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Imipramine
Aka: Imipramine, Tofranil
- Indications
- Panic Disorder
- Pediatric Major Depression
- Attention Deficit Hyperactivity Disorder
- Nocturnal Enuresis (not first line agent)
- Dosing: General
- Adult: 25-50 mg PO qhs
- Dosing: Nocturnal Enuresis in children
- Consider other measures for Nocturnal Enuresis first
- Consider baseline EKG before starting medication
- Initial dose
- Age 6-8 years: 25 mg PO one hour before bedtime
- Age 8-12 years: 50 mg PO one hour before bedtime
- Age over 12 years: 75 mg PO one hour before bedtime
- Maximum dosing: up to 0.9 to 1.5 mg/kg
- Discontinue after 3-6 months (some guidelines suggest maximum of 3 months)
- Taper to one half dose nightly for 2 weeks
- Taper to one half dose every other night for 2 weeks
- Efficacy: Nocturnal Enuresis
- Response in up to 60% of children
- Relapse is common soon after stopping medication
- Pharmacokinetics
- Obtain serum levels in pediatric population
- Avoid as full dose Antidepressant
- Serum Half Life: 11 to 25 hours
- Therapeutic plasma level: 200 to 350
- Adverse effects
- See Tricyclic Antidepressants
- Significant adverse effects
- Anticholinergic Symptoms
- Drowsiness
- Sleep problems
- Gastrointestinal upset
- Orthostatic Hypotension
- Cardiac Arrhythmia
- Weight gain
- Precautions
- See Tricyclic Antidepressants
- Serious cardiotoxicity in overdosage
- References
- Thiedke (2003) Am Fam Physician 67:1499-510 [PubMed]