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Trimipramine: uses and side effects of this antidepressant

Trimipramine: uses and side effects of this antidepressant

September 5, 2023

Trimipramine is a drug that is used to treat mainly depressive states, although it is also prescribed in the case of sleep and anxiety disorders, as well as in some psychosomatic disorders. Because of its high risk of generating adverse effects, this drug is usually prescribed with strict medical supervision.

Then we will see what is trimipramine , what is it for, what are its possible adverse effects and how is it marketed.

  • Related article: "Types of antidepressants: characteristics and effects"

What is trimipramine and what is this drug for?

Trimipramine is an antidepressant of tricyclic type that has sedative and anticholinergic properties . The latter act both centrally and peripherally in the nervous system. Its mechanism of action is not completely known, but it is chemically related to another tricyclic drug called imipramine.

The tricyclic and tetracyclic antidepressants are two of the first to be used in psychopharmacology. These are drugs that prevent the reuptake of serotonin, and sometimes of noradrenaline, in the synaptic space, which produces a high concentration of said neurotransmitters and a reduction of some symptoms of depression .

Trimipramine is used mainly to treat depressive states, whether they are mild or severe. But it is also used for the treatment of psychosomatic disorders that have a depressive background, as well as for states of anxiety and sleep disturbances. The improvement associated with this drug usually occurs after the first weeks, or sometimes a little longer, since the treatment is started.

At the same time, that is, during the first phases of recovery, the risk of suicide that often accompanies depression can increase . Therefore it is recommended to closely accompany the person until the first signs of improvement occur.

In fact, until recently, tricyclic and tetracyclic drugs were the most widely used antidepressants. However, having a nonspecific mechanism of action, these drugs often affect other substances important to the body (such as acetylcholine, histamine and dopamine). This increases the likelihood of suffering adverse effects, as well as overdose mortality, so that their prescription has been reduced.

  • You may be interested: "Are there several types of depression?"

Route of administration and recommended dose

The commercial name of trimipramine is Surmontil and It is sold as tablets containing 35 mg trimipramine maleate , which is equivalent to 25 mg of the active ingredient.

Surmontil administered orally, and in the case of being prescribed to treat minor depressions, psychosomatic states, or sleep and anxiety disorders, it is usually administered for a single dose between 12.5 mg and 50 mg , usually at night. On the other hand, in the case of severe depression, it is generally recommended to take 300 mg to 400 mg per day in 2 to 3 doses. Its validity period is 5 years and it is advisable to keep it at a temperature not exceeding 25º.

Likewise, when it becomes necessary to reduce the doses, the general recommendation is to do it in a progressive way and to monitor the risk of deprivation syndrome.

Possible side effects

As with other tricyclic antidepressant drugs, the adverse effects that trimipramine generates are the following:

  • Weightloss .
  • Endocrine problems, such as mammary hypertrophy or galactorrhea.
  • Allergic skin reactions .
  • Hematological difficulties.
  • Syncope.
  • Dry mouth and urinary retention.
  • Elevation of psychomotor inhibition.
  • Humor changes with the appearance of manic episodes.
  • In people over 50 years of age there is an increased risk of bone fractures.
  • Ideation and suicidal behavior , especially in those under 25 years of age, studies have shown that this happens once the treatment is started or when it is finished.
  • Serotonin syndrome, which can be deadly and can produce neuromuscular excitation, autonomic changes and changes in mental state; and what can happen when this drug is mixed with other serotonergic active substances.
  • Nervous system disorders, which can be caused by the peripheral effects of trimipramine, by its central effects or by enhancing the very nature of depression.
  • Cardiac disorders .
  • Metabolism and nutrition disorders.

Contraindications and interaction with other substances

Trimipramine is contraindicated in children under 12 years of age and in people who have a history of suicidal ideation and attempt.Likewise, trimipramine has the risk of producing liver and kidney failure.

It should not be mixed with antidepressant drugs of the MAOI type , nor administered in periods close to the last intake of these. Also, the mixture of trimipramine with SSRI-type antidepressant drugs, such as fluoxetine and fluvoxamine, increases the risk of toxicity.

The sedative effect of this drug is enhanced when it is mixed with sedatives, morphine derivatives, barbiturates, antihistamines, anxiolytics, methadone, clonidine and hypnotics. The same happens if this drug is mixed with alcoholic beverages. There is also a risk of generalized seizures if this drug is mixed with anticonvulsant medications .

Due to the possibility of its excretion in breast milk, it is not advisable to use this drug during the period of lactation. There is also possibility of secretary through the placenta, so it is discouraged to use it during pregnancy .

Likewise, as with other psychoactive medications, this antidepressant can alter some physical and psychological faculties, so it is recommended to take precautions to drive or operate heavy machinery.

Bibliographic references:

  • Spanish Agency of Medicines and Health Products (2016). Technical Sheet, Surmontil. Retrieved August 16, 2018. Available at //
  • Vademecum (2016). Trimipramine Retrieved August 16, 2018. Available at //

Taking Antidepressants For The First Time (September 2023).

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