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[Update Opipramol].
Maximilian Gahr1, Christoph Hiemke2, Bernhard J Connemann1
1Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm.
Fortschritte Der Neurologie-Psychiatrie
|March 21, 2017
Summary
Opipramol, an antidepressant with unique sigma receptor agonism, shows greater anxiolytic than antidepressant effects. It is well-tolerated and effective for anxiety and somatoform disorders, despite limited scientific focus.
Area of Science:
- Pharmacology
- Psychiatry
Background:
- Opipramol, developed in the 1960s, shares chemical similarities with tricyclic antidepressants but differs in pharmacodynamic properties.
- Unlike tricyclics, opipramol lacks serotonin and noradrenaline reuptake inhibition and exhibits agonism at sigma receptors.
Purpose of the Study:
- To review the pharmacological profile, efficacy, and safety of opipramol.
- To assess its current role in treating somatoform and generalized anxiety disorders.
Main Methods:
- Review of existing clinical data and pharmacological studies on opipramol.
- Analysis of its mechanism of action, focusing on sigma receptor agonism.
- Evaluation of its efficacy and tolerability in approved indications.
Main Results:
- Opipramol demonstrates stronger anxiolytic effects than antidepressant effects.
- Its primary metabolism via CYP2D6 necessitates caution in patients with hepatic impairment or on polypharmacy.
- Clinical data indicate good tolerability and safety, with mild vigilance disturbances and anticholinergic effects as predominant side effects.
Conclusions:
- Opipramol is effective for somatoform disorders and generalized anxiety disorder, with sufficient evidence supporting its use.
- Despite its frequent prescription in Germany, its clinical and scientific role is limited.
- Given the scarcity of treatment options, opipramol warrants consideration for these conditions.