Tofranil

· Generic Name: Imipramine hydrochloride

· Brand Name: Tofranil

· Drug Category: Tricyclic Antidepressants

· Mechanism of Action: Prototype - blocks neurotransmitter (Nepi, dopamine & serotonin uptake @ NMJ). Drug has a long half-life & its effectiveness may be reduced with longer use. Physical & psychological dependence tends to develop over prolonged treatment

· Primarily, for treatment of depression. On a short-term basis, for behavioral therapies such as bedwetting (children > 6 years), bulimia, ADD, OCD and panic/anxiety disorders

· Tofranil (Imipramine) can be taken with or without food. Antidepressant effect is induced usually after 3-4 weeks of continued treatment.

· Usual regimen: Adults - starting dose 75 mg/day with a max. of 200 mg/day. Children - starting dose 25 mg/day with a max. of 75 mg/day. Usually, 1 dose a day at bedtime/should not be taken in the morning because of possible side effects. Sometimes 2 or more doses during the day. If dosage is missed, take forgotten dose immediately. If it's almost time for the next dose, skip the one missed and go back to regular schedule. Do not take two doses at once. Store at room temperature.

· Adverse Effects: blurred vision, dilated pupils, photophobia ¨ xerostomia ¨ urinary retention, constipation, possible aggravation of GLC, epilepsy, CHF, nervousness, convulsions, fatigue, cardiac overstimulation/palpitations due to increased catecholamine activity

· This medication should not be taken if with other types of antidepressants known as MAO inhibitors (i.e. Nardil & Parnate). Tofranil should not be administered within 2 weeks of taking any one of these drugs. Should not be used if recovering from a recent heart attack. Also be cautious if patient is on thyroid medication

· General feelings of illness, headaches and nausea can result if suddenly discontinue use

· Contraindications: MAO inhibitors, alcohol, narcotic painkillers (Percocet), sleep medications (Halcion), tranquilizers (Valium)