Jeffrey Panko NP Psychiatry · Patient education
Trimipramine
Surmontil / Generic capsules
A guide for adults taking trimipramine.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Oral capsules may be taken at bedtime or in divided doses. The prescription determines the schedule.
What it is used for
Trimipramine treats depression. Its sedating effects may influence the choice of dose timing, but sleepiness alone does not establish antidepressant benefit.
How it works
It affects several receptors involved in mood, arousal, and autonomic function. Histamine and muscarinic effects contribute to sedation, dry mouth, and constipation.
What to expect over time
Sleep, energy, or appetite may change before mood improves. Benefit usually builds over several weeks; some conditions need a longer trial at a useful dose.
Track the symptoms you are treating and how you manage daily activities. Keep follow-up appointments. Schedule an earlier appointment if your mood gets worse.
Taking your medication
- Take consistently, with food if needed for stomach discomfort.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Do not take extra capsules for sleep.
- Consult with your provider before reducing or stopping.
When to get help
Emergency symptoms. Get emergency care for a seizure, severe allergic reaction, or sudden eye pain with vision changes. Fever with agitation, diarrhea, and stiff or twitching muscles may be serotonin syndrome and needs urgent assessment.
Prompt medical advice. Contact your provider right away for marked agitation, new hallucinations, or unusually high energy with very little need for sleep.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Drowsiness or dizziness when standing
- Dry mouth, constipation, or blurred vision
- Weight gain or sexual side effects
- Urinary difficulty
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.
Your provider may check pulse, blood pressure, weight, and an ECG, depending on your age, dose, other medications, and heart history. Report constipation or urinary problems before they become severe.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss heart disease, a recent heart attack, fainting, glaucoma, difficulty urinating, severe constipation, seizures, bipolar symptoms, and kidney or liver problems.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Do not combine with an MAOI antidepressant. Switching requires a specific waiting period; fluoxetine can continue to affect other medications for weeks.
Some antidepressants raise tricyclic levels. Medicines that affect heart rhythm, sedating antihistamines, bladder medicines, opioids, and alcohol can add important risks.
Everyday tips
Stand up slowly and use caution on stairs if you feel lightheaded.
Sugar-free gum, regular dental care, and adequate fluids may help dry mouth. Discuss persistent constipation.
Store your supply securely. An overdose can be life-threatening even before symptoms appear.
Your questions answered
Can I stop when I feel better?
Consult with your provider. Continuing treatment after improvement can reduce the chance that symptoms return. Most antidepressants should be reduced gradually to limit withdrawal symptoms.
What if I have sexual side effects?
Changes in desire, arousal, or orgasm are worth discussing. Your provider can review the dose or treatment options; do not stop or skip doses on your own.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.