Depression, or as we all know it, is not a weakness in the mind, it is a medical condition that requires treatment. In such cases, along with psychotherapy, sometimes medication is also needed. One type of medication that is prescribed to treat such depression is Trimipramine. If your doctor has prescribed this medication for you, it is very important to be fully informed about it. Let's talk about this simply.
What really happens with this medicine?
Simply put, Trimipramine belongs to a class of drugs called tricyclic antidepressants (TCAs). Certain chemicals in the brain help regulate our mood. Specifically, they are called serotonin and norepinephrine. The balance of these chemicals can change in cases of depression.
What this drug does is increase the levels of those two chemicals in the brain, which improves your mood. It's like turning on two switches that control happiness and calmness.
Things you need to tell your doctor before taking medicine
Before your doctor prescribes this medicine for you, he or she needs to have a complete picture of your health. Therefore, if you have any of the following conditions, be sure to tell your doctor without hiding anything. This is very important for your own safety.
| Illness or other factors | Why do you need to tell the doctor ? |
|---|---|
| If you have an alcohol addiction | Combining alcohol and this medication may increase side effects. |
| Mental illnesses such as bipolar or schizophrenia | This medicine can change those symptoms. |
| Difficulty urinating, prostate problems | This medication may increase urinary retention. |
| Heart disease, heart rhythm irregularities, recent heart attacks | This medicine can affect heart function. |
| Glaucoma disease | There is a possibility of increased eye pressure. |
| Liver or kidney disease | The process of removing medication from the body may be affected. |
| Lung or respiratory diseases such as asthma | The risk of certain side effects may be increased. |
| Seizures or Stroke | The risks of these conditions can vary. |
| Thyroid diseases | There may be a relationship between hormone levels and the effectiveness of the drug. |
| Suicidal thoughts, attempts, or a family history of such | These thoughts may increase at the beginning of the medication, so close attention is required. |
| If you are pregnant or trying to get pregnant | You should talk to your doctor about the possible effects on the baby. |
| If the baby is breastfed | It should be considered whether the medicine can pass to the baby through breast milk. |
| Allergies to other medications, foods, or dyes | To find out if there is an allergy to the medicine or its ingredients. |
How should I use the medicine?
Take this medicine with a glass of water. Take the dose prescribed by your doctor, at the prescribed time. Never take more than the amount prescribed by your doctor.
Very important: Do not stop taking this medicine suddenly without your doctor's advice. Doing so may worsen your condition or cause other serious side effects. If you stop taking this medicine, do so as directed by your doctor, gradually reducing the dose.
What if I take too much medicine? (Overdose)
If you think you have taken too much medicine, it is an emergency. Immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital. This is not a game.
Remember, this medicine has been prescribed for you only. Do not give this medicine to someone else just because they have the same symptoms as you.
Other medications that may interact with this medicine
This is very important. When you take this medicine, it can interact with some other medicines. This can cause dangerous side effects. So tell your doctor about every medicine, herb, and vitamin you take.
| Never take Trimipramine with these | |
|---|---|
| MAOIs (e.g. Marplan, Nardil, Parnate) | Linezolid |
| Methylene blue (intravenous) | Pimozide |
| Phenothiazines such as Thioridazine | Some medications that control heart rate |
| Cisapride | St. John's Wort (herbal extract) |
| Problems can also occur with this medication (tell your doctor). | |
| High blood pressure medication (e.g. Clonidine) | Medicines for epilepsy (e.g. Carbamazepine) |
| Barbiturates (e.g. Phenobarbital) | Cimetidine |
| Thyroid hormones | Prescription pain medications |
Things to be careful about when taking medication
Mood changes and suicidal thoughts
This is the most important thing. Sometimes, especially in the first few weeks of treatment or when the dose is changed, depressive symptoms may increase or new suicidal thoughts may appear. If you or your family members notice these things , talk to your doctor right away.
- If you feel anxious or worried
- If you feel very restless and angry,
- If you suddenly become overly active
- If you can't sleep
- If you feel like your depression is getting worse
Drowsiness and dizziness
This medicine may make you feel drowsy or dizzy. Therefore, do not drive or operate machinery until you know how this medicine affects you. Do not get up suddenly from a sitting position, especially if you are elderly. This can make you dizzy and fall. Avoid drinking alcohol. This can make you feel even more drowsy.
Dry mouth, constipation and other things
- Dry mouth:This can be controlled by things like chewing sugar-free gum and drinking more water.
- Constipation: If you don't have a bowel movement for 2-3 days, talk to your doctor. Eating a high-fiber diet and drinking plenty of water can help.
- Sun sensitivity: Your skin may become sensitive to sunlight while taking this medication. Therefore, wear protective clothing and use sunscreen when going out in the sun.
What side effects might I experience?
Like any medicine, this one can have side effects. Some are serious, some are common. Let's take a look at what they are.
| Side effects that should be reported to the doctor immediately | |
|---|---|
| Allergic reactions (skin rash, itching, swelling of the face, lips, tongue) | Suicidal thoughts , mood swings |
| Changes in heart rate (fast or irregular heartbeat, chest pain, difficulty breathing) | Sudden eye pain , blurred vision, seeing rings around lights |
| Serotonin Syndrome: Possible symptoms include: restlessness, confusion, rapid heartbeat, muscle stiffness or twitching, excessive sweating, fever, vomiting, and diarrhea. | |
| Tell your doctor if it persists or is bothersome. | |
| Dry mouth | Drowsiness |
| Dizziness | Obstruction |
| Changes in sexual desire or function | Mild tremors (Tremors) |
Take-Home Message
- Never stop taking this medicine suddenly without your doctor's advice.
- Tell your doctor about all other medications, vitamins, and herbal products you are taking. Some of them may interact with this drug.
- Tell your doctor immediately if you experience any sudden changes in your mood or behavior, or suicidal thoughts, especially at the beginning of treatment.
- Avoid drinking alcohol while taking this medicine.
- Avoid driving or doing activities that require alertness until you know how the medication affects you.
- Overdose is an emergency. If this happens, go to the nearest hospital Emergency Department (ETU) immediately.
👩🏽⚕️ Additional questions (FAQs)
💬 What are Trimipramine / Surmontil capsules used for?
This is one of the oldest and most powerful psychiatric drugs in medicine (TCA - Tricyclic Antidepressant class) that can be used to control severe 'Depression'! It is used for treatment-resistant patients who have not seen any improvement/change despite all the other newer psychiatric drugs (SSRI/SNRI) and especially for those who have 'severe insomnia with major depression'.
💬 How does this drug (Trimipramine) relieve depression when it enters the brain?
Depression is caused by a decrease in the brain's happy/energetic chemicals (Serotonin, Norepinephrine). What this medicine does is 100% block the reuptake inhibition of the happy chemicals released by the brain. Then the brain is full of those chemicals, and the patient's depression is completely cured. Also, because it blocks histamine, it provides a 'sedative effect'.
💬 What are the most annoying side effects that can occur if you continue to take these pills (TCA)?
This is an old drug (TCA) so it has a lot of side effects! It has an 'anticholinergic' effect, which causes dry mouth, constipation, blurred vision, and difficulty urinating. Also, there is a high risk of the patient's heart rhythm changing and beating abnormally (Arrhythmia/QT Prolongation), which is a fatal condition, so the doctor should check the ECG regularly.
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