What is desipramine, and how does it work (mechanism of action)?
Desipramine is an oral antidepressant, a member of
the tricyclic antidepressant (TCA) family which also includes
amitriptyline
(Elavil, Endep), and
imipramine (Tofranil).
Depression is an
all-pervasive sense of sadness and gloom. It is believed that in some patients
with depression, abnormal levels of neurotransmitters (chemicals that nerves use
to communicate with each other) may be the cause of their depression.
Desipramine elevates mood by raising the level of neurotransmitters in nerves of
the brain. Desipramine also is responsible for the antidepressant effects of
imipramine because imipramine is converted by the body to desipramine. The FDA
approved desipramine in 1964.
What brand names are available for desipramine?
Norpramin
Is desipramine available as a generic drug?
Yes
Do I need a prescription for desipramine?
Yes
What are the side effects of desipramine?
The most commonly encountered side effects associated with desipramine include:
- fast heart rate,
- blurred vision,
- urinary retention (difficulty urinating),
- dry mouth,
- constipation,
- weight gain or loss,
- low blood pressure upon arising that may cause light-headedness,
- rash,
- hives,
- seizures, and
- hepatitis.
Desipramine also causes elevated pressure in the eyes of some patients with
glaucoma.
Overdoses of desipramine can cause life-threatening
abnormal
heart rhythms or seizures. Sexual dysfunction also has been associated with
desipramine.
Following prolonged therapy with high doses, abrupt discontinuation of TCAs,
including desipramine, could lead to symptoms such as:
Therefore, many doctors recommend a gradual reduction in dose when TCAs are
discontinued.
Antidepressants increased the risk of
suicidal thinking and
behavior in short-term studies in children and adolescents with depression and
other psychiatric disorders. Anyone considering the use of desipramine or any
other antidepressant in a child or adolescent must balance this risk with the
clinical need. Patients who are started on therapy should be closely observed
for clinical worsening, suicidal thinking or behavior, and unusual changes in
behavior.
What is the dosage for desipramine?
The usual adult dose is 100-200 mg at bedtime or divided every 12
hours. The maximum dose is 300 mg daily.
Which drugs or supplements interact with desipramine?
: Desipramine interacts with other medications and drugs
that slow the brain's function, such as alcohol, barbiturates,
benzodiazepines, for example,
lorazepam
(Ativan), diazepam
(Valium), temazepam
(Restoril), oxazepam (Serax),
clonazepam
(Klonopin) as well as
zolpidem (Ambien) and narcotics. Reserpine has a stimulatory effect on
patients taking TCAs.
Desipramine and other TCAs should not be used with monoamine oxidase
inhibiting drugs, for example, isocarboxazid (Marplan), phenelzine (Nardil),
tranylcypromine (Parnate), and procarbazine (Matulane) since high
fever,
convulsions and even death can occur when these drugs are used together.
Cimetidine
(Tagamet) can increase desipramine blood levels, possibly causing side effects.
Other drugs which can increase disipramine blood levels include
propafenone
(Rythmol), flecainide (Tonocard),
quinidine
(Quinidex, Quinaglute), and
fluoxetine
(Prozac).
TCAs may inhibit the antihypertensive effect of
clonidine (Catapres).
Therefore, combining TCAs with clonidine may lead to dangerous elevations in
blood pressure.
Is desipramine safe to take if I’m pregnant or breastfeeding?
Desipramine is secreted in
breast milk
and the effect on nursing infants is known. Nursing should be avoided while
taking desipramine.
What else should I know about desipramine?
What preparations of desipramine are available?
Tablets: 10, 25, 50, 75, 100, and 150 mg.
How should I keep desipramine stored?
Desipramine should be stored at room temperature, below 86 F (30 C),
in a tight, light resistant container.