine Headlines [2014.12.08]
Dr Matt Goldenberg walks through his approach to treating patients with depression.
Medscape Psychiatry

Depression in people who live in unhappy places experienced more than a week a month
Source: Anxiety / Stress News From Medical News Today [2014.12.07]
People in the country's unhappiest communities spend about a quarter of the month so far down in the dumps that it can harm their productivity, according to economists.

Holiday Depression, Anxiety, and Stress
Source: MedicineNet Alcohol Abuse and Alcoholism Specialty [2014.12.04]
Title: Holiday Depression, Anxiety, and Stress
Category: Diseases and Conditions
Created: 11/8/1999 12:00:00 AM
Last Editorial Review: 12/4/2014 12:00:00 AM

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Published Studies Related to Surmontil (Trimipramine)

Outcome in delusional depression comparing trimipramine monotherapy with a combination of amitriptyline and haloperidol--a double-blind multicenter trial. [2009.04]
BACKGROUND: Patients with delusional depression are difficult to treat. The atypical antidepressant trimipramine was effective in a previous 4-week open label pilot study in patients with this disorder. The major neurobiological effect of trimipramine is the inhibition of the hypothalamic-pituitary-adrenocortical (HPA) system. In delusional depression HPA overactivity is more distinct than in other subtypes of depression. HPA suppression is thought to contribute to the action of trimipramine... CONCLUSION: In all, trimipramine monotherapy appears to be an effective treatment in delusional depression.

Outcome in delusional depression comparing trimipramine monotherapy with a combination of amitriptyline and haloperidol - A double-blind multicenter trial. [2008.11.25]
BACKGROUND: Patients with delusional depression are difficult to treat. The atypical antidepressant trimipramine was effective in a previous 4-week open label pilot study in patients with this disorder. The major neurobiological effect of trimipramine is the inhibition of the hypothalamic-pituitary-adrenocortical (HPA) system. In delusional depression HPA overactivity is more distinct than in other subtypes of depression. HPA suppression is thought to contribute to the action of trimipramine... CONCLUSION: In all, trimipramine monotherapy appears to be an effective treatment in delusional depression.

Fluoxetine versus trimipramine in the treatment of depression in geriatric patients. [2005.01]
CONCLUSION: These findings suggest that fluoxetine and trimipramine are comparable in terms of efficacy and tolerability in the treatment of major depression in geriatric patients.

Antipsychotic efficacy of the antidepressant trimipramine: a randomized, double-blind comparison with the phenothiazine perazine. [2003.03]
CONCLUSION: Trimipramine failed to exhibit therapeutic equivalence to perazine in the dosages used. However, there was evidence of a substantial antipsychotic effect of trimipramine. It may be a useful medication if depressive symptoms in psychotic patients require antidepressant treatment or if other antipsychotics cannot be administered.

Differential effects of trimipramine and fluoxetine on sleep in geriatric depression. [2001.03]
The effects of trimipramine, a tricyclic antidepressant (TCA) with atypical pharmacological properties, and fluoxetine, a selective serotonine reuptake inhibitor (SSRI), were compared in an exploratory analysis using mood and polysomnographic parameters during a six-week double-blind trial in 19 depressed geriatric patients.

more studies >>

Clinical Trials Related to Surmontil (Trimipramine)

Optimizing Antidepressant Treatment by Genotype-dependent Adjustment of Medication According to the ABCB1 Gene [Recruiting]
The study evaluates the ABCB1-genotype dependent efficacy of a quick dose-escalation strategy within 28 days of treatment with approved antidepressants that are known substrates of the P-glycoprotein, an efflux pump of the blood-brain barrier expressed by the ABCB1 gene. Moreover, the study evaluates ABCB1-genotype dependent side-effects of approved antidepressants that are known substrates of the P-glycoprotein, an efflux pump of the blood-brain barrier expressed by the ABCB1 gene.

YouScript IMPACT Registry [Recruiting]
This multicenter observational study aims to investigate the benefits of providing pharmacogenetic testing with the YouScript Personalized Prescribing System which includes a clinical decision support tool and individualized pharmacist recommendations to elderly polypharmacy patients who are most at risk of adverse drug events. The YouScript system is unique in identifying drug-gene, and drug-drug-gene interactions that are missed by existing systems, and represent over 35% of significant interaction warnings. Data analysis will assess the impact of recommendations for medication changes on clinical decision making, patient outcomes, and healthcare resource utilization to determine which medications, specialties, or patient segments derive the greatest benefit from this intervention. Data gathered from patients enrolled in this study will be compared to patients matched on key characteristics from Inovalon's MORE2 healthcare database.

Treatment-Resistant Depression, Hippocampus Atrophy and Serotonin Genetic Polymorphism [Recruiting]
Reduction of volume of the hippocampus has been associated with major depression in many studies. It has been suggested that antidepressants may protect against hippocampus volume loss in humans associated with multiple episodes of depression and may also reverse the reduction of volume caused by the depression. In addition, genetic markers for serotonin are implicated with depression, and may be an indication of reduced response to antidepressant treatments.

This study aims to enroll patients who are defined as having treatment resistant depression (no remission after at least 2 treatments trials with an antidepressant). They will receive an MRI scan at the initial visit and either 6 months after sustained remission or 12 months after they enter the study for non-remitters. They will also be asked to give a blood sample for genotyping. They will be matched by age and handedness to healthy volunteers with no personal history of depression who will also receive an MRI scan and genotyping.

The first aim is to compare hippocampal volume of depressed subjects to healthy controls. It is anticipated that subjects will initially have smaller hippocampal volume but of those who sustain remission, there will be a small increase in hippocampal volume. It is also anticipated that specific genetic markers will be related to individuals response to antidepressant treatments.

more trials >>

Reports of Suspected Surmontil (Trimipramine) Side Effects

Rhabdomyolysis (4)Renal Failure Acute (4)Delirium (4)Confusional State (3)Therapeutic Response Increased (3)Disorientation (3)Medication Error (3)Hyponatraemia (3)Tremor (3)Drug Interaction (2)more >>


Page last updated: 2014-12-10

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