AccScience Publishing / ITPS / Volume 6 / Issue 2 / DOI: 10.36922/itps.0505
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PERSPECTIVE ARTICLE

Therapeutic drug monitoring of imipramine correlation with a case study

Mohammed Misbah Ul Haq1* ,  Bachi Tazneem1 ,  Maryam 1
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1 Department of Pharmacy Practice, Deccan School of Pharmacy, Hyderabad, Telangana, India
INNOSC Theranostics and Pharmacological Sciences 2023, 6(2), 0505 https://doi.org/10.36922/itps.0505
Submitted: 16 April 2023 | Accepted: 3 July 2023 | Published: 20 July 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

This article provides an overview of the pharmacokinetics, pharmacodynamics, contraindications, and precautions of imipramine, a tricyclic antidepressant (TCA) medication commonly used to treat depression and other mental health conditions. Imipramine’s pharmacokinetic properties include rapid absorption, distribution to various tissues, metabolism in the liver, and elimination through the kidneys. Imipramine’s pharmacodynamic effects are mediated through its actions on various neurotransmitters, including serotonin, norepinephrine, and dopamine. The article also discusses the contraindications and precautions associated with imipramine use. Imipramine is contraindicated in patients with a history of hypersensitivity to TCAs, recent myocardial infarction, and certain cardiac disorders. It should also be used with caution in patients with a history of seizures, urinary retention, glaucoma, and liver or kidney disease. In conclusion, imipramine is a medication with well-established pharmacokinetic and pharmacodynamic properties, but its use is associated with certain contraindications and precautions. Clinicians should carefully consider these factors when prescribing imipramine to patients with depression or other mental health conditions.

Keywords
Imipramine
Therapeutic drug monitoring
Case study
Adverse drug reactions
Contraindications
Funding
None.
References
  1. Yao LP, Li YF, Sun HF, 2019, Therapeutic drug monitoring of imipramine in the treatment of depression. Int J Clin Exp Med, 12: 12931–12936.

 

  1. Smith HJ, Meredith SE, Appleton KM, 2019, Therapeutic drug monitoring of tricyclic antidepressants: How does it inform clinical practice? Psychopharmacology (Berl), 236: 1037–1051.

 

  1. Fong SY, Saff EB, Zisook S, 1985, Imipramine therapeutic monitoring in a case of refractory depression. J Clin Psychiatry, 46: 37–38.

 

  1. Hicks JK, Swen JJ, Thorn CF, et al., 2013, Implementation consortium. clinical pharmacogenetics implementation consortium guideline for CYP2D6, CYP2C19, and CYP2C9 genotypes and dosing of tricyclic antidepressants. Clin Pharmacol Ther, 93: 402–408. https://doi.org/10.1038/clpt.2013.2

 

  1. Crews KR, Gaedigk A, Dunnenberger HM, et al., 2014, Clinical pharmacogenetics implementation consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update. Clin Pharmacol Ther, 95: 376–382. https://doi.org/10.1038/clpt.2013.254

 

  1. Cipriani A, Barbui C, Butler R, et al., 2009, Depression in Adults: Drug and Physical Treatments. Clinical Guideline [CG90]. London: National Institute for Health and Clinical Excellence.

 

  1. Stahl SM, 2013, Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. United Kingdom: Cambridge University Press.

 

  1. Katzung BG, 2017, Basic and Clinical Pharmacology. United States: McGraw Hill.

 

  1. Preskorn SH, 2013, Clinical pharmacology of antidepressants. In: Handbook of Clinical Neurology. Vol. 117. Netherlands: Elsevier, p291–305.

 

  1. Leucht S, Cipriani A, Spineli L, et al., 2013, Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: A multiple-treatments meta-analysis. Lancet, 382: 951–962. https://doi.org/10.1016/S0140-6736(13)60733-3

 

  1. Schatzberg AF, Nemeroff CB, 2017, Tricyclic and tetracyclic antidepressants. In: The American Psychiatric Association Publishing Textbook of Psychopharmacology. Ch. 18. Washington, D.C.: American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9781615371624

 

  1. Schwartz TL, Sachdeva S, Stahl SM, 2016, Genetic and pharmacokinetic factors that impact the therapeutic window of imipramine. J Psychiatr Pract, 22: 392–399. https://doi.org/10.1097/PRA.0000000000000179

 

  1. Davanzo F, Urso S, Fagiolini A, 2013, The pharmacokinetics and interactions of antidepressants. In: Handbook of Drug Interactions: A Clinical and Forensic Guide. New Jersey: Humana Press, p271–308.

 

  1. Bhatia SC, Bhatia SK, 2012, Drug Metabolism and Pharmacokinetics. Netherlands: Elsevier.

 

  1. Lebel D, Czornyj L, 1986, Imipramine and desipramine pharmacokinetics in children: Lack of correlation with age. Dev Pharmacol Ther, 9: 334–343. https://doi.org/10.1159/000457519

 

  1. Rasmussen BB, Brosen K, 1992, Pharmacokinetics of imipramine and desipramine in elderly patients. Ther Drug Monit, 14: 106–110. https://doi.org/10.1097/00007691-199204000-00004

 

  1. Murthy BR, Srikumar G, 2008, Pharmacokinetic alterations in liver diseases. J Clin Exp Hepatol, 2: 242–248. https://doi.org/10.1016/S0973-6883(08)60170-9s

 

  1. Hiemke C, Baumann P, Wittmann M, 1990, Imipramine and desipramine kinetics in patients with chronic renal failure. J Clin Psychopharmacol, 10: 326–331. https://doi.org/10.1097/00004714-199010000-00005

 

  1. Mendell J, Zwisler J, 1979, Effects of heart failure and cardiac output on imipramine disposition. J Clin Pharmacol, 19: 153–159. https://doi.org/10.1002/j.1552-4604.1979.tb02520.x

 

  1. Hiemke C, Hartter S, 2000, Pharmacokinetics of selective serotonin reuptake inhibitors. Pharmacol Ther, 85: 11–28. https://doi.org/10.1016/S0163-7258(99)00058-6

 

  1. Siniscalchi A, Gallelli L, Cassano T, 2016, Adverse drug reactions to imipramine: A case series. J Pharmacol Pharmacother, 7: 199–202. https://doi.org/10.4103/0976-500X.191180

 

  1. Baumann P, Hiemke C, 1995, Pharmacokinetics of antidepressants in the elderly. Ther Drug Monit, 17: 234–239. https://doi.org/10.1097/00007691-199506000-00008

 

  1. Baumann P, 1988, Protein binding of psychotropic drugs in vitro: A methodological problem. Psychopharmacology, 94: 151–155. https://doi.org/10.1007/BF00735858

 

  1. Tofranil-PMTM (Imipramine Pamoate), n.d., Available from: https://www.accessdata.fda.gov/drugsatfda_docs/ label/2014/017090s078lbl.pdf [Last access on 2023 May 20].

 

  1. Schatzberg AF, Cole JO, DeBattista C, 2010, Manual of Clinical Psychopharmacology. 7th ed. Washington, D.C.: American Psychiatric Publishing, Inc.

 

  1. Leinonen E, Skott A, Lundstrom K, 1980, Effects of phenobarbitone and cigarette smoking on the metabolism of imipramine and nortriptyline in man. Eur J Clin Pharmacol, 18: 377–384. https://doi.org/10.1007/BF00540902

 

  1. Hulten BA, Adams RD, Schwegler JC, 1984, Imipramine overdose: Treatment and clinical course. Ann Emerg Med, 13: 819–823.

 

  1. Rubio MA, Bartolomei M, Perez-Castrillon JL, 1998, Acute hepatitis associated with imipramine therapy. Ann Pharmacother, 32: 1263–1265.

 

  1. Himmelhoch JM, Neil JF, 1982, Hypomania induced by imipramine. Am J Psychiatry, 139: 1221–1222.

 

  1. Lipschitz DA, Mitchell JE, Krall RA, 1976, Imipramine and urinary retention. J Am Med Assoc, 235: 1497.

 

  1. Wijdicks EF, Scott JP, 1994, Imipramine-induced hyponatremia. Neurology, 44: 330–331.

 

  1. Sachdeva M, Kaur T, Ahmed R S, 2015, Pharmacogenetics of cytochrome P450 enzymes of imipramine metabolism: A review. Pharmacol Rep, 67: 230–238.
Conflict of interest
The authors declare that they have no conflicts of interest.
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INNOSC Theranostics and Pharmacological Sciences, Electronic ISSN: 2705-0823 Published by AccScience Publishing
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