sedative effects. However, trimipramine has also been said to be associated with a different side effect profile compared to other TCAs and in general with fewer side effects, chiefly due to its lack of norepinephrine reuptake inhibition and relatively lower anticholinergic effects (although it is still a potent anticholinergic). Somnolence is the most common side effect of the drug. Dry mouth is the most common anticholinergic side effect, but others like constipation, urinary retention, and blurred vision are also present. It is described as being associated with minimal or no orthostatic hypotension, at least in comparison to clomipramine, in spite of its potent and comparable activity as an alpha-1 blocker. However, it has also been said to have a rate of orthostatic hypotension similar to that of other TCAs. Trimipramine is said to be less epileptogenic than other TCAs, although seizures have still been reported in association with it. It is also less cardiotoxic than other TCAs and cardiotoxicity is said to be minimal, with a "very favorable profile". Heavy exposure to any tricyclic antidepressants was associated with an elevated rate ratio for breast cancer 11–15 years later. However, on tests done on Drosophila melanogaster, nongenotoxic TCAs (amitriptyline, maprotiline, nortriptyline, and protriptyline), and genotoxic TCAs (amoxapine, clomipramine, desipramine, doxepin, imipramine, and trimipramine) were identified. List of side effects Common adverse effects include: Sedation — especially common with trimipramine compared to the other TCAs Anticholinergic effects including: - dry mouth - blurred vision - mydriasis - decreased lacrimation - constipation - urinary hesitancy or retention - reduced GI motility - tachycardia (high heart rate) - anticholinergic delirium (particularly in the elderly and in Parkinson's disease) Weight gain Orthostatic hypotension Sexual dysfunction including impotence, loss of libido and other sexual adverse effects Tremor Dizziness Sweating Anxiety Insomnia Agitation Rash Adverse effects with an unknown incidence includes: Confusion Nausea Vomiting Extrapyramidal side effects (e.g. parkinsonism, dystonia, etc.) Tinnitus Paraesthesia ECG changes Increased liver function tests Rare adverse effects include: Seizures Syndrome of inappropriate secretion of antidiuretic hormone Blood dyscrasias including: Agranulocytosis Thrombocytopenia Eosinophilia Leukopenia Myocardial infarction Heart block QTc interval prolongation Sudden cardiac death Depression worsening Suicidal ideation Overdose Compared to other TCAs, trimipramine is relatively safe in overdose, although it is more dangerous than the selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) but less dangerous than bupropion in cases of overdose. Interactions Trimipramine should not be given with sympathomimetic