Imipramine

Do not take Imipramine if you are allergic to any of its contents; if you are taking monoamine oxidase inhibitors (MAOI) or have taken them in the last 14 days, if you have heart diseases, mania, porphyria, glaucoma or are unable to pass urine. Avoid taking buprenorphine/opioids with Imipramine as it could lead to serotonin syndrome. Inform your doctor if you have/had schizophrenia or manic depression, alcohol withdrawal, enlarged prostate, overactive thyroid, epilepsy, low blood pressure, poor circulation, panic attacks, a tumour of the adrenal gland, or if you are being given electroconvulsive therapy. Talk to your doctor immediately if you have suicidal thoughts such as killing or harming yourself. Consult your doctor if you are pregnant or breastfeeding. Avoid driving or operating machinery as Imipramine may cause impaired alertness, drowsiness, or blurred vision. Imipramine is not recommended for children below 6 years as safety and effectiveness have not been established. Avoid consuming alcohol with Imipramine as it could lead to increased drowsiness. Rise slowly from sitting or lying position as Imipramine causes dizziness on standing suddenly.

Drug-Drug Interactions: Imipramine may interact with anti-depressants (fluoxetine, fluvoxamine, duloxetine, escitalopram, sertraline), antipsychotics (aripiprazole, quetiapine), anti-convulsant (carbamazepine, phenytoin, phenobarbital, pregabalin, topiramate), benzodiazepine (diazepam, nitrazepam, oxazepam, alprazolam, clonazepam), pain killer (aspirin, tramadol, codeine, dihydrocodeine), anti-HIV (ritonavir), antacid (cimetidine, esomeprazole), blood thinner (warfarin), skeletal muscle relaxant (cyclobenzaprine), anti-anxiety (alprazolam) and hormone (levothyroxine).

Drug-Food Interactions: Do not take St. John’s wort (herbal supplement to treat depression) along with Imipramine.

Drug-Disease Interactions: Inform your doctor if you have epilepsy, low blood pressure, overactive thyroid, urination problems or enlarged prostate, glaucoma, diabetes, schizophrenia, mania, pheochromocytoma (tumour of the adrenal gland), heart, kidney or liver problems.

• Maintain a healthy diet and exercise regularly as it helps in improving overall health and boosts self-esteem.
• Regularly attend therapy sessions.
• Perform meditation and yoga. This helps in relieving stress and provides relaxation.
• Follow a regular sleep pattern to improve the amount and quality of sleep you get.
• Include foods rich in omega fatty acids such as fish, nuts, fresh fruits, vegetables and olive oils.
• Neurotransmitters are made up of amino acids. Amino acid-rich foods such as meat, dairy products, and certain fruits and vegetables help in the proper maintenance of neurotransmitters. 
• Complex carbohydrates help in stimulating serotonin (a feel-good neurotransmitter). These include whole grains, legumes, spinach, broccoli, oranges and pears.
• Exercising helps in the production of the body’s natural anti-depressants. It also helps in relieving stress, improves mood, boosts self-esteem and provides restful sleep.
• Avoid smoking and alcohol consumption.
• Learn about your condition, understand the risk factors and follow the doctor’s treatment plan.

• Close monitoring of patients taking Imipramine for suicidal behaviour, clinical worsening, or unusual changes in behaviour is recommended. Consult the doctor immediately if the patient experiences suicidal thoughts such as killing or harming oneself.
• Talk to your doctor before taking Imipramine if you are due to have any surgery that involves an anaesthetic, including dental surgery. 
• Your doctor may advise regular blood tests and liver functioning tests while taking Imipramine.
• Imipramine may cause problems with your teeth, so a regular dental check-up is advised.