(trye mi' pra meen)
A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as trimipramine during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take trimipramine, but in some cases, a doctor may decide that trimipramine is the best medication to treat a child's condition.
You should know that your mental health may change in unexpected ways when you take trimipramine or other antidepressants even if you are an adult over age 24. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own.
Your healthcare provider will want to see you often while you are taking trimipramine, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.
The doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with trimipramine. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from the FDA website: Web Site.
No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.
WHY is this medicine prescribed?
Trimipramine is used to treat depression. Trimipramine is in a class of medications called tricyclic antidepressants. It works by increasing the amount of certain natural substances in the brain that are needed to maintain mental balance.
HOW should this medicine be used?
Trimipramine comes as a capsule to take by mouth. It is usually taken one to three times a day. Take trimipramine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take trimipramine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor will start you on a low dose of trimipramine and gradually increase your dose.
It may take up to 4 weeks before you feel the benefit of trimipramine. Continue to take trimipramine even if you feel well. Do not stop taking trimipramine without talking to your doctor.
Are there OTHER USES for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What SPECIAL PRECAUTIONS should I follow?
Before taking trimipramine,
- tell your doctor and pharmacist if you are allergic to trimipramine, clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or any other medications.
- tell your doctor if you are taking monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil) selegiline (Eldepryl, Emsam, Zelapar) and tranylcypromine (Parnate) or if you have taken an MAO inhibitor during the past 14 days. Your doctor will probably tell you not to take trimipramine.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: cimetidine (Tagamet); decongestants; guanethidine (Ismelin); ipratropium (Atrovent); medications for irritable bowel disease, motion sickness, Parkinson's disease, ulcers, or urinary problems; medications for irregular heartbeats such as quinidine (Quinidex), flecainide (Tambocor), and propafenone (Rythmol); other antidepressants; and selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), and sertraline (Zoloft). Tell your doctor or pharmacist if you have stopped taking fluoxetine (Prozac, Sarafem) in the past 5 weeks. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have recently had a heart attack. Your doctor will probably tell you not to take trimipramine.
- tell your doctor if you have or have ever had glaucoma (an eye condition), enlargement of the prostate (a male reproductive gland), difficulty urinating, thyroid disease, seizures, or heart, kidney, or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking trimipramine, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking trimipramine.
- you should know that trimipramine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- remember that alcohol can add to the drowsiness caused by this medication.
- plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Trimipramine may make your skin sensitive to sunlight.
What SPECIAL DIETARY instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do IF I FORGET to take a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What SIDE EFFECTS can this medicine cause?
Trimipramine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- stomach pain
- weakness or tiredness
- excitement or anxiety
- dry mouth
- changes in appetite or weight
- difficulty urinating
- frequent urination
- blurred vision
- changes in sex drive or ability
- excessive sweating
- ringing in the ears
- pain, burning, or tingling in the hands or feet
Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:
- jaw, neck, and back muscle spasms
- slow or difficult speech
- shuffling walk
- uncontrollable shaking of a part of the body
- fever and sore throat
- difficulty breathing or swallowing
- yellowing of the skin or eyes
- seeing things or hearing voices that do not exist (hallucinating)
- chest pain
- pounding or irregular heartbeat
Trimipramine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at Web Site] or by phone [1-800-332-1088].
What should I know about STORAGE and DISPOSAL of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What should I do in case of OVERDOSE?
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What OTHER INFORMATION should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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