Imipraminoxide (brand names Imiprex, Elepsin) is a tricyclic antidepressant and imipramine metabolite that was used in Europe for the treatment of depression. In comparison with the imipramine, Imipraminoxide efficacy was identical to imipramine. However, in clinical trials, imipraminoxide was found to have a faster onset of action, and fewer and less marked side effects, including diminished orthostatic hypotension and anticholinergic effects like dry mouth, sweating, dizziness, and fatigue. Imipraminoxide's pharmacology has not been well elucidated, but based on its very close relationship with imipramine, it likely acts as a serotonin and norepinephrine reuptake inhibitor and serotonin, adrenaline, histamine, and muscarinic acetylcholine receptor antagonist, though with weaker antiadrenergic and anticholinergic actions