Desipramine Hydrochloride(dess ip’ ra meen)
Alti-Desipramine (CAN), Apo-Desipramine (CAN), Norpramin, Nu-Desipramine (CAN), PMS-Desipramine (CAN), ratio-Desipramine (CAN)
PREGNANCY CATEGORY C
Drug Classes
Antidepressant
TCA (secondary amine)
Therapeutic Actions
Mechanism of action unknown; inhibits the presynaptic reuptake of the neurotransmitters norepinephrine and serotonin; anticholinergic at CNS and peripheral receptors; sedating.
Indications
Relief of symptoms of depression (endogenous depression most responsive)
Unlabeled uses: Treatment of eating disorders, chronic urticaria, diabetic neuropathy, ADHD, enuresis, alcohol dependence, postherpetic neuralgia, traumatic brain injury, Tourette syndrome
Contraindications and Cautions
Contraindicated with hypersensitivity to any tricyclic drug, concomitant therapy with an MAOI, recent MI, myelography within previous 24 hr or scheduled within 48 hr.
Use cautiously with ECT; preexisting CV disorders (eg, severe coronary heart disease, progressive heart failure, angina pectoris, paroxysmal tachycardia; possibly increased risk of serious CVS toxicity with TCAs); family history of sudden death or rhythm disturbances; angle-closure glaucoma, increased IOP, urinary retention, ureteral or urethral spasm (anticholinergic effects of TCAs may exacerbate these conditions); seizure disorders (TCAs lower the seizure threshold); hyperthyroidism (predisposes to CVS toxicity, including cardiac arrhythmias); impaired hepatic, renal function; psychiatric patients (schizophrenic or paranoid patients may exhibit a worsening of psychosis with TCA therapy); manic-depressive patients (may
shift to hypomanic or manic phase); elective surgery (TCAs should be discontinued as long as possible before surgery), pregnancy, lactation.
Available Forms
Tablets—10, 25, 50, 75, 100, 150 mg
Dosages
Adults
Depression: 100–200 mg/day PO as single dose or in divided doses initially. May gradually increase to 300 mg/day. Do not exceed 300 mg/day. Patients requiring 300 mg/day should generally have treatment initiated in a hospital. Continue a reduced maintenance dosage after a satisfactory response has been achieved.
Pediatric patients
Not recommended in children younger than 12 yr.
Geriatric patients and adolescents
Initially, 25–100 mg/day PO; dosages more than 100–150 mg are not recommended.
