desipramine, Norpramin

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GENERIC NAME: desipramine

BRAND NAME: Norpramin

DRUG CLASS AND MECHANISM: 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.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 10, 25, 50, 75, 100, and 150 mg.

STORAGE: Desipramine should be stored at room temperature, below 86 F (30 C), in a tight, light resistant container.

PRESCRIBED FOR: Desipramine is used to elevate the mood of patients with depression. Non-FDA approved (off-label) uses include anxiety, attention-deficit hyperactivity disorder, bulimia, cataplexy syndrome, chronic itching, depression caused by traumatic brain injury, neuropathic pain (due to injury of nerves), and panic disorder. Desipramine also has sedative properties although less than most other TCAs. Therefore, it is useful in depressed patients with insomnia, restlessness, and nervousness.

DOSING: The usual adult dose is 100-200 mg at bedtime or divided every 12 hours. The maximum dose is 300 mg daily.

DRUG INTERACTIONS: 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.

Medically Reviewed by a Doctor on 9/12/2014



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