in primary insomnia: results of a polysomnographic double-blind controlled study.
Rhotrimine Tablets Rhodiapharm (Canada) (Canada) (discontinued 2006) Typhoid vaccine, Vivotif (Canada) Crucell Switzerland Ltd.
A large, Canadian case-control study published in 2002 raised concerns of heightened cancer risk among patients prescribed certain tricyclic antidepressants (amoxapine, clomipramine, desipramine, doxepin, imipramine, and trimipramine
) but not others (amitriptyline, maprotiline, nortriptyline, protriptyline) (Br.
The medications were classified as selective serotonin reuptake inhibitors (SSRIs) (citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline); serotonin norepinephrine reuptake inhibitors (venlafaxine); tricyclics (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, maprotiline, nortriptyline, protriptyline, and trimipramine
); newer and atypical agents (mirtazapine, nefazodone, and trazodone); and monoamine oxidase inhibitors (moclobemide, phenelzine, and tranylcypromine).
Patient Age [greater than Antidepressant or equal to]65 <65 Sertraline 25 50 Paroxetine 10 20 Citalopram * 20 20 Fluoxetine 10 20 Fluvoxamine * 100 100 Amitriptyline NR 50 Desipramine 25 100 Doxepin 30 75 Imipramine 30 75 Nortriptyline 30 75 Protriptyline 15 15 Trimipramine
50 75 Clomipramine 75 75 Trazodone 25 150 Buproprion 50 200 Phenelzine 45 45 Tranylcypromine 20 20 Maprotiline 25 75 Nefazodone 100 200 Venlafaxine 50 75 Mirtazapine 15 15 Amoxapine 50 100 * These antidepressants were not addressed in 1997 Department of Veterans Affairs depression guidelines; minimum daily dosage for these medications derived from expert consensus.
maleate Amide Pharmaceutical Surmontil
Some success was reported with the tricyclic antidepressants amitriptyline (4) and nortriptyline, (5,6) but Mihail et al (7) found that trimipramine
was not superior to placebo.
TCAs with a higher ratio of sedative-to-stimulant activity (i.e., amitriptyline, doxepin, maprotiline, and trimipramine
) will cause the most sedation.
"My next anti- depressant treatment was trimipramine
(Surmontil at 14p a pill) which was prescribed by a psychiatrist.
Table 1 CPIC gene/drug combinations with guidelines for psychiatry (a) Gene Drug(s) CYP2D6 Amitriptyline, fluvoxamine, nortriptyline, paroxetine, clomipramine, desipramine, doxepin, imipramine, trimipramine
CYP2C19 Amitriptyline, citalopram, escitalopram, clomipramine, doxepin, imipramine, trimipramine
, sertraline HLA-B Carbamazepine (a) As of April 2017 CPIC: Clinical Pharmacogenomics Implementation Consortium; CYP: cytochrome P450; HLA-B: human leukocyte antigen complex B Source: Reference 5 Table 2 Ms.
Salt-joining makes a hydrophobic molecule hydrophilic; the result, especially in psychoactive drugs, is improved kinetics, absorption, or physicochemical properties (eg, stability, hygroscopicity, fluidity)Y This may be the reason for differences identified between generic and brand-name amitriptyline, nortriptyline, desipramine, and trimipramine
. (28) To avoid problems, physicians should prescribe generics containing the same salt as their brand-name counterparts.
Hypotensive cardio-circulatory failure and metabolic acidosis after suicidal intoxication with trimipramine
Some of the most frequently prescribed tricyclics are amitriptyline (Elavil, Endep), desipramine (Norpramin), clomipramine (Anafranil), doxepin (Sinequan), imipramine, (Tofranil, Tofranil PM), nortriptyline (Pamelor, Aventyl), amoxapine (Asendin), protriptyline (Vivactil) and trimipramine
In preselected populations designed to detect CYP2D6-related pharmacokinetic differences (33, 34), trimipramine
and doxepin clearance differed significantly between carriers of two or only one functional allele.
Bupropion, mirtazapine, nefazodone, trazodone, desipramine, nortriptyline, trimipramine