Opipramol, sold under the brand name Insidon among others, is an anxiolytic and tricyclic antidepressant that is used throughout Europe. Despite chemically being a tricyclic dibenzazepine (iminostilbene) derivative similar to imipramine, opipramol is not a monoamine reuptake inhibitor like most other tricyclic antidepressants, and instead, uniquely among antidepressants, acts primarily as a SIGMAR1 agonist. It was developed by Schindler and Blattner in 1961. Opipramol is typically used in the treatment of generalized anxiety disorder (GAD) and somatoform disorders. Preliminary studies suggest that opipramol shows potential clinical significance in the treatment of severe sleep bruxism. In patients with hypersensitivity to opipramol or another component of the formulation Acute alcohol, sedative, analgesic, and antidepressant intoxications Acute urinary retention Acute delirium Untreated narrow-angle glaucoma Benign prostatic hyperplasia with residual urinary retention Paralytic ileus Pre-existing higher-grade atrioventricular blockages or diffuse supraventricular or ventricular stimulus conduction disturbances Combination with monoamine oxidase inhibitor (MAOI) Experimental animal studies did not indicate injurious effects of opipramol on the embryonic development or fertility. Opipramol should only be prescribed during pregnancy, particularly in the first trimester, for compelling indication. It should not be used during lactation and breastfeeding, since it passes into breast milk in small quantities. Frequently (≥1% to
Douglas Hanahan, Ksenya Shchors, Aristea Massaras