Desipramine Brand Name– Norpramin
What is Desipramine
Desipramine is a tricyclic antidepressant (TCA) of the dibenzazepine type, and is the active metabolite of imipramine. Desipramine is used primarily for the treatment of major depressive disorder (MDD) in adults.
Safety and efficacy have not been established in pediatric patients; usual dosing for adolescents (e.g., age 13 years and older) is suggested within the product labels.
Desipramine is also used off-label for many conditions, such as in treating symptoms of neuropathic pain; however, the evidence for efficacy and safety in these conditions is often of low to moderate quality relative to the evidence available for other treatments.
While it is one of the most studied TCAs for second-line off-label treatment of attention deficit hyperactivity disorder (ADHD) in pediatric patients, evidence regarding efficacy and safety in pediatrics is low due to the lack of large trials of sufficient quality.
Desipramine was first FDA-approved in 1964. The FDA requires a boxed warning detailing the increased risk of suicidality in children, adolescents, and young adults in product labels.
A Patient Medication Guide (MedGuide) should accompany all prescriptions for antidepressants.
Indications
- attention-deficit hyperactivity disorder (ADHD)
- bulimia nervosa
- depression
- diabetic neuropathy
- panic disorder
- postherpetic neuralgia
- social phobia (social anxiety disorder)
For the treatment of major depression
Side Effects
- abdominal pain
- agitation
- agranulocytosis
- alopecia
- anorexia
- anxiety
- ataxia
- blurred vision
- breast enlargement
- confusion
- constipation
- cycloplegia
- depression
- diabetes mellitus
- diarrhea
- dizziness
- drowsiness
- dysarthria
- dysgeusia
- dyskinesia
- dyspepsia
- dystonic reaction
- edema
- EEG changes
- ejaculation dysfunction
- elevated hepatic enzymes
- eosinophilia
- erythema
- fatigue
- fever
- flushing
- galactorrhea
- glossitis
- goiter
- gynecomastia
- hallucinations
- headache
- heart failure
- hepatic failure
- hepatitis
- hyperhidrosis
- hypertension
- hyperthermia
- hyperthyroidism
- hyponatremia
- hypothyroidism
- ileus
- impotence (erectile dysfunction)
- increased urinary frequency
- insomnia
- jaundice
- leukopenia
- libido decrease
- mania
- memory impairment
- mydriasis
- myocardial infarction
- nausea
- nightmares
- ocular hypertension
- orgasm dysfunction
- orthostatic hypotension
- palpitations
- paresthesias
- parotitis
- peripheral neuropathy
- petechiae
- photosensitivity
- PR prolongation
- pruritus
- pseudoparkinsonism
- psychosis
- purpura
- pyrosis (heartburn)
- QT prolongation
- rash
- restlessness
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- stomatitis
- stroke
- suicidal ideation
- testicular swelling
- thrombocytopenia
- tinnitus
- tongue discoloration
- tremor
- urinary retention
- urticaria
- vasculitis
- ventricular tachycardia
- vomiting
- weakness
- weight gain
- withdrawal
- xerostomia
- yawning
Monitoring Parameters
- blood pressure
- ECG
- heart rate
- LFTs
- serum desipramine concentrations
- thyroid function tests (TFTs)
Contraindications
- abrupt discontinuation
- acute myocardial infarction
- agranulocytosis
- alcoholism
- anticholinergic medications
- bipolar disorder
- bradycardia
- breast-feeding
- carbamazepine hypersensitivity
- cardiac arrhythmias
- cardiac disease
- children
- closed-angle glaucoma
- coadministration with other CNS depressants
- congenital heart disease
- contact lenses
- coronary artery disease
- diabetes mellitus
- driving or operating machinery
- electroconvulsive therapy (ECT)
- ethanol ingestion
- females
- geriatric
- heart failure
- hepatic disease
- hypertension
- hyperthyroidism
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypothyroidism
- ileus
- increased intraocular pressure
- leukopenia
- long QT syndrome
- malnutrition
- mania
- MAOI therapy
- myocardial infarction
- neonates
- pheochromocytoma
- pregnancy
- prostatic hypertrophy
- QT prolongation
- radiographic contrast administration
- schizophrenia
- seizure disorder
- seizures
- suicidal ideation
- sunlight (UV) exposure
- surgery
- thyroid disease
- tobacco smoking
- tricyclic antidepressant hypersensitivity
- urinary retention
Interactions
- Abarelix
- Abiraterone
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acetazolamide
- Acetylcholine Chloride
- Acrivastine; Pseudoephedrine
- Albendazole
- Alfentanil
- Alfuzosin
- Alosetron
- Alprazolam
- Amantadine
- Ambenonium Chloride
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- Amlodipine; Celecoxib
- Amobarbital
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
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- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
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- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
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- Efavirenz
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- Eliglustat
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