Imipramine still is the standard to which the antidepressant actitvity of other drugs is compared. Even for severe depressions (particularly of endogenous origins) it has a success rate of 60 to 70%. The effect of imipramine usually only sets in after 2 to 3 weeks but remains efficacious in longer treatments. Amitriptyline has a similar efficacy, but its sedative action is stronger. None of the new drugs have demonstrated a significantly higher antidepressant activity.

Imipramine can be used advantageously for a number of different problems: its use is particularly well documented for anxiety states where it can be an alternative to benzodiazepines (e.g. alprazolam). Its benefits for obsessive syndromes and agoraphobia are not as clearly established. Imipramine can sometimes induce improvement of bulimia and possibly anorexia.

Even though many specialists are sceptical, imipramine is prescribed to bedwetting children; however, a drug therapy is not always necessary. The success of imipramine is also controversial for incontinence in adults. Amitriptyline is better documented for the treatment of chronic pain or painful neuropathies.

Table of Contents | Pharmacology | Adverse Reactions & Interactions | Contraindications & Cautions | Risk Groups | References