Imipramine and Desipramine

General Information

Imipramine (Tofranil) is the prototype of the tricyclic antidepressant drugs, which now exceed 10 in number and have been among the most frequently used agents for the treatment of depression. They bear a close chemical relationship to the phenothiazines (imipramine is a promazine analogue) and yet have certain distinct pharmacological effects.

Desimipramine is the active metabolite of imipramine.  It is a also a drug in its own right (common trade name Norpramin).

Adverse reactions to imipramine therapy include orthostatic hypotension, paresthesias, dry mouth, blurred vision, confusion, disorientation, insomnia, agranulocytosis and paralytic ileus. Fatal hepatic necrosis has been reported. Imipramine toxicity is characterised by hyperactivity, seizures, respiratory depression, hypertension, cardiac arrhythmias, hyperpyrexia, tachycardia, urinary retention, coma, circulatory collapse and death.