Trimipramine •

Drug·lnduced salivary adenitis: fIrst report T rimipramine is a tricyclic antidepressant with inherent anticholinergic properties. A 44-year-old female with crying spells and difficulty in sleeping was given trimipramine (50mgiday)for 3 days. She also received 75mg of the drug at bed time. One week later the patient complained of a dry mouth. However, as she showed some improvement in her depression, the dose of trimipramine was increased to I OOmg at bedtime and I I days later to 125mgiday at bedtime. When the patient was seen again about 2.5 months after her first visit to the clinic, she complained of soreness under her tongue and swelling under her jaw which had been there for the previous 2 weeks. On physical examination, there was no tonsillar hypertrophy but a tender immobile mass was located at the right mandibular angle. There was no evidence of salivary ducl obstrucllon or infection, nor a history of parotid gland disease. Trimjpramine was discontinued and amoxapine (150mg) at bedtime started. Within 2 days of stopping trimipramine her mouth dryness and swelling began to decrease. One month later symptoms resolved completely. It is suggested that the adenitis was caused by a partial reduction in salivary flow secondary to the anticholinergic properties of trimipramine. Ponte, CD.: Drug Intelligence and Clinical Pharmacy 16: 248 (Mar 1982)

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