Trimipramine

Drug Levels and Effects:




Summary of Use during Lactation:


If trimipramine is required by the mother, it is not a reason to discontinue breastfeeding. Because of the lack of data on use during breastfeeding, other antidepressants are preferred during breastfeeding, especially while nursing a newborn or preterm infant.


Drug Levels:


Maternal Levels.

Relevant published information was not found as of the revision date.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


Published information on trimipramine was not found as of the revision date. Follow-up for 1 to 3 years in a group of 20 breastfed infants whose mothers were taking a tricyclic antidepressant found no adverse effects on growth and development.[1] Two small controlled studies indicate that other tricyclic antidepressants have no adverse effect on infant development.[2][3] In another study, 25 infants whose mothers took a tricyclic antidepressant during pregnancy and lactation were tested formally between 15 to 71 months and found to have normal growth and development.[4] However, none of the mothers in any of these studies took trimipramine.


Possible Effects on Lactation:


Trimipramine increases serum prolactin levels[4] and has caused at least one case of galactorrhea.[5] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.


Alternate Drugs to Consider:


Nortriptyline,Paroxetine,Sertraline


References:


1. Misri S, Sivertz K. Tricyclic drugs in pregnancy and lactation: a preliminary report. Int J Psychiatry Med. 1991;21:157-71. PMID:1894455
2. Buist A, Janson H. Effect of exposure to dothiepin and northiaden in breast milk on child development. Br J Psychiatry. 1995;167:370-3. PMID:7496646
3. Yoshida K, Smith B, Craggs M et al. Investigation of pharmacokinetics and possible adverse effects in infants exposed to tricyclic antidepressants in breast-milk. J Affective Disord. 1997;43:225-37. PMID:9186793
4. Nulman I, Rovet J, Stewart DE et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry. 2002;159:1889-95. PMID:12411224
5. Wiegand M, Berger M. Action of trimipramine on sleep and pituitary hormone secretion. Drugs. 1989;38 (Suppl 1):35-42. PMID:2612388
6. Wolfsperger M, Greil W. Galactorrhea during treatment with trimipramine. A case report. Pharmacopsychiatry. 2005;38:326-7. PMID:16342006



Substance Identification:




Substance Name:

Trimipramine

CAS Registry Number:

739-71-9

Drug Class:


  • Antidepressants

  • Tricyclic Antidepressants


  • Administrative Information:




    LactMed Record Number:


    308


    Last Revision Date:


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