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Tricyclic antidepressant (sedating)

Trimipramine

Brand names: Surmontil

Adult dose

Dose: Initial 50–75mg PO ON, max 300mg/day

Route: PO

Frequency: ON

Clinical pearls

Depression with insomnia/anxiety
Highly sedating — bedtime only

Contraindications

Recent MI
Arrhythmias
Mania
Severe hepatic impairment
Concurrent MAOI

Side effects

Sedation (very high)
Anticholinergic
Postural hypotension
QT prolongation
Cardiotoxicity in overdose
Weight gain

Interactions

MAOIs
CNS depressants
QT-prolonging drugs
SSRIs

Monitoring

Mood
ECG
Suicidality

Reference: BNF; NICE NG222; https://bnf.nice.org.uk/drugs/trimipramine/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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