Imipramine

If you need help or want to talk to somebody about your mental health, you can get support from any of the following:

• Free call or text 1737 any time for support from a trained counsellor
• Lifeline 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP)
• Suicide Crisis Helpline 0508 828 865 (0508 TAUTOKO)
• Healthline 0800 611 116
• Samaritans 0800 726 666.

• The dose of imipramine will be different for different people.
• Your doctor will usually start you on a low dose and increase this slowly. This allows your body to get used to the medicine and reduces side effects. Imipramine may be prescribed as a single dose to be taken at bedtime, or it may be prescribed in smaller doses taken 2 or 3 times a day.
• Always take your imipramine exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much imipramine to take, how often to take it, and any special instructions.
• If your tablets look different to your last supply, ask your doctor or pharmacist for advice.

• Timing: Take imipramine at the same times each day. 
• Water: Swallow your imipramine tablets with a glass of water.
• Food: You can take imipramine with or without food.
• Keep taking imipramine every day: It may take a few weeks before you notice the full benefits of imipramine.
• Don't stop suddenly: If you think imipramine isn't working for you, don't stop taking it suddenly. Talk to your doctor or nurse before stopping.
• Missed dose: If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.

Here are some things to know when you're taking imipramine. Other things may be important as well, so ask your healthcare provider what you should know about.

• Alcohol: Avoid alcohol while you're taking imipramine, especially when you first start treatment. Drinking alcohol while taking imipramine can cause drowsiness and affect your concentration, putting you at risk of falls and other accidents. It can also cause agitation, aggression and forgetfulness. If you do drink alcohol, drink only small amounts and see how you feel. Don't stop taking your medicine.
• Other medicines: Imipramine interacts with many other medicines, herbal supplements (eg, St. John's Wort) and rongoā Māori, so check with your doctor or pharmacist before starting imipramine or before starting any new medicines, products or supplements.
• Diabetes: If you have diabetes, you may need to check your blood glucose more often because imipramine can affect the levels of glucose in your blood. 

Like all medicines, imipramine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Suicidal behaviour

The use of antidepressants has been linked with self-harm or suicidal thoughts and behaviour. Children, teenagers, young adults and people with a history of suicidal behaviour are most at risk. This is most likely during the first few weeks of starting treatment or if the dose is changed. It's important to look out for signs of suicidal behaviour eg, suicidal thoughts, self-harm, worsening of low mood, agitation or aggression.

If you notice any of these signs, contact your doctor immediately. If you need urgent help or are concerned, phone:

• Lifeline 0800 543 354 (available 24/7), or
• Healthline 0800 611 116, who can give you the phone number for your local mental health crisis line.

Other side effects