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Effects of imipramine on depression and obsessive-compulsive symptoms.

Most of the controlled studies on the efficacy of medical treatments of obsessive-compulsive disorder (OCD) have involved clomipramine, a tricyclic antidepressant reputed to have anti-obsessional properties. To test the possibility that the drug's antidepressant action mediates the reduction of obsessive-compulsive symptoms, we treated 37 OCD patients with imipramine (mean dose = 233 mg/day) or placebo for 6 weeks and assessed improvement on both obsessive-compulsive and depressive symptoms. Imipramine reduced depression in highly depressed OCD patients, but did not affect obsessive-compulsive symptoms in these or in less depressed patients.

Adolescent↗

Decreased platelet 3H-imipramine binding in Down's syndrome.

Platelet 3H-imipramine binding in 12 subjects with Down's syndrome showed a significantly lower maximal number of binding sites (Bmax) as compared to both unrelated normal and parental controls. No difference in the affinity constant (Kd) was observed. The results support the value of the platelet 3H-imipramine binding assay in the investigation of defects in serotonin metabolism in humans.

Adolescent↗

Lack of specificity of reduced platelet imipramine binding in different psychiatric conditions.

We compared 3H-imipramine binding in 10 major depressives with that in 29 healthy volunteers, 13 patients with panic disorder, 9 patients with bulimia, 9 suicide attempters, and 6 schizophrenic patients. None of the comparison groups had histories of major mood disorders, except the suicide attempters. We found a significant reduction of the maximum binding capacity (Bmax) in all groups of patients as compared with healthy controls. These data cast doubt upon the specificity of the decrease of platelet 3H-imipramine binding in major depression, but suggest a possible pharmacological common denominator involving the serotonin system.

Adolescent↗

3H-imipramine binding to freshly prepared platelet membranes in depression.

3H-Imipramine binding was measured in freshly prepared platelet membranes from 47 drug-free major depressives and 46 healthy controls. Where possible, platelet binding in depressed subjects was repeated following treatment. A significant negative correlation was found between Bmax and assay protein concentration and Bmax values were corrected for this effect. Adjusted Bmax was significantly lower (by 14%) in female depressed patients than in female control subjects, and the difference was of similar magnitude premenopausally and postmenopausally. No such difference was found in males. Kd did not differ significantly between depressed and control subjects. Multiple regression analysis confirmed significant effects on Bmax of presence of depressive illness, age (positive correlation), and season (higher in summer). Within the depressed sample, Bmax was significantly lower in those subjects with obsessional features. Endogenicity (Research Diagnostic Criteria or Newcastle), dexamethasone suppression test result, drug-free interval, family history of depression, depressive psychosis, suicidal ideation, and past history of suicide attempts were not significantly related to Bmax. Paired comparisons revealed no significant effect on Bmax of 6 weeks' treatment with imipramine, maprotiline, or BRL 14342 or of a course of electroconvulsive therapy.

Adult↗

Imipramine binding in depressed patients with psychogenic pain.

Imipramine binding to platelet membranes from depressed patients was analyzed. The patients were divided into two groups: one with depression alone, another with depression and psychogenic pain. The depressed patients with psychogenic pain had lower imipramine binding than the depressed patients without pain.

Blood Platelets↗

Paroxetine shifts imipramine metabolism.

The combination of selective serotonin reuptake inhibitors with tricyclic antidepressants has proven useful in treatment-resistant depression but has the potential for adverse drug-drug interactions. In the present study, the metabolism of a single dose of imipramine was studied before and after treatment with paroxetine. Paroxetine induced significant elevations of approximately 50% in half-life, area under the curve, and Cmax of imipramine and decreased clearance twofold. The effects on desipramine pharmacokinetics were even more pronounced. These findings indicate a significant interaction of paroxetine with the CYP2D6 isoenzyme.

Adult↗

Platelet imipramine binding in patients with posttraumatic stress disorder before and after phenelzine treatment.

Posttraumatic stress disorder (PTSD) is frequently associated with major depressive disorder, and antidepressants have been reported to ameliorate PTSD symptoms in some patients. The present study assessed the number and affinity of platelet imipramine binding sites, as a marker of the serotonin transporter complex, in PTSD male patients (n = 10) before and after phenelzine treatment (30-60 mg/day, for 4 weeks) as well as in comparison to healthy controls (n = 10). In our sample, there was no evidence of a significant difference in the characteristics (Bmax and Kd) of platelet [3H]imipramine binding between the PTSD patients and the controls and within PTSD patients before and after phenelzine treatment. Moreover, no beneficial effect of phenelzine was detected in the patients (as assessed by PTSD, anxiety, and depression scales).

Adult↗

Imipramine treatment and preference for sweets.

Antidepressant-induced changes in food preference were investigated in a group of 40 depressed patients before and during treatment with imipramine. As part of a validated survey, the Pittsburgh Appetite Test, self-reported food preference was categorized by both nutrient and hedonic properties to define individual response. After 4 months of treatment, 14 patients (35%) expressed a clear desire for high-carbohydrate/high-fat foods with a sweet taste. Within this group, eight patients already preferred these foods while medication-free, while six subjects demonstrated a change in preference to these foods during treatment. The other 26 patients (65%) showed no consistent changes in food preference. These results suggest that while approximately one-third of imipramine-treated patients report a preference for sweets, only 15% actually developed this preference during treatment.

Adult↗

Relationship between seasonal patterns of platelet serotonin uptake and 3H-imipramine binding in depressed patients and normal controls.

1. Significant seasonal variations were found in the velocity of serotonin (Vmax) uptake and the density of 3H-imipramine binding sites (Bmax) in blood platelets from normal controls. 2. Peak 3H-imipramine (3H-IMI) binding was found in February whereas peak serotonin (5HT) uptake was found in June and these measures were not correlated in paired comparisons. 3. Both Vmax and Bmax values of depressed patients deviated from the normal seasonal pattern with lower uptake and binding in the patient group. 4. A comparison of Vmax and Bmax deviations from the normal patterns of uptake and binding revealed a significant correlation between these measures such that patients with low Vmax values were the same as those with low Bmax values. 5. The results support previous claims that the 3H-IMI binding site may be closely associated with, or identical to, a 5HT transport carrier. 6. A significant correlation between uptake and binding further suggests that a common defect may be responsible for observed decreases in Vmax and Bmax values of depressed patients.

Adult↗

Different effects of antidepressants on dissociation of 3H-imipramine from solubilized binding sites of rat brain.

1. The effects of several antidepressants and 5-hydroxytryptamine on dissociation of 3H-imipramine from solubilized binding sites were investigated. 2. Binding sites were solubilized from rat brain membranes and gelfiltrated on a column of Sephacryl S-300. 3. Most of the agents used allowed biphasic dissociation with 1mM of displacing agent and without using dilution-induced dissociation. This biphasic dissociation without nonspecific effects of membranes may be due to the existence of low-affinity binding sites. 4. Dissociation of up to 40 min followed first-order kinetics. The dissociation half-life of 3H-imipramine with the various displacing agents was calculated at from 15.0 to 25.0 min, and the differences among the agents were not so significant as the attenuation or the acceleration of the dissociation was indicated. The lower concentration of the displacing agents may obscure the modulation of the dissociation.

Animals↗

Regulation of tyrosine hydroxylase gene expression in mesencephalic dopamine neurons: effect of imipramine treatment.

The effects of a chronic imipramine treatment on the mesoamygdaloid pathway of rats were examined. Using semiquantitative immunocytochemical techniques, it was observed that the level of TH mRNA was decreased in the ventral tegmental area (VTA). In contrast, the TH protein was increased in both the VTA and amygdala. The TH activity was decreased in the amygdala when assessed under normal conditions but increased after a preincubation to phosphorylate the enzyme, suggesting a lowering of the protein-specific activity in the terminals. These results show that TH protein turnover in the mesoamygdaloid neurons can be reduced by chronic imipramine treatments, thereby producing an accumulation of inactive TH protein in the neurons while also decreasing TH gene activity in the cell bodies.

Amygdala↗

Reduction of arthritis and pain behaviour following chronic administration of amitriptyline or imipramine in rats with adjuvant-induced arthritis.

Tricyclic antidepressants (TCAs) are used extensively to treat chronic pain in man without an adequate explanation for their activity. The purpose of the present study was to investigate this problem by testing the effect of chronic TCAs in an animal pain model: the arthritic rat. Sprague-Dawley rats with adjuvant-induced arthritis were injected daily for 4 weeks with amitriptyline (10 mg/kg) or imipramine (10 mg/kg) or saline, beginning 21 days after the induction of arthritis. Baseline evaluations were made prior to the injection series and at 4 weeks, 24 h after the last injection. Both TCAs significantly reduced 'scratching' and increased 'exploring' behaviour, without changing the response to graded foot pressure. In addition clinical signs of arthritis (ankle circumference, swelling, conjunctivitis, balanitis ...) were significantly reduced, while mobility was increased. This study shows that both amitriptyline and imipramine decrease pain behaviour and arthritis in this chronic pain model. Possible 'antiinflammatory' effects of TCAs and their eventual 'analgesic' effect will be discussed.

Amitriptyline↗

Imipramine reduces experimental pain.

In a homogeneous sample of 20 healthy male students, the analgesic effects of the tricyclic antidepressant imipramine (100 mg) were compared to those of the narcotic meperidine (150 mg) and a further tricyclic compound with assumed analgesic properties (fluradoline, 450 mg). Drugs were orally administered, using a placebo controlled, double-blind repeated measures Latin Square design. Phasic pain was induced by intracutaneous electrical shocks with random intensities and interstimulus intervals. Each stimulus block consisted of 80 stimuli and lasted for 20 min. Pain estimates, somatosensory evoked cerebral potentials (SSEPs) and power spectral density of the electroencephalogram (EEG) were measured under each drug condition. Under placebo, pain ratings and SSEP amplitudes were constant within the entire session lasting for approximately 4 h. Meperidine analgesia was evident within 30 min of drug application, reaching a maximum after about 90 min. Imipramine produced a comparable degree of pain reduction, however, with a delay of 2 h. Under both drugs, the decrease in pain ratings was accompanied by decreased amplitudes of the late components of the SSEP, as well as by a reduction in alpha activity and an enhancement of slow EEG waves. Effects of fluradoline on experimental pain could not be affirmed. These findings are discussed in terms of pain relief and decrease in vigilance.

Adult↗

Modifications of [3H]imipramine binding sites in platelets of chronic pain patients treated with mianserin.

Tritiated imipramine binding to whole platelets was measured in 16 chronic pain patients who were free from major depression, and in a control group. The maximum binding was significantly lower in chronic pain patients than in the control group, whereas the binding affinity was not significantly different. Twelve patients were treated with mianserin for 21 days; this produced a significant improvement in the mean scores for pain (evaluated with the McGill Questionnaire) and depressive symptoms (assessed with the Zung Self-Rating Scale). The improvement in both types of symptom was accompanied by a significant mean increase in the density of the [3H]imipramine binding sites without modifications in the values of the constant of affinity. All the patients who responded well to treatment (N = 8) had a family history of depressive spectrum disorders (DSD), while none of those who failed to respond had a first degree relative with DSD.

Binding Sites↗

Effect of citalopram, amineptine, imipramine and nortriptyline on stress-induced (footshock) analgesia in rats.

The influence of the oral administration of different doses of citalopram (5, 15 and 45 mg/kg), imipramine (15, 30, 45 and 60 mg/kg), nortriptyline (15, 45 and 60 mg/kg) and amineptine (45 mg/kg) on stress-induced analgesia has been studied in anaesthetized rats. None of the administered antidepressants seem to have appreciable analgesic activity when analgesia is tested by the tail-immersion method. Citalopram, imipramine and nortriptyline, but not amineptine, increase the analgesia induced by inescapable footshock delivered continuously for 2 min to rats. Citalopram is the most potent drug. Our results support the suggested importance of 5-HT and noradrenaline terminals, but not those of dopamine, in the mediation of the stress-induced analgesia and seem to support the hypothesis that the analgesic activity of antidepressants is partially related to their modulating effects on the endogenously released opioid peptides involved in the endogenous pain inhibitory systems.

Animals↗

Chronic imipramine diminishes the nuclear size of neurons in the locus coeruleus and cingular cortex but not in the hippocampus of the rat brain.

The effect of an antidepressant drug--imipramine--on the nuclear volume of the rat brain neurons was studied. Imipramine was administered per os, 10 mg/kg acutely or chronically (twice a day, for 14 days). A reduction in the nuclear volume was observed after chronic treatment in neurons of the locus coeruleus and cingular cortex, but not in the hippocampus. The diminution in the nuclear volume of the affected cells suggests a decrease in their activity.

Animals↗

Influence of imipramine on neuropeptide Y immunoreactivity in the rat brain.

The effects of treatment with the antidepressant drug imipramine on neuropeptide Y immunoreactivity were studied immunocytochemically in the rat brain cortex and hypothalamus. It was found that the level of neuropeptide Y immunoreactivity in the cortex was significantly lowered three and 24 h after the last dose of chronic (14 days) imipramine administration as well as 3 h after acute administration. A tendency to decrease neuropeptide Y immunoreactivity was also found in the hypothalamus. The results obtained suggest an important role of the cortical neuropeptide Y in the action of the drug.

Animals↗

Morphological changes of isolated rat hepatocytes induced by imipramine.

Effect of imipramine on freshly isolated rat hepatocytes was investigated by scanning and transmission electron microscopy. Soon after the treatment of the cell with imipramine, marked changes in plasma membrane and mitochondria were found. Amitriptyrine, a structurally related drug, produced similar changes in the hepatocytes. On the other hand, Triton X-100, a nonionic surfactant, damaged the cell surface but little influence the features of the organelles.

Animals↗