Depression
Adult: 50-300 mg daily.
Indications and Dosage
Oral
Depression Adult: 50-300 mg daily.
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Contraindications
Intoxication with alcohol, barbiturates or benzodiazepines. Benign prostatic hypertrophy, urinary retention; glaucoma; pyloric stenosis, bowel obstruction; predisposition to seizures or epilepsy. Severe hepatic and renal impairment.
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Special Precautions
Avoid abrupt withdrawal. Bradycardia, cardiac, arrhythmias;; hypokalaemia. May impair ability to drive or operate machinery. Monitor LFTs on prolonged use. Pregnancy and lactation.
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Adverse Reactions
Dry mouth, stuffy nose, fatigue, drowsiness, dizziness, increased sweating, blurred vision, speech impairment, tremors, heart rhythm disturbances, palpitations, orthostatic hypotension, liver dysfunction, constipation, wt gain, urinary retention, decreased libido, increased thirst, rash, urticaria.
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Overdosage
Symptoms: Excitement, restlessness, marked antimuscarinic effects (e.g. dry mouth, hot dry skin, dilated pupils, tachycardia, urinary retention, intestinal stasis), unconsciousness, convulsions and myoclonus, hyperreflexia, hypothermia, hypotension, metabolic acidosis, respiratory and cardiac depression, cardiac arrhythmias. Treatment: Symptomatic and supportive care.
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Drug Interactions
Reduced hypotensive effect of guanethidine, clonidine. Additive CNS depression or may potentiate the action of CNS depressants e.g. alcohol, sedatives or hypnotics. Increased effects/toxicity with cimetidine, phenothiazines, haloperidol, SSRIs. May increase effects of oral anticoagulants. Increased risk of arrhythmias with quinidine. Additive toxicity with other anticholinergics.
Potentially Fatal: Severe and sometimes fatal reactions may occur with MAOIs; at least 2 wk should elapse between discontinuance of a TCA or a MAOI and initiation of therapy with other drug class. May increase pressor and cardiac effects of sympathomimetics. |
Action
Description: Opipramol is a TCA. It exerts its antidepressant action by blocking the neuronal re-uptake of noradrenaline and serotonin.
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MIMS Class
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