Description of the medicine: Imipramin (Imipraminum)
N- (3-Dimethylaminopropyl) iminodibenzyl hydrochloride, or 5- (3-dimethylaminopropyl) -10,11-dihydro-5H-dibenzo [b, f] azepine hydrochloride.
Synonyms: Imizin, Melipramine, Antideprin, Deprenil, Deprimin, Deprinol, Depsonil, Dynaprin, Eupramin, Imipramil, Irmin, Melipramin, Surplix, Tofranil and others.
White crystalline powder. Easily soluble in water and alcohol.
Aqueous solutions have a pH of 3, 7 - 4, 5.
Imipramine is the main representative of typical tricyclic antidepressants. This is one of the first antidepressants, but due to its high effectiveness it is still widely used.
By the mechanism of action, imipramine is a monoamine reuptake inhibitor - neurotransmitters. This action is not selective, it simultaneously blocks the capture of norepinephrine, dopamine, serotonin and other neurotransmitters and leads to their accumulation in the synaptic cleft and enhance their physiological activity. Under experimental conditions, it removes or reduces the depriminating effects of reserpine, enhances the action of sympathomimetic substances, and has anticholinergic activity.
By the nature of the action, imipramine is an antidepressant with a concomitant stimulating effect.
Imipramine is used for depressive states of various etiologies, especially for astheno-depressive conditions accompanied by motor and ideative inhibition, including endogenous depression, involutional, menopausal depression, reactive depression, depressive states with psychopathy and neurosis, etc., with alcoholic depressions.
The drug helps to reduce melancholy, improve mood (timoleptic effect), the appearance of vigor, a decrease in motor inhibition, an increase in the mental and general tone of the body.
Usually prescribed inside (after eating), starting from 0.75 - 0.1 g per day, then the dose is gradually increased (daily by 0.025 g) and adjusted to 0.2-0.25 g per day. When an antidepressant effect occurs, increasing the dose is not recommended. In certain resistant cases and in the absence of side effects, apply up to 0.3 g per day. The duration of treatment is on average 4-6 weeks, then the dose is gradually reduced (by 0.025 g every 2 to 3 days) and switched to the maintenance therapeutic (usually 0.025 g 1 to 4 times a day).
It should be borne in mind that cessation of treatment too early can lead to a resumption of depression. Imipramine should be discontinued gradually.
For severe depression in a hospital setting, you can use combination therapy - intramuscular injections and oral administration of the drug. Start with intramuscular injections of 0.025 g (2 ml of 1, 25% solution) 1 - 2 - 3 times a day; by the 6th day, the daily dose is adjusted to 0.15-0.2 g. Then the dose for injection is started to be reduced and the drug is prescribed by mouth, and every 25 mg of the drug for injection (2 ml of 1, 25% solution) is replaced by 50, respectively mg of the drug in the form of a dragee. Gradually, they switch to taking the drug only inside and then to maintenance therapy.