Detailed Drug Information:

DRUG CLASS AND MECHANISM: Desipramine is a medication that isused to treat depression, defined as an all-pervasive sense of sadness andgloom. Desipramine belongs to the tricyclic class of antidepressantscalled tricyclic antidepressants or TCAs. In some patients withdepression, abnormal levels of neurotransmitters in the brain (chemicalsthat the nerves use to communicate with each other) may be responsible forthe depression. Desipramine elevates mood and relieves depression byraising the levels of neurotransmitters in the brain. Desipramine also isresponsible for the antidepressant effects of another TCA, imipramine (TOFRANIL), since imipramine is converted by the body to desipramine.Desipramine was approved by the FDA in 1964.

PREPARATIONS: Capsules: 10mg, 25mg, 50mg, 100mg.

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

PRESCRIBED FOR: Desipramine is used to elevate the mood ofpatients with depression and to prevent the fluctuations in mood ofpatients who are manic/depressive. Desipramine also has sedativeproperties (although less than most other TCAs). Therefore, it is usefulin depressed patients with insomnia, restlessness, and nervousness.

DOSING: The dose of desipramine is tailored to the patient'sneeds. Some physicians start with relatively low doses, such as 25 mgthree times a day, to reduce the risk of excessive sedation early intreatment; doses then will be slowly increased. Other physicians prefer togive desipramine once daily, in which case it is generally given atbedtime to take advantage of the sedating properties. Elderly persons andpatients with advanced liver disease may need lower doses.

DRUG INTERACTIONS: Desipramine interacts with other medicationsand 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 aszolpidem (Ambien) and narcotics. Reserpine has a stimulatory effect onpatients taking TCAs. Desipramine and other TCAs should not be used withmonoamine oxidase inhibiting drugs, for example, isocarboxazid (Marplan),phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine(Matulane) since high fever, convulsions and even death can occur whenthese drugs are used together.

Cimetidine (Tagamet) can increase desipramine blood levels, possiblycausing side effects. Other drugs which share this effect includepropafenone (Rythmol), flecainide (Tonocard), quinidine (Quinidex,Quinaglute), and fluoxetine (Prozac).

PREGNANCY: There is very little information about the effectsof desipramine on the fetus. Physicians may use desipramine if itsbenefits are deemed to outweigh the potential and unknown risks.

NURSING MOTHERS: It is not known if desipramine is secreted in breast milk.

SIDE EFFECTS: The most commonly encountered side effectsassociated with desipramine include fast heart rate, blurred vision,urinary retention (difficulty urinating), dry mouth, constipation, weightgain or loss, and low blood pressure upon arising. Rash, hives, seizures,and hepatitis are rare side effects. Desipramine also causes elevatedpressure in the eyes of some patients with glaucoma. Overdoses ofdesipramine can cause life-threatening abnormal heart rhythms orseizures.

Following prolonged therapy with high doses, abrupt discontinuation ofTCAs, including desipramine, could lead to cholinergic symptoms such asnausea, vomiting, or diarrhea. Therefore, many physicians recommend agradual reduction in dose when TCAs are discontinued.