How does this medication work? What will it do for me?

Trimipramine belongs to a class of medications called tricyclic antidepressants (TCAs). It is used to treat depression and works by affecting the balance of certain chemicals called neurotransmitters in the brain.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Trimipramine is available in strengths of 12.5 mg, 25 mg, 50 mg, 75 mg, and 100 mg. Ask your pharmacist or doctor for details.

How should I use this medication?

The recommended starting dose of trimipramine is 75 mg daily in 2 or 3 divided doses. Your doctor may increase the dose gradually until a response to the medication occurs (this may take a few weeks or more). The dose is then adjusted to control the symptoms with acceptable side effects. The usual maintenance dose is approximately 150 mg to 200 mg daily in divided doses.

Trimipramine may be taken with or without food.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Trimipramine should not be taken by anyone who:

  • is allergic to any of the ingredients of the medication
  • is allergic to other dibenzazepine-type medications
  • is also taking a MAO inhibitor (e.g., phenelzine, tranylcypromine) or has taken one within the last 2 weeks
  • has acute congestive heart failure
  • has just had a heart attack

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • diarrhea
  • dizziness
  • drowsiness
  • dryness of mouth
  • headache
  • heartburn
  • increased appetite (may include a craving for sweets)
  • increased sweating
  • nausea
  • tiredness or weakness (mild)
  • trouble sleeping
  • unpleasant taste
  • vomiting
  • weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common:

  • blurred vision
  • confusion or delirium
  • constipation (especially for seniors)
  • decreased sexual ability
  • difficulty speaking or swallowing
  • eye pain
  • fainting
  • fast or irregular heartbeat (pounding, racing, skipping)
  • hallucinations
  • loss of balance control
  • mask-like face
  • nervousness or restlessness
  • numbness or tingling sensation in arms and legs
  • problems urinating
  • shakiness or trembling
  • shuffling walk
  • slowed movements
  • stiffness of arms and legs


  • anxiety
  • breast enlargement (both males and females)
  • hair loss
  • inappropriate secretion of milk (females)
  • increased sensitivity to sunlight
  • irritability
  • muscle twitching
  • red or brownish spots on skin
  • ringing, buzzing, or other unexplained sounds in the ears
  • seizures
  • skin rash and itching
  • sore throat and fever
  • swelling of face and tongue
  • swelling of testicles
  • trouble with teeth or gums
  • weakness
  • yellow eyes or skin

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol: Your response to alcoholic beverages may be affected while taking this medication.

Constipation: Trimipramine may cause constipation, especially for seniors.

Medical conditions: Trimipramine should be used with caution by people with a history of seizures, urinary retention, glaucoma, or thyroid disease. Tricyclic antidepressant medications such as trimipramine, particularly when taken in high doses, can cause abnormal heart rhythms. Therefore, trimipramine should be taken with caution by seniors or people with a history of heart disease.

Mental and physical impairment: Trimipramine may impair the mental or physical abilities required for the performance of potentially hazardous tasks, such as driving or operating machinery.

Withdrawal: Stopping treatment with trimipramine after having taken it for a long period of time may produce nausea, headache, and malaise. These symptoms do not mean that you are addicted to the medication. Do not stop taking trimipramine suddenly without first talking with your doctor.

Pregnancy: The safety of trimipramine for use during pregnancy has not been established. If you are or may be pregnant, the possible benefits of taking this medication must be weighed against the possible risks. If you are or may be pregnant, talk to your doctor.

Breast-feeding: The safety of trimipramine for use while breast-feeding has not been established. If you are breast-feeding, the possible benefits of taking this medication must be weighed against the possible risks to the child. If you are breast-feeding, talk to your doctor.

What other drugs could interact with this medication?

There may be an interaction between trimipramine and any of the following:

  • alcohol
  • amphetamines (e.g., dextroamphetamine)
  • anticholinergic medications (e.g., benztropine, atropine)
  • appetite suppressants (e.g., mazindol, phentermine)
  • barbiturates (e.g., phenobarbital, secobarbital)
  • benzodiazepines (e.g., diazepam, lorazepam)
  • cimetidine
  • cisapride
  • clonidine
  • divalproex sodium
  • fluoxetine
  • fluvoxamine
  • guanethidine
  • MAO inhibitors (e.g., tranylcypromine, phenelzine)
  • rifabutin
  • rifampin
  • sertraline
  • sympathomimetic medications (e.g., dopamine, epinephrine)
  • valproic acid

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.