Desipramine

Desipramine

Desipramine is a medication approved by the Food and Drug Administration (FDA) for the treatment of depression. It belongs to a group known as tricyclic antidepressants. Desipramine functions by enhancing the levels of specific natural substances in the brain, which are essential for maintaining mental equilibrium. However, it is advised against prescribing this drug to individuals under the age of 18 due to the potential for severe side effects. Desipramine is available in the form of oral tablets with various dosage options, including 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg. So, if you want to buy Desipramine to treat depression, you need to get a doctor’s prescription.

Desipramine Overview

Desipramine is a tricyclic antidepressant approved by the FDA for treating depression. It works by enhancing specific natural substances in the brain to maintain mental equilibrium. Desipramine is not recommended for individuals under 18 due to severe potential side effects. The medication is available in oral tablets with various dosages: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg. A doctor’s prescription is required to purchase Desipramine. For adults, the typical dosage ranges from 100–200 mg per day, with a maximum of 300 mg per day under hospital supervision. For teenagers, the dosage ranges from 25–100 mg per day.

When taking Desipramine, it is crucial to follow the doctor’s instructions carefully. The medication can be taken with or without food, usually 1 to 3 times daily, based on the patient’s condition and response to treatment. Desipramine may cause drowsiness or wakefulness; hence, it’s essential to take it as directed, either in the morning or at bedtime. Regular use of this medication is necessary to benefit fully, and it should not be abruptly stopped without consulting a doctor, as sudden discontinuation can worsen conditions. Desipramine increases norepinephrine levels in the brain, aiding in mood improvement and combating depression.

Common side effects of Desipramine include loss of appetite, dizziness, blurry vision, dry mouth, and constipation. Serious side effects may include suicidal thoughts, heart conditions, and serotonin syndrome. The medication carries a black box warning due to the potential increase in suicidal thoughts, particularly in young people. It is vital to monitor for any unusual changes in mood or behavior. Desipramine should not be used with MAO inhibitors due to the risk of severe interactions. Patients should inform their healthcare provider of all medications and medical conditions before starting Desipramine to avoid potential interactions and complications.

Uses of Desipramine

• Desipramine tablets are used to treat depression.

Desipramine Dosage

This medication is available in the form of oral tablets and has the following strengths:

• Desipramine 10 mg
• Desipramine 25 mg
• Desipramine 50 mg
• Desipramine 75 mg
• Desipramine 100 mg
• Desipramine 150 mg

Recommended Dosage for Different Patients

Adult Dosage (ages 18 to 64 years):

• Starting Dosage: Your doctor might initiate treatment with a lower dosage, adjusting it as needed. You may take this dosage in divided doses or as a single daily dose.
• Usual Dosage: Typically, 100–200 mg per day, which can be administered in divided doses or as a single dose.
• Maintenance Dosage: Once your depression shows improvement and long-term treatment is needed, you should use the lowest effective dosage. When the maintenance dosage is established, the entire daily dosage may be taken once daily.
• Maximum Dosage: Up to 300 mg per day. If you require this dosage, hospitalization is recommended for close monitoring of your heart rate and rhythm.

Child Dosage (ages 13 to 17 years):

• Typical Dosage: 25–100 mg per day, taken either in divided doses or as a single dose.
• Maintenance Therapy: Following improvement in depression, the minimal effective dose should be used for long-term treatment. When the maintenance dosage is reached, it can be taken as a single daily dose.
• Maximum Dosage: The dosage may be gradually increased to 100 mg per day and in cases of severe depression, up to 150 mg per day. Doses above 150 mg per day are not advised.

Child Dosage (ages 0 to 12 years):

• Desipramine is not recommended for children under 13 years of age.

Senior Dosage (ages 65 years and older):

• Typical Dosage: 25–100 mg per day, which can be administered in divided doses or as a single dose.
• Maintenance Dosage: Once depression improves and long-term treatment is warranted, the lowest effective dosage should be used. Upon reaching maintenance dosage, it can be taken as a single daily dose.
• Maximum Dosage: The dosage may be increased gradually to 100 mg per day and, in more severe cases, up to 150 mg per day. Doses above 150 mg per day are not recommended.

Considerations for Renal Impairment:

• No supplemental dose is necessary for patients undergoing peritoneal or hemodialysis.

This dosing guide outlines the general recommendations for Desipramine use in different patient groups, emphasizing the need for careful dosage adjustments based on the severity of the condition and patient-specific factors, such as age and renal function. Always consult with a healthcare provider for personalized dosing.

[Note: These recommendations mentioned above can vary from person to person. Discuss it with your doctor or pharmacist, and they will customize your Desipramine dosage accordingly.]

How to Take Desipramine?

• Read the Medication Guide provided by your pharmacist before you start taking Desipramine and each time you get a refill. If you have questions, ask your doctor or pharmacist.
• Take Desipramine by mouth with or without food as directed by your doctor, usually 1 to 3 times daily.
• The dosage is based on your medical condition and response to treatment. Your doctor may start you at a low dose & gradually increase your Desipramine dose.
• Desipramine may make you sleepy or wakeful; take the entire dose once daily, either in the morning or at bedtime, as directed by how it affects you.
• Follow your doctor’s instructions carefully. Do not take more or less medication or take it more often than prescribed.
• Use this Desipramine regularly to get the most advantage from it. To help you remember, use it at the same time each day.
• Keep taking this medication even if you feel well. Do not suddenly stop taking it without consulting your doctor.
• Some conditions may become worse when the medication is abruptly stopped. Your dose may need to be gradually decreased.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Desipramine Work?

Desipramine is a type of medication known as a tricyclic antidepressant. This means it’s part of a group of drugs that all work similarly and are often used to treat the same conditions. While the exact mechanism isn’t fully understood till now, it’s believed that Desipramine works by blocking the reabsorption of a chemical in the brain called norepinephrine. Normally, your brain reabsorbs this chemical after it sends messages between brain cells. By preventing this reabsorption, Desipramine increases the amount of norepinephrine available, which is thought to help improve your mood and combat depression.

Important Safety Information

Desipramine Side Effects

Common side effects of Desipramine may include:

• Loss of Appetite
• Dizziness
• Blurry Vision
• Dry Mouth
• Trouble Urinating
• Vomiting
• Constipation
• Drowsiness
• Nausea
• Sexual issues, including reduced libido or erectile dysfunction.
• Rapid heartbeat.
• Blood pressure abnormalities, either high or low blood pressure upon standing after sitting or lying down.

Serious side effects of Desipramine may include:

• Risk of suicide and increasing depression including:
  • Thoughts of suicide or dying
  • Suicide attempts
  • Onset or worsening of depression
  • Increase or new occurrence of anxiety
  • High levels of agitation or restlessness
  • Panic attacks
  • Sleep disturbances
  • Increased irritability
  • Aggressive, angry, or violent behavior
  • Acting on dangerous impulses
  • Manic episodes, characterized by extreme increases in activity and talking
  • Other unusual changes in behavior or mood
• Eye Problems:
  • Eye pain
  • Vision issues, such as blurry vision
  • Swelling or redness around the eyes
• Heart Conditions:
  • Strong, pounding heartbeat
  • Irregular heart rhythm
• Heart Attack Symptoms:
  • Chest pain
  • Shortness of breath
  • Discomfort in upper body areas
• Stroke Symptoms:
  • Weakness on one side of the body or a specific part
  • Slurred speech
• Symptoms of Serotonin Syndrome:
  • Agitation, coma, hallucinations, or other mental status changes
  • Coordination problems, hyperactive reflexes, or muscle twitching
  • Tremors
  • Fast heartbeat
  • Blood pressure fluctuations
  • Sweating or fever
  • Nausea, vomiting, diarrhea
  • Muscle stiffness
• Neuroleptic Malignant Syndrome:
  • Elevated body temperature or fever
  • Sweating
  • Stiff muscles
  • Muscle spasms
  • Involuntary facial movements
  • Irregular or fast heartbeat
  • Elevated blood pressure
  • Loss of consciousness

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Desipramine Warnings

Desipramine Boxed Warning

This medication carries a black box warning, the FDA’s most stringent caution. It is issued to inform both healthcare professionals and patients about potential severe risks associated with the drug. Desipramine has been shown to potentially elevate the risk of suicidal thoughts or behaviors, particularly within the initial months of treatment or when adjusting the dose. This risk is more pronounced in children, teenagers, and young adults. It’s important to monitor for any atypical shifts in mood, behavior, thoughts, or feelings. If you or someone under your care experiences such changes, contact your physician immediately.

Other Warnings

Warning of Worsening Depression: This medication carries a risk of exacerbating depression, particularly during the initial stages of treatment or when dosage adjustments are made. If you experience any unusual behavioral changes, immediate consultation with your doctor is crucial. These symptoms may include suicidal thoughts or attempts, panic attacks, insomnia, feelings of anxiety, agitation, or restlessness. Other signs to watch for are irritability, hostility, aggression, acting on dangerous impulses, or experiencing severe mood swings.

Drowsiness and Dizziness Caution: This drug may induce drowsiness or dizziness. It is advised that you avoid driving, operating heavy machinery, or engaging in any activities that could be hazardous until you fully understand how this medication affects you.

High Blood Pressure During Surgery Caution: If you are scheduled for elective surgery, inform your doctor that you are taking Desipramine. It is recommended to discontinue this medication as early as possible before the procedure due to its potential to cause high blood pressure, which can pose significant risks during surgical operations.

Desipramine Precautions

Allergies: Inform your doctor if you have allergies to this medication or other tricyclic antidepressants like imipramine or amitriptyline, as well as any other allergies you may have. Be aware that certain inactive ingredients in this medication could cause complications. Also, disclose your full medical history, especially if it includes conditions like respiratory issues, glaucoma, diabetes, eating disorders, cardiac issues, liver or kidney disease, mood disorders, seizures, an overactive thyroid, urinary difficulties, or any conditions that increase seizure risk, including certain types of tumors.

Pediatric Considerations: Desipramine’s effects on children have not been thoroughly studied, particularly regarding how age influences its effectiveness and safety. Consequently, the safety and efficacy of Desipramine for the pediatric population remain undetermined. This lack of data underscores the necessity for careful consideration and consultation with a healthcare professional before Desipramine is administered to children. Healthcare providers must weigh potential benefits against the risks when prescribing this medication to the pediatric demographic.

Geriatric Considerations: Although studies have not identified any specific problems for older adults that would restrict the use of Desipramine, caution is advised. Older patients may experience increased susceptibility to confusion, episodes of falling, and renal issues related to aging. These factors necessitate careful monitoring and possibly adjusting the dosage of Desipramine for elderly patients. It is essential to balance the medication’s benefits against these potential risks to optimize treatment and minimize adverse effects in the geriatric population.

Breastfeeding Considerations: The safety of Desipramine use during breastfeeding has not been established through rigorous studies. The lack of definitive data on the risks to infants means that the decision to use this medication while breastfeeding must be made with careful consideration of the potential benefits versus the risks. Nursing mothers should consult their healthcare providers to thoroughly discuss all possible outcomes to make an informed decision about whether to proceed with Desipramine therapy while breastfeeding. This careful deliberation ensures the well-being of both mother and child.

Desipramine Missed Dose

If you forget to take a dose of Desipramine, it’s important to take it as soon as you remember. However, if the time is nearing your next scheduled dose, you should omit the missed dose and continue with your regular dosing regimen. It’s crucial not to take two doses at once in an attempt to compensate for the missed one.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Desipramine Overdose 

If your body contains high levels of this medication, you could quickly show serious signs. These signs include altered heart rhythms and rates, very low blood pressure, and enlarged pupils. You may feel extremely agitated, experience involuntary muscle twitches, have stiff muscles, and throw up. Other signs include either very low or very high body temperatures, a slowed breathing rate, feeling sleepy, fainting, feeling confused, having trouble focusing, experiencing seizures, seeing things that are not there, falling into a coma, or even death. If you think you have taken too much of this medication, you should immediately call your doctor or your local poison control center. If your symptoms are severe, call 911 or go directly to the nearest emergency room.

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

Desipramine Storage

• Ensure that Desipramine is stored in a tightly sealed container to prevent contamination and preserve its potency. The container should be kept at room temperature, ideally between 59°F & 86°F (15°C & 30°C). Avoid exposing the medication to extremes, such as heat sources, high humidity, and direct sunlight, which could degrade its effectiveness.
• Always store Desipramine in a location that is inaccessible to children. This is crucial to prevent accidental ingestion, which can be dangerous. Choose a secure storage area that children cannot reach or easily access.
• Do not retain Desipramine that has passed its expiration date or that you no longer need for your treatment. Keeping outdated or unnecessary medications can lead to accidental misuse or could be potentially hazardous.
• Consult with your healthcare provider about the proper disposal methods for Desipramine. Disposing of medication safely is important to prevent environmental contamination and to ensure that it does not pose a risk to others. 
• Your healthcare professional can provide specific instructions based on local regulations and available disposal options.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Desipramine Interactions

Certain medications should not be combined, while in some cases, using two different medications together may be possible even if an interaction is expected. In such situations, your healthcare provider might adjust the dosage or suggest additional precautions. It’s critical that your healthcare professional is aware of all the medications you are taking. Here are some specific guidelines regarding potential medication interactions:

Contraindicated Medications: It is generally advised not to use the following medications with this medicine. Your doctor may choose not to prescribe this medication or might change other medications you’re taking:

• Bepridil, 
• Bromopride, 
• Cisapride, 
• Dronedarone, 
• Furazolidone and many others

Medications with Possible Dose Adjustments: In some cases, although not recommended, you may still be prescribed this medicine along with others. If so, adjustments in dosages or frequency of administration might be necessary:

• Abiraterone Acetate, 
• Acecainide, 
• Aceclofenac and many others

Other Considerations:

• Food and Drug Interactions: Some medications should not be taken at meal times or with certain types of food as interactions may occur. The use of alcohol or tobacco with certain medications may also lead to interactions.
• Impact of Other Medical Conditions: The presence of other medical conditions can influence the effectiveness of this medication. Ensure your doctor is informed if you have conditions like mood or behavior changes, diabetes, glaucoma, arrhythmia, schizophrenia, a history of seizures, or urinary retention, as these conditions may worsen with the use of this medicine. Additionally, recent heart attacks or certain chronic conditions like heart or blood vessel disease, thyroid disease, or kidney disease require careful use of this medication due to potential exacerbation of side effects or increased medication effects due to slower drug clearance.

Interactions with MAO inhibitors: Desipramine should not be used in conjunction with or shortly after taking MAO inhibitors due to the high risk of severe drug interactions. If you have taken any MAO inhibitors within the last 14 days, starting Desipramine is contraindicated. MAO inhibitors are a group of medications that include isocarboxazid, linezolid, methylene blue injection, rasagiline, phenelzine, tranylcypromine, and selegiline, among others. These drugs can cause significant and dangerous interactions when combined with Desipramine. Moreover, after discontinuing Desipramine, it is crucial to allow a minimum of two weeks before starting any MAO inhibitor. This waiting period is necessary to clear Desipramine from your system and reduce the risk of potential interactions.

[Note: This isn’t a complete list, and there could be other drugs that interact with Desipramine. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Desipramine Alternatives

• Prozac (fluoxetine)
• Zoloft (sertraline)
• Lexapro (escitalopram)
• Effexor XR (venlafaxine)
• Cymbalta (duloxetine)
• Elavil (amitriptyline)
• Pamelor (nortriptyline)
• Remeron (mirtazapine)
• Desyrel (trazodone)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

Is Desipramine a sedative?

Desipramine is a medication that does not typically alter mood or arousal in individuals who are not experiencing depression; however, it can induce sedation in these cases. For those who are depressed, Desipramine has a beneficial impact on mood, helping to alleviate depressive symptoms. This drug belongs to a class of medications known as tricyclic antidepressants (TCAs), which are highly effective in blocking the reuptake of serotonin and norepinephrine, two neurotransmitters that play crucial roles in regulating mood. By inhibiting the reuptake of these neurotransmitters, Desipramine helps to increase their levels in the brain, thereby improving mood and alleviating depressive symptoms in individuals suffering from depression.

Is Desipramine a narcotic?

Desipramine, marketed under the brand name Norpramin, is not classified as a narcotic. Narcotics typically refer to drugs that are controlled substances due to their potential for misuse, dependence, or addiction. Desipramine does not fall into this category because it does not pose a significant risk of misuse or addiction. Instead, Desipramine is categorized as a tricyclic antidepressant (TCA). TCAs are primarily used to treat depression and certain other mental health conditions by affecting the balance of neurotransmitters in the brain. Thus, Desipramine is neither a narcotic nor a controlled substance but rather a medication specifically designed for the treatment of depressive disorders.

Is Desipramine used for nerve pain?

Desipramine may be used in the management of nerve pain. This drug belongs to the same group of medications as amitriptyline, another well-known tricyclic antidepressant commonly prescribed for neuropathic pain relief. Desipramine functions by altering the levels of certain chemicals in the brain, thereby helping to reduce the pain signals sent through the nervous system. Its effectiveness in treating neuropathic pain makes it a valuable option for patients suffering from conditions that cause chronic nerve pain, providing an alternative or complementary treatment to other medications in its class.

Is Desipramine used for sleep?

Desipramine, a tricyclic antidepressant, is specifically used to treat REM sleep behavior disorder, a type of sleep disorder in which individuals physically act out their dreams while sleeping. This condition can lead to potentially harmful behaviors during sleep, such as talking, shouting, or even violent movements. By affecting the balance of certain neurotransmitters in the brain, Desipramine helps to reduce or eliminate these disruptive sleep behaviors, thereby improving the quality and safety of the affected individual’s sleep.

What is the duration of Desipramine?

Desipramine is known for its extended duration in the body, with a half-life that ranges from 12 to 54 hours. This variability means that the time it takes for the concentration of Desipramine in the blood to reduce by half can vary significantly from person to person. The half-life is influenced by various factors, including individual metabolism and overall health. Desipramine is also the pharmacologically active metabolite of another tricyclic antidepressant, imipramine. 

This means that when imipramine is metabolized in the body, it converts into Desipramine, which then exerts therapeutic effects. Both Desipramine and imipramine exhibit high binding affinity to plasma proteins, with up to 95% of the drugs being bound in the bloodstream. This high degree of plasma protein binding influences their distribution, metabolism, and excretion, contributing to their prolonged action in the body.

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