Imipramine Foods

Substrates Inhibitors Inducers CYP1A2 Acetaminophen, caffeine, clozapine, imipramine, theophylline, propranolol Most fluoroquinolone antibiotics, fluvoxamine, cimetidine Tobacco smoking, charcoal-broiled foods, cruciferous vegetables, omeprazole... 

Fernstrom MH, Krowinski RL, Kupfer DJ. Appetite and food preference in depression effects of imipramine treatment. Biol Psychiatry 1987 22(5) 529-39. 

Nishida KJ, Dougherty GG, Ellinwood EH, Rockwell WJK (1990) Effects of chronic chlorimipramine and imipramine administration on food hoarding behavior in male rats. Res Commun Psychol Psychiatry Behav 15 115-128 Rosofsky M, Geary N (1989) Phenylpropanolamine and amphetamine disrupt postprandial satiety in rats. Pharmacol Biochem Behav 34 797-803... 

NE secretion can be effectively decreased by administration of reseipine, an alkaloid isolated from a small woody perennial found in India (Rauwolfia), which has a high affinity for the vesicular monoamine h ansporter-2 (VMAT-2) and as such prevents NE storage. Alternatively, NE secretion can be increased by administration of tyramine (decarboxylated tyrosine), which is a constituent of a variety of foods including red wine, pickled herring and cheese. Amphetamine has a similar effect, which is most prominently manifested in the CNS. The termination of NE effects can be circumvented by the administration of cocaine, which blocks NE transport into presynaptic nerve endings (NET) an effect, which is also shared by some of the first generation antidepressants, such as imipramine. 

In a carefnlly controlled 3-week comparison of phenelzine (np to 90 mg/day, mean 77 mg) and imipramine (np to 150 mg/day, mean 139 mg), fonr patients developed antisocial behavior, three overt paranoid psychosis, and one a hypertensive crisis, despite all precantions to avoid interacting foods and dmgs (4). 

Clinically important, potentially hazardous interactions with amitriptyline, amoxapine, amphetamines, bupropion, citalopram, clomipramine, cyproheptadine, desipramine, dextroamphetamine, dextromethorphan, diethylpropion, dopamine, doxepin, entacapone, ephedrine, epinephrine, fluoxetine, fluvoxamine, imipramine, levodopa, mazindol, meperidine, methamphetamine, nefazodone, nortriptyline, paroxetine, phendimetrazine, phentermine, phenylephrine, phenylpropanolamine, pizotifen, protriptyline, pseudoephedrine, rizatriptan, sertraline, sibutramine, sumatriptan, sympathomimetics, tramadol, tricyclic antidepressants, trimipramine, tryptophan, tyramine-containing foods, venlafaxine, zolmitriptan... 

Abernethy DR, Divoll M, Greenblatt DJ, Shader RI. Imipramine pharmacokinetics and absolute bioavailability effect of food ClinRes (1983) 31, 626A,... 

Milnacipran, although relatively new on the market in the USA, has been in use in Europe since 1996. It was first approved for the treatment of major depression in France in December 1996 and is currently marketed under the brand name Ixel in over 45 countries worldwide and under the brand name Toledomin in Japan. Milnacipran has been compared to imipramine, SSRIs, TCAs, and additional antidepressant medications. When comparing milnacipran with TCAs, both are equally efficacious however, significantly fewer side effects were experienced with milnacipran. As with other antidepressant medications, 1 to 3 weeks may elapse before significant antidepressant action becomes clinically evident. In January 2009 the US Food and Drug Administration (FDA) approved milnacipran (under the brand name Savella) for the treatment of fibromyalgia, making it the third medication approved for this purpose in the USA. 

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