Imipramine dosage

These interactions are inadequately established. There is no obvious reason for avoiding concurrent use, but it would seem reasonable to be alert for any evidence of toxicity and/or lack of response to tricyclic antidepressant treatment in those taking oestrogens in any form. One study suggested that the imipramine dosage should be reduced by about one-third. More study is needed. 

Hayes, T. A., Panitch, M. L and Barker, E. (1975) Imipramine dosage in children a comment on imipramine and EKG abnormalities in hyperactive children. Amer. J. Psvehiat., 132l5, 546. 

Some studies compare dietary supplements to sub-therapeutic dosages of prescription medicine. For example, St. John s wort is compared to some of the tricyclic antidepressants. However, the given doses of amitriptyline and imipramine were below the recommended antidepressant doses. 

S. Ahuja, Study on Dosage Variations on Individual Capsules and Tablets of Desipramine and Imipramine Hydrochloride. Presented at A.Ph.A. Meeting, Miami, FL, May, 1968 J. Pharm. Sci. 57(11) (1968) 1979-1982. B. Kratochvil and J.K. Taylor, Anal. Chem., 53 (1981) 924A. 

Drugs that may require dosage reduction with smoking cessation acetaminophen, caffeine, imipramine, oxazepam, penfazocine, propranolol, fheophylline, insulin, prazocin, labetalol... 

Like alprazolam, clonazepam may cause treatment-emergent depression in some patients. Pollack et al. (42) also reported that only 10% of their patients who remained on clonazepam had a history of depression, although 47% lost to follow-up and 30% who eventually required alternate treatment had histories of dysthymia or depression. Of 31 patients without a prior history of affective illness, depression developed in three on low daily dosages (0.75, 1.5, and 2 mg), one was switched to alprazolam, and the others responded to the addition of desipramine or imipramine. These investigators recommend that, until further data are available, PD patients with chronic or concurrent depression should not be given clonazepam alone and that those in whom depression develops during clonazepam therapy should have their dose lowered or an adjunctive antidepressant added. 

The Division of Drug Experience of the US Department of Health and Welfare issued a note on five cases of the syndrome of inappropriate antidiuretic hormone secretion and drugs to which it has been attributed (1137). All involved drugs with a tricyclic structure one patient was taking imipramine, three carbamazepine, and the others the closely related muscle relaxant cyclobenz-aprine. The dosage of imipramine was 50 mg/day for 3 weeks and the patient was a 72-year-old woman. Other cases have been reported, involving amitriptyline (1137), imipramine, and protriptyline (SEDA-17,17). 

More serious and sometimes fatal liver necrosis has been reported with a number of different tricyclic structures and probably represents an extreme form of hypersensitivity (111,112). Liver necrosis in a 33-year-old woman who took imipramine 300 mg/day for over 1 month led the authors to suggest that once-daily dosage may pose a special hazard, because peak concentrations can exceed the toxic concentration, even though steady-state plasma concentrations are in the usual target range (113). A particular hazard appears to be posed by amineptine (qv). 

Moskovitz R, DeVane CL, Harris R, Stewart RB. Toxic hepatitis and single daily dosage imipramine therapy. J Clin Psychiatry 1982 43(4) 165-6. 

Amoxapine is less potent than other tricyclic antidepressants, with a therapeutic dosage range of 75-600 mg/day (usually 200 00 mg/day). Clinical effects have not been consistently correlated with plasma concentrations, but amoxapine has similar efficacy to other tricyclic antidepressants in heterogeneous populations of depressed patients. Controlled comparisons have shown that its clinical profile is very similar to that of imipramine (3) and that it is somewhat less sedative than amitriptyline (4—6). In two of these studies (4,6) the results confirmed the suggestion of a somewhat earlier onset of action. 

In chick embryos there was a high prevalence of abnormalities, including microphthalmia, micromelia, and reduced body size, after the administration of imipramine, but the dosages of imipramine were close to lethal (125). 

Imipramine and other TCAs are effective for enuresis at wide dosage ranges. TCAs have rapid onset, but side effects may be problematic for some patients. 

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