Trimipramine is a generic prescription drug approved to treat depression. It is not available in a brand-name version. Trimipramine comes as an oral capsule.

Specifically, trimipramine is used in adults to treat depression.

To learn more about trimipramine’s uses, see the “Uses for trimipramine” section.

Trimipramine basics

Trimipramine is a generic medication. A brand-name version of the drug isn’t currently available.

Generic drugs are considered as safe and effective as the brand-name drug they’re based on, but they usually cost less.

Trimipramine belongs to a group of drugs called tricyclic antidepressants (TCAs).

Trimipramine has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Precautions” section.

Trimipramine is prescribed to treat depression in adults.

Depression is a mental health condition that affects a person’s behavior, mood, and actions. It often involves losing interest in activities that used to be enjoyable and feeling ongoing, intense sadness. Depression may cause symptoms such as weight changes, sleeping too much or too little, and withdrawal from social activities.

It’s not fully known how trimipramine works to treat depression. For more details, see “What are some frequently asked questions about trimipramine?”

Like most drugs, trimipramine may cause mild to serious side effects. The following lists contain some of the more common side effects trimipramine may cause, but they don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of trimipramine. They can also suggest ways to help reduce side effects.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking trimipramine and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Here’s a list of some of the mild side effects that trimipramine can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read trimipramine’s prescribing information.

Mild side effects of trimipramine that have been reported include:

  • blurred vision
  • changes in taste
  • confusion
  • difficulty sleeping or nightmares
  • digestive system problems, such as constipation, diarrhea, nausea, or vomiting
  • dizziness
  • drowsiness
  • dry mouth
  • feeling anxious, restless, or agitated
  • loss of coordination
  • numbness or tingling in the arms or legs
  • skin rash or itching
  • sweating
  • tinnitus (ringing in the ears)
  • weight gain or loss

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from trimipramine can occur, but they aren’t common. If you have serious side effects from trimipramine, call your doctor right away. If you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of trimipramine that have been reported include:

For more information about side effects related to boxed warnings, see the “Precautions” section.

Allergic reaction

For some people, trimipramine can cause an allergic reaction. But it’s not clear whether this side effect occurred in the drug’s studies.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue trimipramine treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to trimipramine, they may have you switch to a different treatment.

The trimipramine dosage your doctor prescribes will depend on several factors. These include:

  • the severity of the condition you’re taking trimipramine to treat
  • your age
  • other medical conditions you may have
  • other medications you may take
  • whether you’re taking trimipramine while staying in a hospital

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Form and strengths

Trimipramine is available as an oral capsule in three strengths:

  • 25 milligrams (mg)
  • 50 mg
  • 100 mg

Recommended dosages

Your doctor will prescribe the dosage of trimipramine that’s right for you. Keep reading to learn more.

Dosage for depression

For treating depression in a hospital setting, the typical starting dose of trimipramine is 100 mg per day divided into smaller doses. Your doctor may gradually increase the dose up to a maximum of 300 mg per day, depending on how your condition responds.

For treatment of depression outside of a hospital setting, the usual starting dose is 75 mg per day divided into smaller doses. If needed, your doctor may gradually increase the dose up to 150 mg per day.

Your doctor will recommend how often you should take trimipramine each day. In some cases, the full daily dose may be taken once at bedtime to make treatment more convenient.

About taking trimipramine

The following are some common questions about taking trimipramine.

  • Can trimipramine be chewed, crushed, or split? The manufacturer of trimipramine hasn’t stated whether the capsules can be chewed, crushed. If you have trouble swallowing the capsules whole, you can get tips on how to swallow pills, or ask your doctor or pharmacist for advice.
  • Should I take trimipramine with food? Trimipramine can be taken with or without food.
  • Is there a best time of day to take trimipramine? You can take Trimipramine at any time of day, but it’s best to take it on a consistent schedule. This helps keep a steady level of the drug in your body, which helps trimipramine work effectively.
  • What if I miss a dose of trimipramine? If you miss a dose of trimipramine, take it as soon as you remember. But if it’s almost time to take your next dose, skip the missed dose and take the next dose at its usual time. You should not take two doses at once to make up for a missed dose. Doing so could raise your risk of side effects.
  • Will I need to take trimipramine long term? Trimipramine may be taken as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.
  • How long does trimipramine take to work? Trimipramine starts working after your first dose, but it may take several weeks for the drug to reduce the symptoms of your condition. If you have questions about what to expect from treatment with trimipramine, talk with your doctor.

Overdose

Do not take more trimipramine than your doctor prescribes, as this can lead to harmful effects.

Symptoms caused by an overdose can include:

  • agitation
  • confusion
  • difficulty concentrating
  • drowsiness
  • hallucinations
  • heart problems, such as changes in heart rhythm
  • severely low blood pressure

In rare cases, an overdose of trimipramine may lead to coma or death.

What to do in case of overdose

Call your doctor if you think you’ve taken too much trimipramine. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Trimipramine can interact with several other medications and certain supplements. But the drug isn’t known to interact with any foods.

Before taking trimipramine, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, or supplements you use. Sharing this information can help you avoid potential interactions.

Interactions with medications and supplements

The following table highlights medications and supplements that can interact with trimipramine. This list does not contain all drugs that may interact with trimipramine. If you have questions about interactions that may affect you, ask your doctor or pharmacist.

Medications that can interact with trimipramine• other tricyclic antidepressants (TCAs), such as imipramine and amitriptyline

• monoamine oxidase inhibitors, such as linezolid (Zyvox) and phenelzine (Nardil)

• selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft) and fluoxetine (Prozac)

• serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor XR) and duloxetine (Cymbalta)

• opioids, such as hydrocodone (Hysingla ER) and oxycodone (Oxycontin, Roxicodone, others)

• triptans, such as rizatriptan (Maxalt, Maxalt-MLT) and sumatriptan (Imitrex, Tosymra, others)

• amphetamines, such as dextroamphetamine (Dexedrine, Xelstrym) and amphetamine/dextroamphetamine (Adderall, Adderall XR)

• thyroid hormone drugs, such as levothyroxine (Synthroid, Unithroid, others) and liothyronine (Cytomel)

• anticholinergic drugs, such as oxybutynin (Oxytrol) and dicyclomine
• lithium (Lithobid)

• buspirone

• cimetidine (Tagamet)
Supplements that can interact with trimipramine• St. John’s wort

Trimipramine and alcohol

It may not be safe to consume alcohol while taking trimipramine. Drinking alcohol while taking the drug could lead to worsened drowsiness, confusion, and dizziness. If you have concerns about avoiding alcohol during trimipramine treatment, talk with your doctor or pharmacist.

Whether you have health insurance or not, cost may be a factor when you’re considering trimipramine. What you’ll pay for trimipramine may depend on several things, such as your treatment plan and the pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.

The following is important information to consider and discuss with your doctor or pharmacist before starting trimipramine treatment.

Pregnancy and breastfeeding

It’s not known whether trimipramine is safe to take during pregnancy or while breastfeeding. If you’re pregnant or breastfeeding, or planning to become pregnant or to breastfeed, talk with your doctor before taking this drug.

This section describes the warnings and precautions for trimipramine.

FDA warning: Risk of suicidal thoughts and actions

Trimipramine has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Trimipramine may increase the risk of suicidal thoughts and actions in people ages 24 years and younger. This risk may be highest during the first few months of treatment and after a dosage change.

Suicidal thoughts and actions were not reported in studies of trimipramine. However, this side effect is a known risk of antidepressants. (Trimipramine is a tricyclic antidepressant drug.)

During trimipramine treatment, your doctor may advise you, your close friends, and family members to watch for symptoms such as the following:

  • feeling more agitated, angry, irritable, or restless than usual
  • panic attacks
  • difficulty sleeping
  • new or worsened depression or anxiety
  • thoughts of harming yourself or others

If you have any unusual changes in behavior, mood, or actions while you’re taking trimipramine, tell your doctor right away. They can recommend whether it’s safe to continue trimipramine treatment.

Other precautions

Before starting trimipramine, discuss your health history with your doctor. This medication may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

  • cardiovascular disease, such as irregular heart rhythm, heart attack, or stroke
  • liver problems
  • overactive thyroid
  • urinary retention
  • seizures
  • schizophrenia
  • hypomania, mania, or bipolar disorder
  • narrow eye angles
  • planned surgery or procedure
  • previous allergic reaction to this or a similar drug
  • pregnancy
  • breastfeeding

Note: For more information about the potential negative effects of trimipramine, see the “Side effects of trimipramine” section.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

There haven’t been studies on whether trimipramine can cause drug dependence. (Drug dependence occurs when your body gets used to a drug and needs it to function as usual.)

However, suddenly stopping trimipramine may lead to withdrawal symptoms. These are uncomfortable side effects that can happen if you stop taking a drug your body has become used to. Possible symptoms include nausea, headache, or malaise (a general feeling of being unwell).

If you and your doctor decide to stop trimipramine, they’ll create a plan to gradually lower your dose. Doing so helps reduce your risk of withdrawal symptoms after stopping the drug.

Here are answers to some commonly asked questions about trimipramine’s side effects.

Is trimipramine prescribed for sleep?

Trimipramine is not approved as a sleep aid.

However, the drug may cause drowsiness as a side effect. Because of this, some doctors may prescribe trimipramine off-label for sleep. (Off-label use means a drug is given for a condition it hasn’t been approved to treat.)

If you’re interested in learning more about taking trimipramine for sleep, talk with your doctor. They can recommend the right treatment options for you.

How does trimipramine work?

It’s not fully known how trimipramine works to treat depression.

Trimipramine belongs to a group of drugs called tricyclic antidepressants (TCAs). It’s thought to work by affecting the levels of certain chemicals in the brain, which may help improve mood and relieve symptoms of depression.

If you’d like to learn more about how trimipramine works, talk with your doctor or pharmacist. They can help explain how the drug fits into your treatment plan.

Other drugs are available that can treat depression. If you’d like to explore an alternative to trimipramine, talk with your doctor. They can tell you about other medications that might work well for you.

The following drugs are similar to trimipramine:

  • other tricyclic antidepressants (TCAs), such as imipramine and amitriptyline
  • selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft) and fluoxetine (Prozac)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor XR) and duloxetine (Cymbalta)
  • bupropion (Wellbutrin SR, Wellbutrin XL)

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.