Categories: Drugs

Contraindications and side effects of Trimipramine

Discover the contraindications and side effects of Trimipramine.

This antidepressant, well known as Surmontil, has powerful effects on the human mind.

An antidepressant with side effects to watch out for.

Trimipramine is a drug that is used mainly to treat depressive states, although it is also prescribed in the case of sleep and anxiety disorders, as well as in some psychosomatic disorders.

Due to its high risk of generating adverse effects, this drug is usually prescribed with strict medical supervision.


Next, we will see what trimipramine is, what it is for, what are its possible adverse effects and how it is marketed.

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What is trimipramine and what is this drug for?

Trimipramine is a tricyclic antidepressant that has sedative and anticholinergic properties. The latter act both centrally and peripherally in the nervous system.

Its mechanism of action is not entirely known, but it is chemically related to another tricyclic drug called imipramine.

Tricyclic and tetracyclic antidepressants are two of the first to be used in psychopharmacology.


These are drugs that prevent the reuptake of serotonin, and sometimes norepinephrine, in the synaptic space, which produces a high concentration of these neurotransmitters and a reduction in some symptoms of depression.

Trimipramine is used primarily to treat depressive states, whether they are mild or severe.

But it is also used for the treatment of psychosomatic disorders that have a depressive background, as well as for states of anxiety and sleep disturbances.

The improvement associated with this drug usually occurs after the first few weeks, or sometimes a little longer, from the start of treatment.

At the same time, that is, during the early stages of recovery, the risk of suicide that often accompanies depression can increase.


Therefore, it is recommended to closely accompany the person until the first signs of improvement appear.

In fact, until recently, tricyclic and tetracyclic drugs were among the most widely used antidepressants.

However, having a nonspecific mechanism of action, these drugs usually affect other important substances for the body (such as acetylcholine, histamine, and dopamine).

This increases the probability of suffering adverse effects, as well as mortality from an overdose, which is why its prescription has been reduced.

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Route of administration and recommended dose

The trade name of trimipramine is Surmontil and it is marketed as tablets containing 35 mg of trimipramine maleate, which is equivalent to 25 mg of the active substance.

Surmontil is administered orally, and in the case of being prescribed to treat minor depressions, psychosomatic states, or sleep and anxiety disorders, it is usually administered as a single dose between 12.5 mg and 50 mg, usually at night.

On the other hand, in the case of severe depression, it is generally recommended to take 300 mg to 400 mg per day in 2 to 3 doses. Its validity period is 5 years and it is advisable to keep it at a temperature that does not exceed 25º.

Likewise, when it becomes necessary to reduce the doses, the general recommendation is to do so progressively and monitor the risk of deprivation syndrome.


Possible side effects of trimipramine

As with other tricyclic antidepressant drugs, the adverse effects that trimipramine generates are the following:

•Weight loss.

•Endocrine problems, such as breast hypertrophy or galactorrhea.

•Allergic skin reactions.

•Hematological difficulties.



•Dry mouth and urinary retention.

•Elevation of psychomotor inhibition.

•Mood swings with the appearance of manic episodes.

•In people over 50 there is an increased risk of bone fractures.


•Suicidal ideation and behavior, especially in those under 25 years of age, studies have shown that this occurs once treatment is started or as soon as it ends.

•Serotonin syndrome, which can be fatal and can lead to neuromuscular excitement, autonomic changes, and changes in mental status; and what can happen when this drug is mixed with other serotonergic active ingredients.

•Nervous system disorders, which can be caused by the peripheral effects of trimipramine, by its central effects, or by enhancing the very nature of depression.

•Cardiac disorders.

•Metabolism and nutrition disorders.


Contraindications of trimipramine and interaction with other substances

Trimipramine is contraindicated in children under 12 years of age and in people who have a history of suicidal ideation and attempt.

Likewise, trimipramine has the risk of producing liver and kidney failure.

It should not be mixed with MAOI-type antidepressant drugs or administered in periods close to the last intake of these.

Likewise, mixing trimipramine with SSRI-type antidepressant drugs, such as fluoxetine and fluvoxamine, increases the risk of toxicity.

The sedative effect of this drug is enhanced when mixed with sedatives, morphine derivatives, barbiturates, antihistamines, anxiolytics, methadone, clonidine, and hypnotics.


The same happens if this drug is mixed with alcoholic beverages. There is also a risk of generalized seizures if this drug is mixed with anti-seizure drugs.

Due to the possibility of its excretion in breast milk, it is not advisable to use this drug during breastfeeding. There is also the possibility of secretion through the placenta, so it is not recommended to use it during pregnancy.

Likewise, as with other psychoactive medications, this antidepressant can alter some physical and psychological faculties, so it is recommended to take precautions when driving or operating heavy machinery.

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