Trimipramine: MedlinePlus Drug Information (2023)

pronounced as (trye mi' pra meen)

  • Why is this drug prescribed?
  • How should this medicine be used?
  • Other uses of this substance
  • What special precautions should I take?
  • What special dietary recommendations should I follow?
  • What should I do if I miss a dose?
  • What side effects can this drug cause?
  • What should I know about the storage and disposal of this medicine?
  • In case of emergency/overdose
  • What other information do I need to know?
  • Brand names


A small number of children, teenagers and young adults (up to 24 years) who took antidepressants ('mood enhancers') such as trimipramine during clinical trials have had suicidal thoughts (thinking about harming or killing themselves, planning or trying to). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may have a higher risk of suicide than children, teens, and young adults who do not take antidepressants to treat these conditions. However, experts aren't sure how big that risk is and how much it should be taken into account when deciding whether a child or teenager should take an antidepressant. Children under the age of 18 should not usually take trimipramine, but in some cases a doctor may decide that trimipramine is the best medicine to treat a child's condition.

You should know that your mental health can change in unexpected ways while you are taking trimipramine or other antidepressants, even if you are an adult over the age of 24. Suicidal thoughts may occur, especially at the beginning of treatment and when the dose is increased or decreased. You, your family or relatives should contact your doctor immediately if you experience any of the following symptoms: new or worsening depression; thinking about, planning or trying to harm or kill yourself; extreme worry; excitement; panic attack; difficulty falling or staying asleep; aggressive behavior; irritability; acts without thinking; severe anxiety; and crazy, abnormal tension. Make sure your family or loved ones know which symptoms may be serious so they can call a doctor when you are unable to seek treatment on your own.

Your doctor will want to see you often while you are taking trimipramine, especially at the beginning of treatment. Remember to make an appointment with your doctor for all office visits.

Your doctor or pharmacist will give you the manufacturer's Patient Information Leaflet (Medication Guide) when you start treatment with trimipramine. Please read the information carefully and ask your doctor or pharmacist if you have any questions. The Medication Guide can also be obtained from the FDA website:

Regardless of your age, before taking an antidepressant, you, your parent, or guardian should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that depression or other mental illness greatly increases the risk of suicide. This risk is higher if you or someone in your family has or has ever had bipolar disorder (mood swings from depressed to abnormally excited) or mania (frenzy, abnormally excited mood), or have thought or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family history. You and your doctor will decide which type of treatment is right for you.

Why is this drug prescribed?

(Video) Introduction to MedlinePlus

Trimipramine is used to treat depression. Trimipramine belongs to a class of drugs 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 be taken by mouth. It is usually taken one to three times a day. Take trimipramine at about the same time each day. Follow the directions on the prescription label 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 benefits of trimipramine. Continue to take trimipramine even if you feel well. Do not stop taking trimipramine without talking to your doctor.

Other uses of this substance

This medication may be prescribed for other purposes; ask your doctor or pharmacist for more information.

What special precautions should I take?

Before taking trimipramine,

  • Tell your doctor and pharmacist if you are allergic to trimipramine, clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or any other medications or any of the ingredients in trimipramine capsules. Ask your doctor or pharmacist for a list of ingredients.
  • Tell your doctor if you take monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have taken an MAOI inhibitor within the last 14 days. Your doctor will probably tell you not to take trimipramine.
  • Tell your doctor and pharmacist what prescription and over-the-counter medicines, vitamins, supplements and herbal remedies you are taking or plan to take. Be sure to list one of the following: cimetidine (Tagamet); decongestants; guanethidine (Ismelin); ipratropium (Atrovent); medicines for irritable bowel syndrome, motion sickness, Parkinson's disease, ulcers or urinary tract problems; medicines for irregular heartbeat, 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) within the last 5 weeks. Your doctor may need to change the dose of your medication or monitor you closely 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 an enlarged prostate (male reproductive gland), difficulty urinating, thyroid disease, seizures, or heart, kidney, or liver disease.
  • Tell your doctor if you are pregnant, planning to become pregnant or breast-feeding. If you become pregnant while taking trimipramine, contact your doctor.
  • talk to your doctor about the risks and benefits of taking trimipramine if you are 65 or older. Older adults should not usually take trimipramine because it is not as safe or effective as other drugs that may be used to treat the same condition.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking trimipramine.
  • you should know that trimipramine can cause drowsiness. Do not drive or operate machinery until you know how this medicine affects you.
  • remember that alcohol can increase the drowsiness caused by this drug.
  • plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Trimipramine can make your skin sensitive to sunlight.
  • you should know that trimipramine can cause angle-closure glaucoma (a condition in which fluid is suddenly blocked and unable to drain out of the eye, causing a rapid, severe increase in eye pressure that can lead to vision loss). Talk to your doctor about getting an eye exam before you start taking this medicine. If you have nausea, eye pain, vision changes such as seeing colored rings around lights, and swelling or redness in or around the eye, contact your doctor immediately or seek emergency medical attention.
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What special dietary recommendations should I follow?

Unless your doctor tells you otherwise, continue with your normal diet.

What should I do if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed dose.

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What side effects can this drug cause?

Trimipramine can cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • nausea
  • vomiting
  • diarrhea
  • stomach ache
  • somnolens
  • weakness or fatigue
  • tension or anxiety
  • confusion
  • dizziness
  • headache
  • Nightmares
  • dry mouth
  • changes in appetite or weight
  • constipation
  • difficulty urinating
  • frequent urination
  • changes in sex drive or ability
  • excessive sweating
  • the 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 or SPECIAL PRECAUTIONS section, contact your doctor or seek emergency medical attention immediately:

  • muscle spasms in the jaw, neck and back
  • slow or difficult speech
  • shaky gait
  • uncontrollable shaking of body parts
  • fever and sore throat
  • difficulty breathing or difficulty swallowing
  • rash
  • yellowing of the skin or eyes
  • cramps
  • seeing things or hearing voices that aren't there (hallucinations)
  • pain in the chest
  • palpitations 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 healthcare provider can submit a report to the Food and Drug Administration (FDA) MedWatch Online Adverse Event Reporting Program ( or by phone (1-800-332-1088).

What should I know about the storage and disposal of this medicine?

Keep this medicine in the container it came in, tightly closed and out of the reach of children. Store it at room temperature, away from excess heat and moisture (not in the bathroom).

It is important to keep all medicines out of the reach of children, as many containers (such as weekly pill containers and containers for eye drops, creams, patches and inhalers) are not child-resistant and can be easily opened by small children. To protect young children from poisoning, always keep the safety caps closed and immediately put the medicine in a safe place - one that is upstairs, out of the sight and sight of children.

Unnecessary medicines should be disposed of in a special way to ensure that pets, children and others cannot ingest them. However, do not flush this medicine down the toilet. Instead, the best way to get rid of your medication is through the medication take-back program. Talk to your pharmacist or contact your local waste/recycling department to find out about take-back programs in your community. See the FDA Safe Disposal of Drugs website ( for more information if you do not have access to the return program.

In case of emergency/overdose

In the event of an overdose, call the poison control hotline at 1-800-222-1222. Information is also available online at If the victim has passed out, had a seizure, is having trouble breathing, or is unable to wake up, call 911 immediately.

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What other information do I need to know?

Save all medical appointments.

Do not let anyone take your medicine. Ask your pharmacist any questions about refilling your prescription.

It is important to keep a written list of all prescription and over-the-counter medications you take, as well as any products such as vitamins, minerals or other supplements. You should take this list with you every time you visit your doctor or if you are admitted to hospital. This is also important information to have with you in case of emergency.

Brand names

  • Surmontil®
Most recently -15.09.2018

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Trimipramine: MedlinePlus Drug Information? ›

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.

What are the warnings for trimipramine? ›

See also the Warning section. Dizziness, drowsiness, difficulty urinating, headache, weakness, changes in appetite/weight, dry mouth, blurred vision, and constipation may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.

What drug interacts with trimipramine? ›

Drug Interactions
  • Bepridil.
  • Bromopride.
  • Cisapride.
  • Clorgyline.
  • Furazolidone.
  • Grepafloxacin.
  • Iproniazid.
  • Isocarboxazid.
May 1, 2023

Is trimipramine still available? ›

Trimipramine was approved for use in the United States in 1979 and is still clinically available, although now not widely used. Trimipramine is available as capsules of 25, 50 and 100 mg generically and under the brand name Surmontil.

Is trimipramine FDA approved? ›

History of Surmontil

The U.S. Food and Drug Administration (FDA) approved trimipramine maleate (as Surmontil) oral capsules on January 1, 1982 as a 25 mg and 50 mg capsule.

Is trimipramine good for anxiety? ›

The drug is also an effective anxiolytic, and can be used in the treatment of anxiety. In addition to depression and anxiety, trimipramine is effective in the treatment of insomnia, and unlike most other hypnotics, does not alter the normal sleep architecture.

Is trimipramine a sedating? ›

Trimipramine is a sedating tricyclic antidepressant that has been used as a hypnotic [1]; it shares this activity with other drugs of its class, notably amitriptyline, dosulepin, doxepin, and trazodone, and with the tetracyclics mianserin and mirtazapine.

Which substance should never be taken with antidepressants? ›

Mixing antidepressants with alcohol, cocaine, Molly or other illegal drugs is never recommended. If you're taking medication for depression, it is important that you leave the drug alone and don't throw in any other substances that might prevent it from doing its job.

Does trimipramine cause constipation? ›

See your eye doctor if the problem does not go away or is severe. This medication can cause constipation.

Is trimipramine addictive? ›

If you've been taking trimipramine for a while and want to stop taking it, talk to your provider first. While it's not addictive, stopping trimipramine suddenly can cause nausea, headache, and uneasiness for a few days until your body readjusts.

What are the benefits of trimipramine? ›

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.

What is the cost of trimipramine? ›

Oral Capsule
QuantityPer unitPrice
30$10.27 – $15.54$308.22 – $466.26

What is the new medicine for treatment-resistant depression? ›

There's good news for people with severe treatment-resistant depression: Esketamine is a groundbreaking therapy that can provide relief from major depression within hours. “For the first time in 60 years, we have a new antidepressant therapy that isn't just a spinoff of existing drugs,” says Adam Kaplin, M.D., Ph.

What class of drug is trimipramine? ›

  • Generic Name: trimipramine.
  • Brand Name: Surmontil.
  • Drug Class: Antidepressants, TCAs.

What is the active ingredient in trimipramine? ›

PRINCIPAL DISPLAY PANEL - 100 mg 30 Capsule Bottle Label
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength

What is the safest antidepressant for liver disease? ›

The best antidepressant options for patients with liver failure is desvenlafaxine. This drug is an active metabolite of venlafaxine, with high percentage of unchanged metabolites eliminated in the urine.

What is the number 1 anxiety medication? ›

The most prominent of anti-anxiety drugs for the purpose of immediate relief are those known as benzodiazepines; among them are alprazolam (Xanax), clonazepam (Klonopin), chlordiazepoxide (Librium), diazepam (Valium), and lorazepam (Ativan).

What are the top 3 anxiety medications? ›

Benzodiazepines most commonly used to treat anxiety disorders are clonazepam (Rivotril)*, alprazolam (Xanax) and lorazepam (Ativan).

What is the best anti anxiety drug on the market? ›

Benzodiazepines (also known as tranquilizers) are the most widely prescribed type of medication for anxiety. Drugs such as Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam) work quickly, typically bringing relief within 30 minutes to an hour.

Why not drink coffee with antidepressants? ›

“If you're taking antidepressants to manage an anxiety disorder, caffeine can directly counteract the effect of the antidepressants or make anxiety worse,” Dr. Netherton says. Also? Caffeine and antidepressants may also make you more prone to your medication's side effects.

What is the best and safest antidepressant? ›

Bupropion, citalopram, escitalopram, and sertraline were better tolerated than the other antidepressants. Escitalopram and sertraline were found to have the best combination of efficacy and acceptability.

What is the least damaging antidepressant? ›

Selective serotonin reuptake inhibitors (SSRIs).

Health care providers often start by prescribing an SSRI . These antidepressants generally cause fewer bothersome side effects and are less likely to cause problems at higher therapeutic doses than other types of antidepressants.

How do I stop taking trimipramine? ›

Trimipramine should not be stopped abruptly unless serious side effects have occurred. Slowly tapering the dose in 25 – 50 mg increments over 3 to 4 weeks, or longer if necessary, can help prevent discontinuation symptoms such as anxiety, flu-like symptoms and insomnia.

How much trimipramine can you take? ›

Adults—At first, 75 milligrams (mg) per day, taken in divided doses. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day. Teenagers and older adults—At first, 50 mg per day.

How do you take trimipramine? ›

It is usual to take trimipramine once a day, at bedtime. Some doctors, however, may recommend smaller doses taken two or three times a day. Your doctor will tell you which is right for you and the directions will also be printed on the label of the pack to remind you about what the doctor said to you.

Does Trimipramine increase dopamine? ›

The data suggest that the mechanism of action of imipramine in this model is an increase in functional activity at dopamine (DA) synapses.

What is the half life of Trimipramine maleate? ›

Plasma protein binding of trimipramine is about 95%. The plasma elimination half-life is around 23 hours.

What is the best drug on the market for depression? ›

Selective serotonin reuptake inhibitors (SSRIs) were launched in the mid to late 1980s. This generation of antidepressants is now the most common class used for depression. Examples include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), fluoxetine (Prozac, Sarafem), and sertraline (Zoloft).

What is most widely prescribed to treat depression? ›

SSRIs are the most widely prescribed type of antidepressants. They're usually preferred over other antidepressants, as they cause fewer side effects. An overdose is also less likely to be serious. Fluoxetine is probably the best known SSRI (sold under the brand name Prozac).

What are the strongest depression meds? ›

6 most effective antidepressants sold in the United States
  • Amitriptyline.
  • Effexor (venlafaxine)
  • Lexapro (escitalopram)
  • Paxil (paroxetine)
  • Remeron (mirtazapine)
  • Trintellix (vortioxetine)
Feb 8, 2022

What is the danger of serotonin reuptake inhibitors? ›

Some people have suicidal thoughts and a desire to self-harm when they first take SSRIs. Young people under 25 seem particularly at risk. Contact your GP or go to hospital immediately if you have thoughts of killing or harming yourself at any time while you're taking SSRIs.

What are the warnings for tiagabine? ›

Tiagabine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
  • dizziness or lightheadedness.
  • drowsiness.
  • lack of energy or weakness.
  • wobbliness, unsteadiness, or incoordination causing difficulty walking.
  • depression.
  • hostility or anger.
  • irritability.
  • confusion.
Jan 15, 2018

Is mirtazapine a high alert medication? ›

FDA warning: Suicide risk

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous. Mirtazapine may cause an increase in suicidal thoughts or actions.

Are serotonin reuptake inhibitors risky? ›

Some SSRIs can cause dizziness, drowsiness and blurred vision, particularly when you first start taking them. If you do experience these symptoms, you shouldn't drive or use heavy tools and machinery. The symptoms should be temporary, but speak to your doctor if you're unsure.

Why would you want to block serotonin reuptake? ›

After carrying a message, serotonin is usually reabsorbed by the nerve cells (known as "reuptake"). SSRIs work by blocking ("inhibiting") reuptake, meaning more serotonin is available to pass further messages between nearby nerve cells.

Which antidepressant has highest risk of serotonin syndrome? ›

Tricyclic antidepressants are also serotonin reuptake inhibitors, with clomipramine and imipramine being the most potent and likely the only TCAs to be involved in serotonin toxicity; other TCAs such as amitriptyline are weaker inhibitors and are thus unlikely to cause toxicity.

Why would you want to inhibit serotonin reuptake? ›

Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain nerve cells (neurons). SSRIs block the reabsorption (reuptake) of serotonin into neurons. This makes more serotonin available to improve transmission of messages between neurons.

Why is gabapentin bad? ›

Gabapentin is known to cause respiratory depression, particularly when combined with other central nervous system depressants. Long-term use can cause physiologic dependence and withdrawal syndrome on cessation, characterized by diaphoresis, anxiety, confusion and, rarely, seizures.

What is the bad side of gabapentin? ›

Gabapentin may cause vision changes, clumsiness, unsteadiness, dizziness, drowsiness, sleepiness, or trouble with thinking. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert, well-coordinated, or able to think or see well.

What is life threatening about gabapentin? ›

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema. These can be life-threatening and require immediate medical attention.

Who Cannot take mirtazapine? ›

Mirtazapine is not suitable for some people. To make sure it's safe for you, tell your doctor before starting to take mirtazapine if you: have ever had an allergic reaction to mirtazapine or any other medicine. have a heart problem as mirtazapine can cause low blood pressure.

What is the best medication for anxiety in the elderly? ›

What are the first-line medications to treat anxiety in older adults?
  • Escitalopram (Lexapro)
  • Duloxetine (Cymbalta)
  • Buspirone (Buspar)
  • Venlafaxine (Effexor)
  • Sertraline (Zoloft)
  • Considerations.
  • Paying for medication.
  • Summary.
Aug 9, 2022

Why is mirtazapine given to the elderly? ›

In conclusion, from my review of the literature and from my clinical experience: (1) mirtazapine is effective in the treatment of depression; (2) side effects of mirtazapine, such as somnolence and increased appetite, can be beneficial in the depressed elderly patient who is not sleeping or eating, especially in the ...

What is the downside of too much serotonin? ›

Serotonin is a chemical that the body produces naturally. It's needed for the nerve cells and brain to function. But too much serotonin causes signs and symptoms that can range from mild (shivering and diarrhea) to severe (muscle rigidity, fever and seizures). Severe serotonin syndrome can cause death if not treated.

What are signs of serotonin syndrome? ›

Symptoms occur within minutes to hours of taking medicines that can cause serotonin syndrome, and may include:
  • Agitation or restlessness.
  • Abnormal eye movements.
  • Diarrhea.
  • Fast heartbeat and high blood pressure.
  • Hallucinations.
  • Increased body temperature.
  • Loss of coordination.
  • Nausea and vomiting.
Apr 16, 2022

Which SSRI is best for anxiety? ›

Selective serotonin reuptake inhibitors. These include fluoxetine (aka Prozac), paroxetine (aka Paxil), sertraline (aka Zoloft), fluvoxamine (aka Luvox), citalopram (aka Celexa), and escitalopram (aka Lexapro). They tend to be the first line choice for multiple anxiety disorders and depression.


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