Page 21 - ITPS-6-2

INNOSC Theranostics

and Pharmacological Sciences

PERSPECTIVE ARTICLE
Therapeutic drug monitoring of imipramine

correlation with a case study

Mohammed Misbah Ul Haq*, Bachi Tazneem, and Maryam
Department of Pharmacy Practice, Deccan School of Pharmacy, Hyderabad, Telangana, India

Abstract

This article provides an overview of the pharmacokinetics, pharmacodynamics,
contraindications, and precautions of imipramine, a tricyclic antidepressant (TCA)
medication commonly used to treat depression and other mental health conditions.
Imipramine’s pharmacokinetic properties include rapid absorption, distribution
to various tissues, metabolism in the liver, and elimination through the kidneys.
Imipramine’s pharmacodynamic effects are mediated through its actions on various
neurotransmitters, including serotonin, norepinephrine, and dopamine. The article
also discusses the contraindications and precautions associated with imipramine
use. Imipramine is contraindicated in patients with a history of hypersensitivity to
TCAs, recent myocardial infarction, and certain cardiac disorders. It should also be
used with caution in patients with a history of seizures, urinary retention, glaucoma,
and liver or kidney disease. In conclusion, imipramine is a medication with well-
established pharmacokinetic and pharmacodynamic properties, but its use is
associated with certain contraindications and precautions. Clinicians should carefully
consider these factors when prescribing imipramine to patients with depression or
*Corresponding author: other mental health conditions.
Mohammed Misbah Ul Haq
(misbahjed@hotmail.com)
Citation: Ul Haq MM, Tazneem B, Keywords: Imipramine; Therapeutic drug monitoring; Case study; Adverse drug
Maryam, (2023), Therapeutic drug reactions; Contraindications
monitoring of imipramine correlation
with a case study. INNOSC
Theranostics and Pharmacological
Sciences, 6(2): 0505.
https://doi.org/10.36922/itps.0505 1. Introduction
Received: April 16, 2023 Therapeutic drug monitoring (TDM) is a crucial process in pharmacotherapy that
Accepted: July 3, 2023 involves measuring drug concentrations in the blood to optimize drug therapy.
Imipramine, a tricyclic antidepressant (TCA), is widely used to treat major depression,
Published Online: July 20, 2023 anxiety disorders, and chronic pain. However, its narrow therapeutic index and potential
Copyright: © 2023 Author(s). for adverse effects can limit its clinical use. In this context, TDM emerges as a valuable
This is an Open Access article tool to optimize imipramine dosing while minimizing the risk of side effects .
[1]
distributed under the terms of the
Creative Commons Attribution TDM of imipramine ensures that patients receive appropriate medication doses to
License, permitting distribution,
and reproduction in any medium, achieve the desired therapeutic effect while minimizing the risk of side effects. This
provided the original work is monitoring technique is particularly useful in cases involving concerns about drug
properly cited. interactions or individual variability in drug metabolism. For instance, in a case study, a
Publisher’s Note: AccScience patient taking imipramine for depression may experience side effects such as drowsiness
Publishing remains neutral with or confusion. TDM can help determine whether the patient’s blood levels of imipramine
regard to jurisdictional claims in
published maps and institutional are excessively high, contributing to the side effects and whether dosage adjustments or
affiliations. a switch to a different medication would be appropriate [2,3] .

Volume 6 Issue 2 (2023) 1 https://doi.org/10.36922/itps.0505