Trimipramine—an Atypical Neuroleptic?

Antipsychotic Efficacy of the Antidepressant Trimipramine: A Randomized, Double-blind Comparison with the Phenothiazine Perazine

“…The time course of the BPRS total score changes and of the dropouts, as well as the treatment results of the first-week completer subgroup compared to the whole patient sample, showed that trimipramine was less effective mainly in the first week of treatment. This was consistent with the results of the previous pilot study [7], where all patients who had to be withdrawn from the study (21 %) deteriorated during the first week of treatment. These dropouts occurred due to agitation and excitement, suggesting that trimipramine may exhibit weaker effects on these symptoms.…”

“…The primary aim of the study was to compare the antipsychotic efficacy of trimipramine with that of perazine in the dosage employed. With reference to two previous studies using these sub- Original Paper stances in a similar dosage [7,35], a mean difference in the change in BPRS total scores between the two treatment groups of 2.2 points was assumed, as well as an equivalence interval of 8 points and a standard deviation (of the means of the BPRS total scores at the end of treatment) of 10 points. With a risk of a type I error of a = 0.05 and a type II error of û = 0.20, the number of cases per treatment group required was calculated to be n = 38 (one-sided test).…”

“…In an open pilot study, patients with schizophrenia (n = 28) were treated with trimipramine for 5 weeks during an acute psy-chotic episode [7,8]. Brief Psychiatric Rating Scale (BPRS) [25] total scores were significantly reduced (p < 0.05).…”

Alternative approaches to refractory depression in bipolar illness

“…This approved agent had an unknown mechanism of action since it was not a potent reuptake blocker. More recently, it has been shown to be a moderately potent antagonist of D 2 and D 4 receptors with a profile somewhat similar to that of clozapine (Eikmeier et al, 1991;Gross et al, 1991). It has also been reported in open studies to be effective in the treatment of acute schizophrenic episodes.…”

Inhibitory potencies of trimipramine and its main metabolites at human monoamine and organic cation transporters

“…Interestingly, the affinity values at dopamine and 5-HT 2 -receptors and at α 1 -adrenoceptors closely resemble those observed for the atypical antipsychotic drug clozapine. This may point at the potential mechanisms of trimipramine's antipsychotic properties as large doses of trimipramine have been described to have antipsychotic effects in schizophrenic patients, without inducing extrapyramidal side effects (Eikmeier et al 1990;Eikmeier et al 1991;Seeman 1992). Recently, it has been shown to be effective in patients with delusional depression (Künzel et al 2009).…”