Tag Archives: Trimipramine

Current Therapies for Insomnia

Most individuals who suffer from insomnia either self-treat with nonprescription sleep aids (e.g., antihistamines, herbal remedies), use alcohol as a sedative, or take no drug therapy at all. For those who do seek professional help (approximately one-third of insomniacs), the majority receive physician-prescribed benzodiazepine or non-benzodiazepine sedative hypnotics to treat their insomnia. Such hypnotic agents… Read More »

Causes and treatment of sleep disorders in the elderly

Insomnia in the elderly can have many different causes, frequently in combination (). A precise differential diagnosis is therefore required for appropriate treatment. Common causes of insomnia in the elderly are: (a) psychiatric illness – depression, dementia, and agitated dementia; (b) organic problems – cardiovascular symptoms, nocturia, chronic pain, bronchitis and asthma; (c) sleep apnoea… Read More »

Minor Depression: Tricyclic Antidepressant

Tricyclic antidepressants entered the market in the 1960s after the Monoamine Oxidase Inhibitors but quickly lost their popularity when the selective serotonin reuptake inhibitors entered the market. Although tricyclic antidepressants are as effective as the selective serotonin reuptake inhibitors and serotonin/norepinephrine reuptake inhibitors in treating most forms of depression, they have the potential for cardiotoxicity… Read More »

Minor Depression: Escitalopram, Paroxetine, Sertraline, and Fluoxetine

Selective Serotonin Reuptake Inhibitors The seven available agents in the selective serotonin reuptake inhibitor class are citalopram (Lund-beck’s Cipramil, Forest Laboratories’ Celexa, generics) and its single enan-tiomer, escitalopram (Lundbeck’s Cipralex, Forest’s Lexapro); paroxetine (GSK’s Paxil/Seroxat, Novartis’s Frosinor, generics); the controlled-release version of paroxetine (GSK’s Paxil CR); sertraline (Pfizer’s Zoloft); fluoxetine (Eli Lilly’s Prozac, generics); and… Read More »

Pharmacotherapy for Depression

Pharmacological treatments have gained popularity during the last 50 years as a method of treatment intervention for depression as well as for many other psychological disorders. They have been proven effective in ameliorating the symptoms for a large percentage of depressed individuals and are now the most common form of treatment for depression. The constraints… Read More »

Tricyclic Antidepressants

The tricyclic antidepressants – TCAs Tricyclic antidepressants continue to be prescribed worldwide (Table Dosing of Tricyclic Antidepressants), although in most countries they are considered second line agents due to their limited safety and tolerability. Among the tertiary amines, amitriptyline, clomipramine and imipramine are the main mixed-uptake blocking agents and have been most extensively investigated. In… Read More »

First-Generation Anticonvulsants

Carbamazepine Psychopharmacology Carbamazepine, chemically related to the antidepressant imipramine, is a neutral and lipophilic compound. After 2 to 3 weeks of treatment, the plasma levels may drop 20-30%, because carbamazepine auto-induces its own metabolism through the induction of the cytochrome P450 hepatic system (isoform CYP 3A3/4) (Table Anticonvulsants: Pharmacokinetics). Its most important metabolite, the 10,11-epoxide-carbamazepine,… Read More »