II. Indications
III. Mechanism
- See Tricyclic Antidepressant
- Desipramine is derived from demethylated Imipramine
IV. Dosing: Major Depression
- Adults
- Start: 50 mg orally daily for 3 days
- Next: 50 mg orally twice daily for 3 days
- Next: 100 mg orally at bedtime for 3 days
- Therapeutic dose: 150 mg orally at bedtime
- Maximum: 250 mg mg/day
- Teens and Elderly
- Start 25 mg orally at bedtime
- Advance to 50 to 100 mg orally daily or divided twice daily as tolerated and to effect
- Maximum: 150 mg/day
V. Dosing: Nocturnal Enuresis in Children
- Same dosing as with Imipramine
- Consider other measures for Nocturnal Enuresis first
- Consider baseline EKG before starting medication
- Initial dose
- Avoid in age <6 years
- Start at 10 mg orally nightly given one hour before bedtime
- Maximum dosing: up to 0.9 to 1.5 mg/kg
- Age 6-8 years
- May increase dose by 10 mg every 1-2 weeks as needed up to 25 mg per night one hour before bed
- Age 8-12 years
- May increase dose by 10 mg every 1-2 weeks as needed up to 50 mg per night one hour before bed
- Age over 12 years
- May increase dose by 10 mg every 1-2 weeks as needed up to 75 mg per night one hour before bed
- Age 6-8 years
- Discontinue after 3-6 months (some guidelines suggest maximum of 3 months)
- Taper to one half dose nightly for 2 weeks
- Taper to one half dose every other night for 2 weeks
VI. Pharmacokinetics
- Serum Half Life: 21 hours
- Therapeutic plasma level: 125 to 300
VII. Safety
- Unknown safety in pregnancy
- Safe in Lactation
VIII. Adverse effects
- See Tricyclic Antidepressants
- Much less adverse effects than tertiary amines
- Moderate adverse effects
IX. Precautions
- See Tricyclic Antidepressants
- Serious cardiotoxicity in overdosage
X. Advantages
- Activating
- Inexpensive
- Attention Deficit Hyperactivity Disorder effect
XI. Resources
XII. References
- (2023) Med Lett Drugs Ther 62(1592): 25-32
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 36-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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Related Studies
desipramine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
DESIPRAMINE 10 MG TABLET | Generic | $0.10 each |
DESIPRAMINE 100 MG TABLET | Generic | $0.56 each |
DESIPRAMINE 150 MG TABLET | Generic | $0.74 each |
DESIPRAMINE 25 MG TABLET | Generic | $0.18 each |
DESIPRAMINE 50 MG TABLET | Generic | $0.46 each |
Ontology: Desipramine (C0011685)
Definition (NCI) | An active metabolite of imipramine, a tertiary amine and a synthetic tricyclic derivative of the antidepressant. Desipramine enhances monoamine neurotransmission in certain areas of the brain by inhibiting the re-uptake of noradrenaline and serotonin at the noradrenergic and serotoninergic nerve endings, respectively. It also induces sedation through histamine 1 receptor blockage and hypotension through beta-adrenergic blockage. |
Definition (MSH) | A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholinergic activity, through its affinity to muscarinic receptors. |
Definition (CSP) | tricyclic dibenzazepine compound that potentiates neurotransmission; desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport; this compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D003891 |
SnomedCT | 33378002, 372705002 |
LNC | LP16103-1, MTHU004929 |
English | Desipramine, Demethylimipramine, Desmethylimipramine, 5H-Dibenz(b,f)azepine-5-propanamine, 10,11-dihydro-N-methyl-, desmethylimipramine, Desipramine [Chemical/Ingredient], desipramine, DESIPRAMINE, Desipramine (product), Desipramine (substance) |
Swedish | Desipramin |
Czech | desipramin |
Finnish | Desipramiini |
Russian | DEZIPRAMIN, DESMETILIMIPRAMIN, DEZIPRAMINGIDROKHLORID, ДЕЗИПРАМИН, ДЕЗИПРАМИНГИДРОХЛОРИД, ДЕСМЕТИЛИМИПРАМИН |
Japanese | デシプラミン, デスメチルイミプラミン |
Italian | Desmetilimipramina, Demetilimipramina, Desipramina |
Croatian | DESIPRAMIN |
Polish | Dezypramina |
Spanish | desipramina (producto), desipramina (sustancia), desipramina, Desipramina, Desmetilimipramina |
French | Désipramine |
German | Desipramin, Desmethylimipramin |
Portuguese | Desipramina, Desmetilimipramina |
Ontology: Pertofrane (C0031232)
Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
MSH | D003891 |
English | Pertofrane, Pertofran, Novartis Brand of Desipramine Hydrochloride, Pertrofran, Rhône Poulenc Rorer Brand of Desipramine Hydrochloride, Rhône-Poulenc Rorer Brand of Desipramine Hydrochloride |
Ontology: Norpramin (C0701352)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D003891 |
Croatian | NORPRAMIN |
English | norpramin, Norpramin, Aventis Behring Brand of Desipramine Hydrochloride, Aventis Brand of Desipramine Hydrochloride |