Imipramine overdose

Imipramine can be harmful in large amounts.

Imipramine is sold under many brand names. Some of these are:

• Antideprin
• Berkomine
• Janimine
• Norpramin
• Tipramine
• Tofranil

Medicines with other names may also contain imipramine.

Below are symptoms of an imipramine overdose in different parts of the body.

AIRWAYS AND LUNGS

• Slow, labored breathing

BLADDER AND KIDNEYS

• Cannot urinate
• Hard to start urinating, or weak urine stream

EYES, EARS, MOUTH, NOSE, AND THROAT

• Blurred vision
• Dry mouth
• Enlarged pupils
• Very dry eyes
• Ringing in the ears

HEART AND BLOOD VESSELS

• Low blood pressure
• Irregular heartbeat
• Pounding heartbeat (palpitations)
• Rapid heartbeat

NERVOUS SYSTEM

• Agitation
• Coma (lack of responsiveness)
• Confusion
• Convulsions (seizures)
• Delirium (confusion and agitation)
• Depression
• Drowsiness
• Hallucinations
• Inability to concentrate
• Nervousness
• Tremor
• Unsteadiness

SKIN

• Dry, red skin

STOMACH AND INTESTINES

• Constipation
• Increased appetite
• Weight gain
• Vomiting

Have this information ready:

• Person's age, weight, and condition
• Name of the product (ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed
• If the medicine was prescribed for the person

Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container to the hospital with you, if possible.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.

The person may receive:

• Activated charcoal
• Blood and urine tests
• Breathing support, including a tube through the mouth into the lungs and a breathing machine (ventilator)
• Chest x-ray
• EKG (electrocardiogram, or heart tracing)
• Fluids through a vein (by IV)
• Laxative
• Medicines to treat symptoms (including one to reverse the effects of the imipramine)
• Tube through the mouth into the stomach to empty the stomach (gastric lavage)

An imipramine overdose can be very serious. Heart rhythm disturbances can be fatal.

People who overdose on this drug are almost always admitted to the hospital. The faster they get medical help, the better the chance of recovery. Complications such as pneumonia, muscle damage from lying on a hard surface for a prolonged period of time, or brain damage from lack of oxygen may result in permanent disability. Death can occur.

Tofranil overdose; Janimine overdose

Brush DE, Aaron CK. Tricyclic and other cyclic antidepressants. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 27.

Christian MR, Bryant SM. Antidepressants and antipsychotics In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 147.

Velez LI, Feng S-Y. Anticholinergics. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 150.

Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.