Imipramine Alcohol

Ciraulo DA, Jaffe JH Tricyclic antidepressants in the treatment of depression associated with alcoholism. Clin Psychopharmacol 1 146—150, 1981 Ciraulo DA, Nace E Benzodiazepine treatment of anxiety or insomnia in substance abuse patients. Am J Addict 9 276—284, 2000 Ciraulo DA, Barnhill JG, Jaffe JH, et al Intravenous pharmacokinetics of 2-hydroxy-imipramine in alcoholics and normal controls. J StudAlcohol 51 366-372, 1990 Ciraulo DA, Knapp CM, LoCastro J, et al A benzodiazepine mood effect scale reliability and validity determined for alcohol-dependent subjects and adults with a parental history of alcoholism. Am J Drug Alcohol Abuse 27 339—347, 2001 Collins MA Tetrahydropapaveroline in Parkinson s disease and alcoholism a look back in honor of Merton Sandler. Neurotoxicology 25 117-120, 2004 COMBINE Study Research Group Testing combined pharmacotherapies and behavioral interventions in alcohol dependence rationale and methods. Alcohol Clin Exp Res 27 1107-1122, 2003a... 

Kleber HD, Weissman MM, Rounsaville BJ, et al Imipramine as treatment for depression in addicts. Arch Gen Psychiatry 40 649-633, 1983 Kleber HD, Riordan CE, Rounsaville BJ, et al Clonidine in outpatient detoxification from methadone maintenance. Arch Gen Psychiatry 42 391-394, 1983 Kleber HD, Topazian M, Gaspari J, et al Clonidine and naltrexone in the outpatient treatment of heroin withdrawal. Am J Drug Alcohol Abuse 13 1-17, 1987 Kornetsky C. Brain stimulation reward, morphine-induced stereotypy, and sensitization implications for abuse. Neurosci Biobehav Rev 27 777-786, 2004 Kosten TR, Kleber HD Buprenorphine detoxification from opioid dependence a pilot study. Life Sci 42 633-641, 1988... 

It is interesting to note that one of the founders of modern psychiatry, Kraepelin, listed only nine substances that were available for the treatment of psychiatric illness in the 1890s. These were opium, morphine, scopolamine, hashish, chloral hydrate, a barbiturate, alcohol, chloroform and various bromides. Later Bleuler, another founder of modern psychiatry, added paraldehyde and sodium barbitone to the list. Thus psychopharmacology is a very recent area of medicine which largely arose from the chance discovery of chlorpromazine by Delay and Deniker in France in 1952, and of imipramine by Kuhn in Switzerland in 1957. 

Imipramine is a tricyclic antidepressant and when it is administered concomitantly with alcohol, increased sedation occurs. 

Amitriptyline Amitriptyline, 5-(3-dimethylaminopropyliden)-10,ll-dihydrodibenzocy-cloheptene (7.1.4), differs from imipramine in that the nitrogen atom in the central part of the tricyclic system is replaced by a carbon, which is bound to a side chain by a double bond. Amitriptyline (7.1.4) is synthesized by interaction of 10,ll-dihydro-A,iV-dimethyl-57f-dibenzo[a,d]cyclohepten-5-one with 3-dimethylaminopropyhnagnesium bromide and the subsequent dehydration of the resulting tertiary alcohol (7.1.3) using hydrochloric acid [ 11]. 

Smoking cessation, with or without nicotine substitutes, may alter response to concomitant medication in ex-smokers. Smoking may affect alcohol, benzodiazepines, beta-adrenergic blockers, caffeine, clozapine, fluvoxamine, olanzapine, tacrine, theophylline, clorazepate, lidocaine (oral), estradiol, flecanide, imipramine, heparin, insulin, mexiletine, opioids, propranolol, catecholamines, and cortisol. 

Frewer L, Lader M. The effects of nefazodone, imipramine, and placebo, alone and combined with alcohol in normal subjects. Int Clin Psychopharmacol 1993 8 13-20. 

Of the antidepressants available, imipramine is the most extensively studied. A trial assessing this agent s effectiveness for alcoholism with co-morbid depression had certain advantages over its predecessors, including the following ... 

Nunes EV, McGrath PJ, Quitkin FM, et al. Imipramine treatment of alcoholism with comorbid depression. Am J Psychiatry 1993 150 963-965. 

Acute endogenous depression is not generally considered to be an indication for treatment with lithium. Alcohol and substance abuse have a high association with bipolar illness. However, recurrent endogenous depressions with a cyclic pattern are controlled by either lithium or imipramine, both of which are superior to a placebo. 

For instance, blurring of vision and diplopia are caused by the use of imipramine, iproniazid, chlorpromazine, thioridazine, and promethazine. Impairment of visual acuity is caused by chlorpropamide, tolbutamide, alcohol, chlorpromazine, phenylbutazone, indomethacin, chloroquine, sulfonamides, ethambutol, chloramphenicol, isonex, clioquinol, quinine, streptomycin, and paraaminosalicylate. Yellow vision (xanthopsia) has been traced to the use of sulfonamides, streptomycin, methaqualone, barbiturates, chlorothiazide,... 

A-Oxidation -Oxidation P-Oxidation Desulfuration Nicotine, dimethylaniline, imipramine Thiobenzamide, phorate, thiourea Diethylphenylphosphine Fonofos Alcohol Dehydrogenase... 

Clinically important, potentially hazardous interactions with alcohol, amiodarone, amphotericin B, cisapride, clonidine, digitalis, diltiazem, disopyramide, erythromycin, glucocorticoids, halofantrine, haloperidol, hypokalemic diruretics, imipramine antidepressants, levodopa, lithium, pentamidine, pimozide, quinidine, sotalol, stimulant laxatives, tetracosactides, thioridazine... 

Clinically important, potentially hazardous interactions with alcohol, cimetidine, erythromycin, imipramine, ketoconazole, promethazine, rifampicin, rifampin, thioridazine... 

Antidepressant effects of valerian were identified by Oshima and associates using a methanol extract of Valeriana fauriei roots (Oshima et al., 1995). They found a strong antidepressant activity in mice as measured by the forced swimming test. One active component isolated was a-kessyl alcohol, a volatile oil component. At 30 mg/kg intraperitoneally, a-kessyl alcohol exhibited an effect similar to imipramine, a commonly used antidepressant. Kessanol and... 

The dibenzapine derivatives are called tricyclic antidepressants and include imipramine (Tofranil), desipramine (Norpramin), amitriptyline (Elavil), nortriptyline (Aventyl), protriptyline (Vivactil), and doxepin (Adapin). Amitriptyline is indicated in depression major depression with melancholia or psychotic symptoms depressive phase of bipolar disorder depression associated with organic disease, alcoholism, schizophrenia, or mental retardation anorexia or bulimia associated with depression (see Figure 20). 

Trazodone is perhaps the most sedative antidepressant available, being more sedative than amitriptyline, trimi-pramine, doxepan, or imipramine. Therefore, death has occurred in patients taking trazodone with alcohol, chloral hydrate, diazepam, chlordiazepoxide, meprobamate, or amobarbital. 

Messiha, F.S. Determination of carbamazepine by HPLC electrochemical detection and application for estimation of imipramine, desipramine, doxepin and nordoxepin. Alcohol, 1986, 3, 135-138 Soto-Otero, R. Mendez-Alvarez, E. Sierra-Marcuno, G. Simultaneous determination of ethosuximide, phenobarbital, phenytoin, and carbamazepine in brain tissue by HPLC. J.Liq.Chromatogr., 1985,8, 753-763... 

The potentiometric determination of die dissociation constants of amitriptyline HCl, doxepin HCl, imipramine HCl, and noxiptiline HCl in ethyl alcohol and water systems is described."... 

The ability to drive, to handle dangerous machineiy or to do other tasks requiring complex psychomotor skills may be impaired by amitriptyline, and to a lesser extent by doxepin or imipramine, particularly during the first few days of treatment This impairment can be increased by alcohol Amoxapine, clomipramine, desipramine, and nortriptyline appear to interact with alcohol only minimally. Information about other tricyclics appears to be lacking, although most manufacturers of tricyclics warn that the effects of alcohol may be enhanced. There is also evidence that alcoholics (without liver disease) may need larger doses of desipramine and imipramine to control depression. However, the toxicity of some tricyclics may be increased by alcohol, and in alcoholics with liver disease. 

Imipramine 150 mg daily has also been reported to enhance some of the hypno-sedative effects of alcohol, and unexplained blackouts lasting a few hours have been described in 3 women after they drank only modest amounts of alcohol they had been taking amitriptyline or imipramine for only a month. The half-life of oral imipramine was about 45% lower in recently detoxified alcoholics (without liver disease) compared with healthy subjects, and the intrinsic clearance was 200% greater. ... 

Part of the explanation for the increased C3S1S depression is that both alcohol and some of the tricyclics, particularly amitriptyline, cause drowsiness and other CNS depressant effeets, which can be additive with the effects of alcohol. The sedative effects have been reported to be greatest with amitriptyline, then doxepin and imipramine, followed by nortriptyline, and least with amoxapine, clomipramine, desipramine, and protriptyline. In addition acute alcohol intake causes marked increases (100 to 200%) in the plasma levels of amitriptyline, probably by inhibiting its first pass metabolism. Alcohol-induced liver damage could also result in impaired amitriptyline metabolism. The lower serum levels of imipramine and desipramine seen in abstinent alcoholics are attributable to induction of the cytochrome P450 isoenzymes by alcohol. ... 

Frewer LJ, LaderM. The effects of ne xlone, imipramine and placebo, alcxie and combined with alcohol, in normal subjects. IntClinP [Pg.81]

A woman who had been taking tranylcypromine 10 mg twice daily for about 3 weeks, stopped taking it 3 days before she took a single tablet of imipramine. Within a few hours she complained of an excruciating headache, and soon afterwards lost consciousness and started to convulse. The toxic reactions manifested were a temperature of 40.6°C, pulse rate of 120 bpm, severe extensor rigidity, carpal spasm, opisthotonos and cyanosis. She was treated with amobarbital and phenytoin, and her temperature was reduced with alcohol-ice-soaked towels. The treatment was effective and she recovered. ... 

Naltrexone modestly increases the rate and extent of acamprosate absorption. There is no pharmacokinetic interaction between acamprosate and alcohol or diazepam. Disulflram does not alter the pharmacokinetics of acamprosate, and acamprosate does not alter the pharmacokinetics of imipramine. The combination of acamprosate and barbiturates, meprobamate, or oxazepam does not appear to increase the risk of adverse effects. 

A 15-day study in 591 patients, to assess the effects of the concurrent use of acamprosate with other drugs eommonly used in the management of alcohol withdrawal, found no evidence of additional adverse effeets with meprobamate, oxazepam, or the barbiturate complex tetrabamate (that includes phenobarbital). Other studies found that acamprosate eaused no clinically relevant ehanges in imipramine pharmacokinetics, and the pharmacokinetics of both diazepam and acamprosate were unchanged by concurrent use. ... 

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