Melipramin® [Imipramine]

Inside, during or immediately after a meal (to reduce irritation of the gastric mucosa), individual dose selection is necessary, adults in the initial dose — 25–50 mg 3–4 times a day, then increase the dose daily by 25 mg and bring it to 200-250 mg / day, sometimes up to 300 mg / day; the duration of treatment in mild forms of depression - 4-6 weeks. After that, the dose is gradually reduced (by 25 mg every 2-3 days) and transferred to maintenance therapy at a dose of 25 mg 1-4 times a day for another 4-6 weeks. In older persons, the initial dose is 10 mg / day, with a gradual increase to 30-50 mg or more, until the optimum effect is obtained. To reduce the irritating effect on the gastric mucosa, a post-meal intake is recommended. For maintenance therapy, a single dose at night is often used, fractional administration is left in the elderly, adolescents, and in patients with cardiovascular disease. Higher doses for adults inside: single - 100 mg, daily - 200 mg (on an outpatient basis), 300 mg (in the conditions of a hospital) and 100 mg of elderly patients. Children, as an antidepressant, initial dose - 10 mg; within 10 days, the dose is gradually increased: for children aged 6-8 years - up to 20 mg, 8-14 years - up to 20-25 mg, over 14 years old - up to 50 mg and more (up to a maximum of 100 mg), at 2 divided doses. With bedwetting at the beginning of treatment, the daily dose: for children aged 6-8 years - 25 mg, 9-12 years - 25-50 mg, over 12 years - 50-75 mg, 1 time per day for 1 hour before sleep . With incontinence, manifested in the early night hours, the daily dose can be administered in 2 doses: one half of the dose is taken in the middle of the day, and the other - before bedtime. If there is no effect after 1 week of treatment, higher doses are prescribed. A daily dose above 75 mg does not usually improve the results. The highest daily dose for children is 2.5 mg / kg. In severe forms of depression in a hospital, you can apply a combination therapy - in / m and orally. As an antidepressant - up to 100 mg / day in divided doses. Higher doses for adults: single - 50 mg, daily - 300 mg. Children under 12 are not recommended. Too early discontinuation of treatment can lead to a resumption of depression. Imipramine should be abolished gradually.

The drug is contraindicated for use during pregnancy and lactation.

When prescribing Melipramin in patients with epilepsy, careful monitoring of the condition is necessary, since The drug can trigger an epileptic seizure in the first days of treatment.

When using the drug should note that the therapeutic effect occurs not earlier than 1-3 weeks from the start of treatment, the maintenance dose should be taken at least 3 months. In the initial period of Melipramin therapy, constant medical supervision of patients with suicidal tendencies is necessary.

When the drug is suddenly discontinued, withdrawal symptoms (nausea, headache, irritability, insomnia, arrhythmia, and extrapyramidal disorders) develop.

Do not use electroshock therapy while applying Melipramin.

In the case of bipolar depression, the drug may provoke the patient's transition to the manic phase.

In the first days of using tricyclic antidepressants to treat a panic condition, a paradoxically increased psychomotor anxiety may occur. If this condition does not pass in 2 weeks, then it is advisable to prescribe drugs - benzodiazepine derivatives.

Caution is prescribed Melipramin to patients with a tendency to constipation.

Melipramin should be carefully prescribed for pheochromocytoma or acute porphyria due to the threat of exacerbation of diseases with the development of the crisis.

Precautions should be prescribed the drug to elderly patients and children, because these groups of patients may have serious side effects.

During the period of treatment with Melipramin, systematic general blood tests, evaluation of liver function indicators, ECG monitoring and blood pressure levels are recommended.

Along with treatment with Melipramin, alcoholic beverages should not be consumed.

Influence on ability to drive motor transport and control mechanisms

During the period of use of Melipramin, it is prohibited to drive vehicles and perform other potentially hazardous work that requires increased concentration of attention and psychomotor speed.

Symptoms: psychomotor agitation, dry mouth, mydriasis, tachycardia, urinary retention, confusion, difficulty breathing, convulsions, coma.

Treatment: it is necessary to monitor the function of the cardiovascular and respiratory systems, symptomatic therapy is carried out. When seizures in / in enter diazepam, phenytoin, phenobarbital.

Imipramine does not undergo dialysis. Forced diuresis is also ineffective.