IRFANA PARVEEN
By Irfana Parveen

B.Sc (Psychiatry Ward)

23 November 2021
Medically reviewed by
Sumayya Salam
Pharm D
Can Imipramine Cause Weight gain or Weight Loss?
Table of Contents

Weight gain can be said to be the increase in body weight caused by excess fat accumulation. It is widespread among all other individuals. Some people tend to gain weight more rapidly in a short period, which should be looked after with the help of the respective doctor; some factors are determined by gaining weight, like any medical condition, genetics, mental illness, some medication, and alcohol. 

Everyone doubts whether antidepressants will lead to weight gain; yes, it looks like weight gain is possible. It will differ from one to another, according to your health. Certain drugs like tricyclic antidepressants such as imipramine will cause weight gain, But now? Let us see more in detail. 

What Is Imipramine?

Imipramine is also called imipramine hydrochloride and is a prescription drug. It interferes with neurotransmitters which are certain brain chemicals that may be unbalanced and responsible for depression. 

Imipramine was the first tricyclic antidepressant introduced in the late 1950s. It has a three-ring molecular structure hence the name tricyclic. 

Advantages In Uses

Imipramine helps to ease the symptoms caused by depression, such as loss of appetite and disturbing sleep. 
Some further benefits of Imipramine are:

  • Proper sleep
  • Improved mood
  • Appetite
  • Increase energy level

These are some positive factors that help us positively in our daily lives.

How Does Imipramine Work?

Imipramine belongs to a group of antidepressants called tricyclic antidepressants. It is a group of drugs that works in a similar way to treat some conditions like depression. The drug works on the central nervous system by increasing the chemicals in your brain.

It works by increasing the chemicals in the brain called serotonin and norepinephrine levels and blocking certain levels of serotonin, adrenergic, histamine, and cholinergic receptors. This will help to improve your depression.

Who Can Take Imipramine?

Adults who are in depression can take Imipramine. It is also used to treat nighttime bedwetting (Enuresis) in children six years and older.

Inform your doctor if you ever had these conditions:

  • Heart diseases or strokes
  • Seizures
  • Bipolar disorder
  • Kidney or liver disease
  • Thyroid issues
  • Problems with urination
  • If you are pregnant or breastfeeding
  • Allergies to medicines.

Dosages Of Imipramine 

1. Adult Dose For Depression:

Tablets (for hospitalised patients)
An initial dose of 100 mg orally once daily, increasing to 200 mg if needed.
Maintenance dose of 100- 200 mg once a day.
Maximum dose of 300 mg/ day.
Tablets (for outpatients)
An initial dose of 75 mg/ day
Maintenance dose of 50- 150 mg orally once a day
The maximum amount of 200 mg/ day. 

2. Dose For Children With Enuresis:

Tablets (6-12 years of age)
An initial dose of 25 mg orally once a day
Maintenance dose of 50 mg orally once a day
Tablets (12-18 years of age)
An initial amount of 25 mg orally once a day
Maintenance dose of 75 mg orally once a day

3. Dosage for Senior adult

When taken in older adults over 65 years, their kidneys will probably not work like younger ones, leading the drug to process in the body very slowly. The high amount of the drug lasting in the system will increase the side effect. 
When a doctor recommends a lower dose, it will be helpful to process in your body. 

An initial dose: 30-40mg per day.
Maintenance dose: Not more than 100mg per day.

How Should You Take Imipramine?

Imipramine comes in tablets and capsules to be taken orally. The medicine is usually taken one or more times a day and can be consumed with or without food. 

Imipramine tablets are usually taken an hour before sleeping when used to prevent bedwetting in children. Children who wet the bed in the evenings are typically given one dose in the mid-afternoon, and another they sleep at night. Try to take Imipramine daily at around the same time. 

Use the directions on your prescription label carefully before taking medicine. Feel free to ask your doctor if you do not understand anything. Take Imipramine precisely as directed. Do not take more, less, or more frequently than advised.

Imipramine can be used to treat depression and also used in sleep and appetite and restore your daily activities. Imipramine is also used in bedwetting for children to control nightmare.
Imipramine can lead to serotonin syndrome when combined with drugs such as buspirone, fentanyl, lithium, tryptophan etc.
Some long-term effects are dry mouth, sweating, and increased heart rate; for people who overdose, it should be treated with proper medical attention.

Possible Side Effects

Report any worsening symptoms to your doctor. Some people may have suicidal thoughts after first taking antidepressants.
Common Side Effects Caused Due To Imipramine Are:

Common Side Effects Severe Side effects
Tunnel vision, eye pain Swelling or redness in the eye
Light-head blurred vision
Fever Unusual changes in the mode
Nausea Weight loss (After treatment)
Drowsiness Weight gain (During treatment)
Sore Throat Violent behavior 
Unusual bleeding Aggressiveness 
Chest pains Trouble in sleeping
Confusion and hallucinations Panic attack 
Increased blood pressure Slow or difficult speech
Dry mouth Irregular heartbeat

Can Imipramine Cause Weight Loss?

With many positive effects, most antidepressants, like any other medicine, can cause side effects to some people. Weight gain is one of the most common side effects of such antidepressants. 

In a placebo-controlled double-blind study, the patients on Imipramine lost -2.2+/ -1.8 kg compared to placebo-treated subjects (+0.2+/-3.3 kg, p<.001).  

Study On Imipramine Cause Weight Loss

A study by Gilbert H. Berken, Dorothy O. Weinstein, and Warren C. Stern stated that chronic administration of low to modest doses of tricyclic antidepressants frequently causes considerable weight gain. It also can significantly interfere with the ability to provide long-term maintenance therapy. 

Bodyweight and appetite were evaluated in 40 depressed patients from private psychiatric practice. They were receiving low to modest doses of tricyclic antidepressants such as Amitriptyline (maximum of 150 mg per day), nortriptyline(full of 50 mg per day), and Imipramine (full of 80 mg per day) were given for an average of 6 months of the treatment. A considerable weight gain of 1.3-2.9 lbs/month and an average total weight gain of 3-16 lbs. This depended on the dose, drug, and usage, which varied. These weight increases were linear over time and marked by the increased preference for sweets. 

In the end, excessive weight gain was the most common cause off-occurring in one-half of the patients. Significant weight loss occurred upon discontinuation of the drug.

It is nowhere stated that a patient could lose weight during the medication but may gain weight. It is only after the treatment they may lose weight drastically. Consulting your doctor from time to time is advisable.  

PrecautionsWhile Taking Imipramine

Some young people taking antidepressants will have suicidal thoughts in the initial days, so be alert to your mood and behavior. If you see any symptoms consult with your doctor immediately

Before taking the drug:

If you are allergic to other antidepressant drugs like 

  • amitriptyline,  
  • amoxapine, 
  • nortriptyline, and 
  • Doxepin. 
  • This may lead to trouble breathing, swelling, and rashes.

Inform your doctor:

If you had any heart disease or stroke.

  • Any mental illness like bipolar disorder, depression, schizophrenia 
  • kidney or liver dysfunction
  • glaucoma 
  • urination problem

During Pregnancy:

The FDA has not assigned the drug to use in pregnancy. It is unknown whether the drug will be safe or harm your Unborn Baby. If you are pregnant, inform or plan to become pregnant and tell your doctor. 

During Breastfeeding:

It is not recommended to use while breastfeeding because it passes into your breast milk and harms your new brand. Restricted to children without advice is not given to younger children less than 18 years of age for the treatment of depression. 

Alcohol:

While drinking alcohol with the medication will lead to increasing your suicidal thoughts, so if you are an alcoholic person, consult with your doctor.    

Drug Interactions:

Imipramine can interact with other medications, vitamins, and Herbal supplies if consumed. Drug interaction is between interacting one or two drugs together. It will change the drug substance. It will be harmful and prevent the drug from working in states to avoid the interaction, consult with your doctor; some of the examples are given below,

Monoamine oxidase inhibitors(MAOIs) : 

Consuming imipramine with MAOI drugs leads to seizures or even death. After stopping imipramine, do not take MAOI for the last two weeks; ask your doctor for more details.

Drugs like cimetidine and quinidine:

Taking these drugs with imipramine will lead to seizure, coma, or even death, so avoid consuming them together.

Selective serotonin reuptake inhibitors:

Drugs like sertraline,  fluoxetine, and paroxetine. If you want to take these drugs, inform your doctor, and your doctor will lower the dose of the imipramine drug.

Ask your doctor about taking drugs like,

  • Narcotic pain relievers
  • over the counter medication
  • Muscle relaxer
  • Any depression or anxiety drugs.

Bottom Line From Practical Anxiety Solutions

As far now we understand the drug in detail, Imipramine is an antidepressant group of medicines that works similarly to treat depression. While people say weight gain is possible when taking the medication, Normally, antidepressants will have a form of gaining weight in people due to the depressive effect. People tend to feel less active and do not perform the task. This promotes increased accumulation in your body. 

Side effects are expected due to the initial stage. If you face any severe side effects, Consult with your doctor if you face any side effects.

  • Berken, Gilbert H., Dorothy O. Weinstein, and Warren C. Stern. "Weight gain: a side-effect of tricyclic antidepressants." Journal of Affective Disorders 7.2 (1984): 133-138. https://doi.org/10.1016/S0022-5347(01)63940-5 Obtain On 24/11/2022
  • Rickels, Karl, et al. "Antidepressants for the treatment of generalized anxiety disorder: a placebo-controlled comparison of imipramine, trazodone, and diazepam." Archives of General Psychiatry 50.11 (1993): 884-895. doi:10.1001/archpsyc.1993.01820230054005 Obtain On 24/11/2022
  • Berken GH, Weinstein DO, Stern WC. Weight gain. A side-effect of tricyclic antidepressants. J Affect Disord. 1984 Oct;7(2):133-8. doi: 10.1016/0165-0327(84)90031-4. PMID: 6238068. Obtain On 24/11/2022
  • Kuhn, Roland. "The treatment of depressive states with G 22355 (imipramine hydrochloride)." American Journal of Psychiatry 115.5 (1958): 459-464. https://doi.org/10.1176/ajp.115.5.459 Obtain On 24/11/2022
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