Manufacturer: Novartis manufactures Tofranil - Imipramine.
The uses of Tofranil - Imipramine include:
Tofranil is indicated in the treatment of depressive illness, especially where sleep disturbance, anxiety or agitation is a presenting symptom. Sleep disturbance is controlled within 24 hours and true antidepressant action follows within 7-10 days.
Dosage and Administration
Mild/Moderate Depression in General Practice
The recommended dosage is 50-75mg orally given two hours before bedtime, the larger dose (75mg) being preferable for those patients with more marked sleep disturbance. Treatment should be continued for at least three weeks.
Moderate/Severe Depression (Patients under Psychiatric Supervision)
Initial dosage - 75mg orally per day. This is best given as a single dose late in the evening or as 25mg midday and 50mg late in the evening. Dosage should then be increased as necessary until the optimal therapeutic level is reached, usually 150-300mg per day. Treatment at this dosage should be continued for four to six weeks, dosage then being reduced to a maintenance level, usually within the range of 75-150mg per day, for two to three months. Giving most of the total daily dosage at night induces a rapid return to normal sleep, reduces the need for night-time sedation and minimises daytime drowsiness.
Initially 10-25mg three times a day. The initial dose should be increased with caution under close supervision.
Half the normal maintenance dose may be sufficient to produce a satisfactory clinical response.
Not recommended for use in adolescent patients 13-18 years of age for the treatment of depression, unless under the supervision of a specialist.
Impaired Liver Function
As trimipramine is metabolised in the liver, patients with liver disease may require a reduced dosage.
Trimipramine should be used with caution in patients with chronic renal failure.
Cyclothymic patients with recurrent depression may require maintenance therapy for up to one year or even longer.
When discontinuing treatment with Imipramine, this should be done with a gradually reducing dosage regimen. If during this regimen there are signs of a relapse, patients should be maintained on the therapy for a further 3-6 months before a second attempt at treatment discontinuation is made.