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 imipramine hydrochloride 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. Imipramine hydrochloride is not approved for use in pediatric patients (
WARNINGS, Clinical Worsening and Suicide Risk; PRECAUTIONS, Information for Patients
PRECAUTIONS, Pediatric Use).
Tofranil, imipramine hydrochloride USP, the original tricyclic antidepressant, is available in ampuls for intramuscular administration.
Tofranil (imipramine) is indicated for the following:
Depression: For the relief of symptoms of depression. Endogenous depression is more likely to be alleviated than other depressive states. One to three weeks of treatment may be needed before optimal therapeutic effects are evident.
Published Studies Related to Tofranil (Imipramine)
Comparison between imipramine and imipramine combined with pseudoephedrine in 5-12-year-old children with uncomplicated enuresis: a double-blind clinical trial. [2011.02]
OBJECTIVE: Monosymptomatic nocturnal enuresis is a common entity, with a prevalence of 10% at the age of 7 years. For its primary treatment, we compared the effect of combination medical therapy (imipramine with pseudoephedrine) with imipramine alone... CONCLUSION: The additive pharmacologic effects of imipramine with pseudoephedrine for the treatment of monosymptomatic nocturnal enuresis in children were well tolerated, and gave significantly faster results than single drug therapy using imipramine. The moderate-to-high recurrence rate following discontinuation of medical treatment indicates the need for a longer term study involving more cases. Crown Copyright (c) 2010. Published by Elsevier Ltd. All rights reserved.
Comparison between imipramine and imipramine combined with pseudoephedrine in
5-12-year-old children with uncomplicated enuresis: a double-blind clinical
imipramine alone... CONCLUSION: The additive pharmacologic effects of imipramine with pseudoephedrine
Serum zinc level in depressed patients during zinc supplementation of imipramine treatment. [2010.11]
BACKGROUND: Recurrent major depression is associated with decreased blood zinc concentrations that may be increased by effective antidepressant therapy. Some clinical investigations point to alterations of the zinc level in blood as a potential marker of depression... CONCLUSIONS: Serum zinc is a state marker of depression. Copyright (c) 2010 Elsevier B.V. All rights reserved.
Low-dose gabapentin as useful adjuvant to opioids for neuropathic cancer pain when combined with low-dose imipramine. [2010.06]
PURPOSE: Painful neuropathic conditions of cancer pain often show little response to nonopioid and opioid analgesics but may be eased by antidepressants and anticonvulsants. Although gabapentin is effective in the treatment of neuropathic pain in patients with cancer, some patients experience intolerable side effects sufficient to warrant discontinuation. The aim of this study was to see whether low-dose gabapentin is effective in treating cancer-related neuropathic pain when combined with low-dose imipramine... CONCLUSION: Low-dose gabapentin-antidepressant combination with opioids was effective in managing neuropathic cancer pain without severe adverse effects.
Treatment of unipolar psychotic depression: a randomized, double-blind study comparing imipramine, venlafaxine, and venlafaxine plus quetiapine. [2010.03]
CONCLUSION: That unipolar psychotic depression should be treated with a combination of an antidepressant and an antipsychotic and not with an antidepressant alone, can be considered evidence based with regard to venlafaxine-quetiapine vs. venlafaxine monotherapy. Whether this is also the case for imipramine monotherapy is likely, but cannot be concluded from the data.
Clinical Trials Related to Tofranil (Imipramine)
Bioequivalency Study of Imipramine Pamoate 75 mg Capsules Under Fasted Conditions [Completed]
The objective of this study was to prove the bioequivalence of Imipramine Pamoate 75 mg
Capsules under fasting conditions
Imipramine and Pregabalin Combination in Painful Polyneuropathy [Not yet recruiting]
Polyneuropathy of different etiologies is often associated with pain and the standard
treatment for this type of pain is gabapentinoids or antidepressants. The hypothesis of this
study is that the combination of the gabapentinoid pregabalin and the antidepressant
imipramine will provide better pain relief than the single compounds alone.
This is a randomized, placebo-controlled, double-blind, 4-way, cross-over trial of
pregabalin 300 mg/day, imipramine 75 mg/day and their combination versus placebo. The study
will include 60 patients and the treatment outcome will be pain intensity as measured by
numeric rating scales.
To Demonstrate the Relative Bioavailability of Sandoz Inc. and Tyco Healthcare (Tofranil) 50 mg Imipramine Hydrochloride Tablets In Healthy Adults Volunteers Under Fasting Conditions [Completed]
Imipramine Treatment for Patients With Multi-organ Bodily Distress Syndrome [Active, not recruiting]
The aim of this study is to test the effect of the tricyclic antidepressant Imipramine in
patients with longlasting health problems with no known medical explanation, defined as
multi-organ Bodily distress syndrome (BDS). Pharmacological treatment of patients with BDS
have never been tested, and Imipramine i low dosage (10-75 mg) has the potential of reducing
both pain and other symptoms of bodily distress for patients with BDS. Control conditions
are pill placebo. Study duration is 19 weeks for each of the 140 patients.
Dichotic Listening as a Predictor of Medication Response in Depression [Completed]
Depressed patients will have hearing tests and then be treated with up to three treatments
(i. e., Fluoxetine, Imipramine and Placebo) until remitted, to see whether test results
predict specific outcomes.
Reports of Suspected Tofranil (Imipramine) Side Effects
Confusional State (7),
Bipolar Disorder (6),
Weight Increased (4),
Drug Ineffective (3),
Chronic Obstructive Pulmonary Disease (3),
Dyspepsia (3), more >>
Page last updated: 2013-02-10