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Imparimine
Imparimine antidepressants are the most commonly used drugs. They produce anti-depressants effects by blocking the neuronal uptake of noradrenaline and exert anticholinergic activity. They also inhibit neuronal uptake of 5 HT and dopamine. The exact mechanism of action is not known. The antidepressant effect is noticed after 3-4 weeks of drug administration.
Indications: Depressions of all types, nocturnal enuresis, intractable chronic pain, narcolepsy, mood disturbances, sleep apnoea syndrome.
Contradictions: Hypersensitivity, acute myocardial infraction.
Safety Profile: In patients with history of epilepsy, cardiac arrhythmias, renal and hepatic diseases. Glaucoma, hyperthyroidism, withdrawal symptoms on sudden withdrawal.
Adverse Effects: Palpitation, tachycardia, arrhythmias, dryness of mouth, constipation. Blurring of vision, hyperpyrexia, gynaecomastia, cholestatic, jaundice, agranulocytosis, skin rashes, itching, drowsiness, tremors, ataxia.
Drug Interactions: Increased effect of atropine like drugs. Barbiturates : Additive respiratory depressant effect. Clonidine : Severe hypertension. Fluoxetine: haloperidol: Increased action of imipramine L-Dopa: Bio availability decreased hypertension. Oral contraceptives: Reduced bio availability.
Barbiturates: Reduced plasma levels.
Dosage: Adults : Initially 75 mg/day increasing slowly to 100mg a day. Children: 7-11 years 25-50 mg. Over 11 yrs. 50-75 mg/day.