Imipramine in Epilepsy

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Abstract
Experiments with cats showed that imipramine hydrochloride (Tofranil) resembled trimethadione (Tridione) and ethosuximide (Zarontin) in its ability to depress the corticofugal inhibition of afferent activity in the spinal trigeminal nucleus. Imipramine was, therefore, given to a group of 20 patients with petit mal and minor motor seizures who had failed to respond to conventional anticonvulsant medications or had become refractory to them. Fifteen patients had a good initial response to 1 to 3 mg/kg of imipramine hydrochloride, and six of them have continued to show a significant therapeutic response for more than one year. Imipramine thus appears to have the anticonvulsant effect predicted by our experimental data. Our observations suggest that the ability to depress cortical inhibitory pathways is an important feature of drugs that prevent minor seizures.