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Re: imipramine: dosage? alcohol?

Posted by jd on January 29, 2000, at 15:59:31

In reply to Re: imipramine, posted by Cam W. on January 29, 2000, at 10:15:11

Tom,

Cam's advice is right on--It's very unusual to drop down in dosage so quickly, but you should definitely check to see if the tablets have changed to different strengths! A standard "clincial" dosage of imipramine is usually 75mg/day or more; if you've suddenly shifted down to 25mg/day and don't know why, I would seek a GOOD explanation from your doctor as to why this has been done. (Some people actually do better on very low dosage, or can't tolerate high ones, or taper down after 6+ months of positive response, but I'm not sure if any of these fit your situation.)

As for the alcohol question, this is a delicate issue. From a medical point of view, imipramine and alcohol do not mix well and can potentially be dangerous in combination. While high enough amounts could ostensibly cause a coma, a lot of the concern has to do with drinking and driving, since imipramine with alcohol can cause increased discoordination and response times. All this being said, I myself have taken imipramine (50-100mg/day) for more than five years and have really had no problems at all drinking socially, generally 1 or 2 drinks to an occasion. Perhaps the imipramine made me a bit more of a "lightweight" at the outset of treatment (when I was very cautious), but now I don't notice any difference whatsoever. As long as you have no prior history of alcohol problems or abuse, I would thus advise cautiously monitoring how you respond to a single drink (under safe conditions) and to take it from there. Just be careful and avoid driving at all costs if you're intent on trying this! People do respond differently...

best,
jd


> > I started imipramine on 11/11/99. I started with 1 for
> > 7 days, then 2, then 3. On my first refill my Dr. cut
> > it back to 1 per day. Does this sound routine or am I
> > missing something? I called the pharmacy to make sure
> > that they didn't make an error and they say no; it was
> > written that way.
> >
> > Also, the Dr. says absolutely no alcohol with this
> > stuff. I was wondering why and what it would do to you
> > if you did indulge on occasion.
> >
> > thanks...
>
> Tom - Did the tablets change in strength, so that you can get the same effect from 1 (eg 75mg) tablet as you can from 3 (eg 25mg) tablets. If not, and your doctor did not talk with you about reducing your dose, call your doctor to ask if this is what he meant to do. (Actually, any GOOD pharmacist would have done this for you) Unless you are having problems with the drug, the dose is not usually lowered. The dose is built up to help avoid the side effects that can occur at the initiation of therapy. We all make mistakes, even doctors and pharmacists, so it is important that you check whenever you are not sure about something that has been changed with your medication regimen. Good luck and call your doc. - Cam W.


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