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Psychotropic Use during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Three neonates whose mothers used imipramine during late third trimester exhibited symptoms consistent with withdrawal (transient respiratory, circulatory, and neurological adaptation abnormalities) (Eggermont et al., 1972).
Parasomnias
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Medical intervention for the juvenile somnambulist is usually unnecessary. Nevertheless, when sleepwalking episodes disrupt the family’s psychological stability or threaten harm to the sleepwalker, treatment is justified. Lorazepam (O.S to 1.0 mg) or diazepam (1.0 to 3.0 mg) one hour before bedtime is the treatment of choice. Imipramine has been tried in childhood sleepwalkers (2), but its less certain efficacy and low therapeutic index argue against use in this patient population. Psychotherapy is rarely indicated.
Antiepileptic Drugs Useful in the Treatment of Absence Seizures
Published in Carl L. Faingold, Gerhard H. Fromm, Drugs for Control of Epilepsy:, 2019
The main side effect encountered during the use of imipramine for the treatment of absence and myoclonic-astatic seizures has been the occasional exacerbation of tonic-clonic or partial seizures,6,10 requiring an increase in the dose of the medications being administered for the control of the latter seizures. Imipramine has never provoked an uncontrollable increase in major seizures.
Virtual screening and zebrafish models in tandem, for drug discovery and development
Published in Expert Opinion on Drug Discovery, 2023
David Hernández-Silva, Francisca Alcaraz-Pérez, Horacio Pérez-Sánchez, Maria Luisa Cayuela
Xenograft. Fascin 1 is a vital actin-bundling protein involved in cancer invasion and metastasis whose expression goes hand in hand with poor prognosis. Therefore, Fascin 1 is an excellent therapeutic target in cancer treatment. In silico screening calculations of 9591 compounds, including 2037 approved by the FDA, were performed and analyzed by VS to identify a potential fascin1 blocker [88]. Among the 20–30 top candidate compounds, imipramine (antidepressants) and raltegravir (anti-retroviral) were selected by different techniques such as thermofluor, fluorescence titration, and in vitro characterization. Finally, both compounds were tested using the process of xenograft transplantation into larvae to evaluate their inhibitory activity in tumor growth, invasion, and metastasis. Imipramine is being tested in an approved phase II clinical trial [89]. The combination screenings allowed the repurposing to take place in less than 3 years, and the number of compounds tested in vitro/in vivo was greatly reduced (99,5% of the library were eliminated in silico)
New insights on the phytochemical intervention for the treatment of neuropsychiatric disorders using the leaves of Michelia champaca: an in vivo and in silico approach
Published in Pharmaceutical Biology, 2022
Pushpa V. H., Jayanthi M. K., Rashmi H. R., Veeresh Kumar N. Shivamurthy, Shashank M. Patil, Prithvi S. Shirahatti, Ramith Ramu
OSIRIS property explorer uses Lipinski’s rule of five for the analysis of drug-likeness and toxicity of the compounds. Lipinski’s rule of five states that a potential drug candidate must have its molecular weight ≤500 Da, cLogP value (logarithm of its partition coefficient between n-octanol and water log(coctanol/cwater) ≤4.15, hydrogen bond acceptors ≤10, hydrogen bond donors ≤5 and rotatable bonds ≤10) (Lipinski et al. 2001). Based on these parameters, nine compounds obtained from previous virtual screening were assessed for their drug-likeness and toxicity. Out of the nine compounds, only doripenem was predicted with no violation of Lipinski’s rule of five. It was also predicted with no risk of causing mutagenic, tumorigenic, irritating and reproductive aberrations. Although reference drugs diazepam and imipramine showed no violations of Lipinski’s rule of five, their drug scores were found to be lower than doripenem. Besides, during the toxicity analysis, diazepam was predicted with a high risk showing possible mutagenicity, tumorigenicity and reproductive health aberrations. In addition, imipramine was also predicted with reproductive health aberrations. Apart from docking simulations, drug-likeness and toxicity studies also favour doripenem in comparison with the reference drugs (Table 9).
Contemporary management of unipolar depression in the perinatal period
Published in Expert Review of Neurotherapeutics, 2021
Bhuvaneshwari Sethuraman, Susan Thomas, Krishnamachari Srinivasan
Most protocols recommend the use of sertraline and citalopram as the first line of treatment for antenatal depression [3,10,84]. Paroxetine is to be avoided during pregnancy as its use during pregnancy is associated with an increased risk of cardiac malformations in the newborn [112]. Similarly, it is better to avoid clomipramine during pregnancy as in some studies it has been associated with an increased risk of congenital malformations such as cleft palate, open eyelids, ear defects and neck defects [114]. UK Teratology body recommends the use of amitriptyline and imipramine as the first line options for treatment of depression during pregnancy [10]. Benzodiazepines as a class of drugs should be avoided as some studies have noted its use to be associated with an increased risk for floppy infant syndrome, withdrawal signs in the newborn, congenital malformations such as esophageal atresia, microphthalmia and pulmonary valve stenosis [115] and impaired cognitive development in children [116]. There is limited evidence for safe and efficacious use of other antidepressant medications during pregnancy.