Opipramol Dihydrochloride

What it is and how it works

Opipramol has a tricyclic structure but, unlike tricyclic antidepressants, does not significantly inhibit monoamine reuptake; it acts mainly as a high-affinity sigma-1 and sigma-2 receptor agonist and has moderate histamine H1, dopamine D2 and 5-HT2 antagonist activity, producing anxiolytic and mildly sedative effects.

Indications

Generalised anxiety disorder and somatoform disorders.

Dosage and administration (summary)

Oral: usually 50 mg in the morning and at midday and 100 mg in the evening (150 mg daily), adjusted to 50–300 mg daily according to response.

Contraindications

Acute alcohol, hypnotic, analgesic or psychotropic intoxication, acute urinary retention, acute delirium, untreated angle-closure glaucoma, prostatic hypertrophy with residual urine, paralytic ileus, pre-existing high-grade AV block, and concomitant MAOI therapy.

Warnings and precautions

Anticholinergic effects, sedation and orthostatic hypotension may occur; caution in cardiovascular disease, epilepsy and hepatic or renal impairment. It may impair driving ability, especially with alcohol. Blood counts and liver function should be monitored during prolonged treatment.

Pregnancy

Avoid, particularly in the first trimester, because data are limited.

Storage and supply

Store below 25–30 °C.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.