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$Title{TRIMIPRAMINE}
$Subject{Surmontil (Wyeth-Ayerst)}
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Copyright (C) 1991 Publications International, Ltd.


TRIMIPRAMINE
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BRAND NAME (Manufacturer):
     Surmontil (Wyeth-Ayerst)
TYPE OF DRUG:
     Tricyclic antidepressant
INGREDIENT:
     trimipramine
DOSAGE FORM:
     Capsules (25 mg, 50 mg, and 100 mg)
STORAGE:
     This medication should be stored at room temperature in a tightly closed
       container.

USES

     Trimipramine is used to relieve the symptoms of mental depression.  This
medication belongs to a group of drugs referred to as the tricyclic
antidepressants.  These medicines are thought to relieve depression by
increasing the concentration of certain chemicals necessary for nerve
transmission in the brain.

TREATMENT

     This medication should be taken exactly as your doctor prescribes.  You
can take it with water or with food to lessen the chance of stomach
irritation, unless your doctor tells you to do otherwise.
     If you miss a dose of this medication, take the missed dose as soon as
possible, then return to your regular dosing schedule.  However, if the dose
you missed was a once-a-day bedtime dose, do not take that dose in the
morning; check with your doctor instead.  If the dose is taken in the morning,
it may cause unwanted side effects.  Never double the dose.
     The effects of therapy with this medication may not become apparent for
at least two or three weeks.

SIDE EFFECTS

     Minor.

     Agitation, anxiety, blurred vision, confusion, constipation, cramps,
diarrhea, dizziness, drowsiness, dry mouth, fatigue, heartburn, insomnia, loss
of appetite, nausea, peculiar tastes in the mouth, restlessness, sweating,
vomiting, weakness, or weight gain or loss.  As your body adjusts to the
medication, these side effects should disappear.
     This drug may cause increased sensitivity to sunlight.  Avoid prolonged
exposure to sunlight and sunlamps, wear protective clothing and sunglasses,
and use an effective sunscreen.
     Dry mouth can be relieved by chewing sugarless gum or by sucking on ice
chips or a piece of hard candy.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).
     To avoid dizziness or light-headedness when you stand, contract and relax
the muscles of your legs for a few moments before rising.  Do this by pushing
one foot against the floor while raising the other foot slightly, alternating
feet so that you are "pumping" your legs in a pedaling motion.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
chest pain, convulsions, difficulty in urinating, enlarged or painful breasts
(in both sexes), fainting, fever, hair loss, hallucinations, headaches,
impotence, mood changes, mouth sores, nervousness, nightmares, numbness or
tingling in the fingers or toes, palpitations, rapid weight gain or loss
(three to five pounds within a week), ringing in the ears, seizures, skin
rash, sleep disorders, sore throat, tremors, uncoordinated movements or
balance problems, unusual bleeding or bruising, or yellowing of the eyes or
skin.

INTERACTIONS

     Trimipramine interacts with other types of medications:
     1. Extreme drowsiness can occur when it is taken with central nervous
system depressants (drugs that slow the activity of the brain and spinal
cord), including alcohol, antihistamines, barbiturates, benzodiazepine
tranquilizers, muscle relaxants, narcotics, pain medications, phenothiazine
tranquilizers, and sleeping medications, or with other tricyclic
antidepressants.
     2. Trimipramine may decrease the effectiveness of antiseizure medications
and may block the blood-pressure-lowering effects of clonidine and
guanethidine.
     3. Oral contraceptives (birth control pills) and estrogen-containing
drugs can increase the side effects and reduce the effectiveness of the
tricyclic antidepressants (including trimipramine).
     4. Tricyclic antidepressants may increase the side effects of thyroid
medication and over-the-counter (nonprescription) cough, cold, allergy,
asthma, sinus, and diet medications.
     5. The concurrent use of tricyclic antidepressants and monoamine oxidase
(MAO) inhibitors should be avoided because the combination may result in
fever, convulsions, or high blood pressure.  At least 14 days should separate
the use of this drug and the use of a MAO inhibitor.
     Before starting to take trimipramine, BE SURE TO TELL YOUR DOCTOR about
any medications you are currently taking, especially any of those listed
above.

WARNINGS

     * Tell your doctor if you have had unusual or allergic reactions to any
medications, especially to trimipramine or other tricyclic antidepressants
(such as amitriptyline, imipramine, doxepin, amoxapine, protriptyline,
desipramine, maprotiline, and nortriptyline).
     * Tell your doctor if you have a history of asthma, high blood pressure,
liver or kidney disease, heart disease, heart attack, circulatory disease,
stomach problems, intestinal problems, alcoholism, difficulty in urinating,
enlarged prostate gland, epilepsy, glaucoma, thyroid disease, or mental
illness or have ever received electroshock therapy.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
     * Do not stop taking this drug suddenly.  Stopping it abruptly can cause
nausea, headache, stomach upset, fatigue, or a worsening of your condition.
Your doctor may want to reduce the dosage gradually to prevent or minimize
this reaction.
     * The effects of this medication may last as long as seven days after you
have stopped taking it, so continue to observe all precautions during that
period.
     * Be sure to tell your doctor if you are pregnant.  The use of this
medication in human pregnancy has not been established.  Studies have shown
side effects in the offspring of animals that were given large doses of this
medication during pregnancy.  Also, tell your doctor if you are breast-feeding
an infant.  Small amounts of this drug can pass into breast milk and may cause
unwanted effects, such as irritability or sleeping problems, in nursing
infants.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
