Trimipramine Side Effects

It is possible that some side effects of trimipramine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to trimipramine: oral capsule, oral tablet

As well as its needed effects, trimipramine may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking trimipramine, check with your doctor immediately:

Incidence not known
  • Abdominal or stomach pain
  • agitation
  • black, tarry stools
  • bleeding or bruising
  • blood in the urine or stools
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain or discomfort
  • clay-colored stools
  • cold sweats
  • confusion about identity, place, and time
  • continuing ringing, buzzing, or other unexplained noise in the ears
  • convulsions
  • cool, pale skin
  • cough or hoarseness
  • dark urine
  • decrease in the frequency of urination
  • decreased urine output or volume
  • depression
  • difficulty in passing urine (dribbling)
  • difficulty with speaking
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • double vision
  • drooling
  • dry mouth
  • false beliefs that cannot be changed by facts
  • fast, pounding, or irregular heartbeat or pulse
  • feeling of warmth
  • feeling, seeing, or hearing things that are not there
  • feeling that others are watching you or controlling your behavior
  • feeling that others can hear your thoughts
  • fever with or without chills
  • flushed, dry skin
  • fruit-like breath odor
  • general feeling of tiredness or weakness
  • headache
  • hearing loss
  • hostility
  • hyperventilation
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • increased hunger
  • increased need to urinate
  • increased thirst
  • increased urination
  • irritability
  • itching
  • lack of coordination
  • lethargy
  • loss of appetite
  • loss of balance control
  • lower back or side pain
  • mood or mental changes
  • muscle spasm or jerking of all extremities
  • muscle trembling or stiffness
  • muscle twitching
  • nausea
  • nightmares
  • pain or discomfort in the arms, jaw, back, or neck
  • painful or difficult urination
  • passing urine more often
  • pinpoint red or purple spots on the skin
  • pounding in the ears
  • rapid weight gain
  • rash
  • redness of the face, neck, arms, and occasionally, upper chest
  • restlessness
  • shakiness and unsteady walk
  • shuffling walk
  • slow speech
  • slurred speech
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stiffness of the limbs
  • sudden loss of consciousness
  • sweating
  • swelling of the face, ankles, legs, or hands
  • swollen glands
  • talking, feeling, and acting with excitement
  • trouble in holding or releasing urine
  • trouble sleeping
  • twisting movements of the body
  • uncontrolled movements, especially of face, neck, and back
  • unpleasant breath odor
  • unsteadiness, awkwardness, trembling, or other problems with muscle control or coordination
  • unusual behavior
  • unusual tiredness or weakness
  • vomiting of blood
  • weakness in the arms, hands, legs, or feet
  • weight gain or loss
  • yellow eyes or skin

Some trimipramine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Incidence not known
  • Abdominal or stomach cramps
  • bigger, dilated, or enlarged pupils (black part of the eye)
  • black tongue
  • bloating
  • decreased interest in sexual intercourse
  • diarrhea
  • difficulty having a bowel movement (stool)
  • disturbance of accommodation
  • enlargement of the breast
  • hair loss or thinning of the hair
  • heartburn
  • hives or welts
  • inability to have or keep an erection
  • increase in sexual ability, desire, drive, or performance
  • increased sensitivity of the eyes to light
  • increased sensitivity of the skin to sunlight
  • loss in sexual ability, desire, drive, or performance
  • pain or discomfort in the chest, upper stomach, or throat
  • peculiar taste
  • redness or other discoloration of the skin
  • severe sunburn
  • small red or purple spots on the skin
  • swelling of the breasts or breast soreness in both women and men
  • swelling of the testicles
  • swelling or inflammation of the mouth
  • swollen, painful, or tender lymph glands in the neck
  • unexpected milk flow from the breasts

For Healthcare Professionals

Applies to trimipramine: compounding powder, oral capsule

Cardiovascular

Cardiovascular side effects including hypertension, hypotension, tachycardia, palpitation, myocardial infarction, arrhythmias, heart block, and stroke have been reported.[Ref]

Nervous system

Nervous system side effects including numbness, tingling, paresthesias of the extremities, incoordination, ataxia, tremors, peripheral neuropathy, extrapyramidal symptoms, seizures, alterations in EEG patterns, sleep abnormalities, and tinnitus have been reported.[Ref]

Nearly all selective serotonin reuptake inhibitors, mixed serotonin/norepinephrine reuptake inhibitors, and tricyclic antidepressants cause sleep abnormalities to some extent. These antidepressants have marked dose-dependent effects on rapid eye movement (REM) sleep, causing reductions in the overall amount of REM sleep over the night and delays the first entry into REM sleep (increased REM sleep onset latency (ROL)), both in healthy subjects and depressed patients. The antidepressants that increase serotonin function appear to have the greatest effect on REM sleep. The reduction in REM sleep is greatest early in treatment, but gradually returns towards baseline during long-term therapy; however, ROL remains long. Following discontinuation of therapy the amount of REM sleep tends to rebound. Some of these drugs (i.e., bupropion, mirtazapine, nefazodone, trazodone, trimipramine) appear to have a modest or minimal effect on REM sleep.[Ref]

Psychiatric

Psychiatric side effects including states of confusion (especially in the elderly) with hallucinations, disorientation, delusions, anxiety, restlessness, agitation, insomnia, nightmares, hypomania, and exacerbation of psychosis have been reported.[Ref]

Genitourinary

Chronic animal studies have reported occasional evidence of degeneration of seminiferous tubules at the highest dose tested.[Ref]

Genitourinary side effects including urinary retention, urinary frequency, delayed micturition, and dilation of the urinary tract have been reported.[Ref]

Endocrine

Endocrine side effects including gynecomastia in the male, breast enlargement and galactorrhea in the female, increased or decreased libido, impotence, testicular swelling, elevation or depression of blood sugar levels, and syndrome of inappropriate antidiuretic hormone secretion have been reported.[Ref]

Gastrointestinal

Gastrointestinal side effects including nausea, vomiting, anorexia, epigastric distress, diarrhea, peculiar taste, stomatitis, abdominal cramps, black tongue, dry mouth, constipation, parotid swelling, and paralytic ileus have been reported. Sublingual adenitis has rarely been reported.[Ref]

Hypersensitivity

Hypersensitivity side effects including skin rash, petechiae, urticaria, itching, photosensitization, and edema of the face and tongue have been reported.[Ref]

Hematologic

It is recommended that leukocyte and differential counts be performed in any patient who develops a fever and soar throat during therapy. The drug should be discontinued if there is evidence of a pathologic neutrophil depression.[Ref]

Hematologic side effects including bone marrow depression have been reported. Bone marrow depression has included agranulocytosis, eosinophilia, purpura, and thrombocytopenia.[Ref]

Hepatic

Hepatic side effects including jaundice (simulating obstructive) and altered liver function have been reported.[Ref]

General

General side effects including weight gain or weight loss, drowsiness, dizziness, weakness, fatigue, and headache have been reported.[Ref]

Dermatologic

Dermatologic side effects including perspiration, flushing, and alopecia have been reported.[Ref]

Ocular

Ocular side effects including blurred vision, disturbances of accommodation, and mydriasis have been reported.[Ref]

Other

Although these symptoms have been reported to occur following abrupt cessation of treatment, this is not felt to be indicative of an addiction to the drug.[Ref]

Other side effects include nausea, headache, and malaise which have been reported to sometimes occur following abrupt cessation of treatment.[Ref]

References

1. "Product Information. Surmontil (trimipramine)" Wyeth-Ayerst Laboratories, Philadelphia, PA.

2. Wilson S, Argyropoulos S "Antidepressants and sleep: a qualitative review of the literature." Drugs 65 (2005): 927-47

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