Overview
Desipramine is a tricyclic antidepressant (TCA) that works by raising norepinephrine (a neurotransmitter) to normal levels. Desipramine is also an anticholinergic (an agent that blocks the parasympathetic nerves.) It is used to treat depression. It is the active metabolite of the drug Tofranil (imipramine), and it has many of the same properties and effects.

Desipramine usually takes effect within two to four weeks, but the time may be longer due to dosage and an individual’s reaction to the drug.

Why is this drug prescribed?
Desipramine is used primarily to treat endogenous depression including involutional melancholia, psychotic depression, and the depressed phase of manic depression, and certain types of depressive neurosis.

Desipramine is also used to treat:

1. craving for cocaine
2. associated depression
3. chronic pain syndromes
4. attention deficit disorder with hyperactivity (ADHD)
5. resistant malaria
6. binge eating due to bulimia

Warnings and Precautions
Desipramine can cause photosensitivity and can reduce sweating which impairs the body's ability to adapt to heat. Patients should avoid saunas and other very hot environments as well as sun lamps.

Desipramine should not be given to children under six years old. Children over six and adolescents may need a lower dosage. It should only be prescribed for children under the care of a child psychiatrist. Children are especially susceptible to side effects, though these often disappear with continued use.

Desipramine is not addictive. Suddenly discontinuing Desipramine may cause withdrawal symptoms. Dosages should be gradually tapered to minimize withdrawal.

Treatment of the depressed phase of manic depression with Desipramine may result in a rapid swing to the manic phase.

Desipramine can affect a patient’s concentration and coordination. Patient’s should not drive or operate heavy machinery until it is known that Desipramine does not impair the ability to safely engage in these activities.

For Pregnant or Nursing Mothers: Controlled studies have not been done in pregnant women, but there have been reports of newborns suffering from muscle spasms and heart, breathing, and urinary problems when their mothers had taken tricyclic antidepressants immediately before delivery. Animal studies show that some tricyclic antidepressants may have undesirable effects on a fetus. Tricyclic antidepressants pass into breast milk and are reported to cause drowsiness in nursing infants.

Contraindications
Desipramine should Not be used for people with the following medical conditions:

1. an allergy or negative reaction to Desipramine
2. epilepsy or seizure disorder – Desipramine lowers the seizure threshold
3. glaucoma
4. cardiovascular disease – there is a possibility of conduction defects, arrhythmias, tachycardias, strokes and acute myocardial infarction
5. thyroid disease
6. schizophrenia – Desipramine may worsen symptoms of schizophrenia

Adverse Reactions
Desipramine may cause the following reactions:

1. drowsiness
2. dizziness
3. insomnia
4. blurred vision
5. dry eyes – especially in contact lens wearers
6. rash
7. dry mouth
8. photosensitivity
9. agitation
10. diarrhea
11. high blood pressure
12. hair loss
13. increased or decreased libido
14. nausea
15. sweating
16. swelling
17. weight gain or loss
18. seizures
19. delirium
20. delusions
21. hallucinations
22. Tourette syndrome
23. liver / kidney toxicity
24. heart rhythm disturbances
25. abnormally low white blood cell and platelet count
26. tremors
27. ECG changes
28. raised or lowered blood sugar

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Desipramine are:

1. MAO Inhibitors (within 14 days) serious, even fatal, interactions can occur when taken with Doxepin
2. Alcohol - when taken with Desipramine or another TCA can increase the intoxicating effects of alcohol and combination can depress brain function significantly; alcohol should be avoided completely
3. Vitamin C - high doses may blunt the effects of Desipramine
4. all atropine like drugs, all sedative drugs, norepinephrine, Dilantin (phenytoin), and Coumadin (warfarin) – Desipramine may increase the effects of these
5. Catapres (clonidine), Hylorel (guanadrel), Ismelin / Esimil (guanethidine), and Tenex (guanfacine) – Desipramine may decrease the effects of these
6. Tagamet (cimetidine), estrogens, Prozac (fluoxetine), Luvox (fluvoxamine), Normodyne (labetalol), Ritalin (methylphenidate), oral contraceptives, phenothiazines, Quinaglute (quinidine), and Zantac (ranitidine)
7. Norvir (ritonavir) and other protease inhibitors may lead to drug toxicity when taken with Desipramine
8. Stimulant drugs (such as cocaine, amphetamines, Proventil, sutafed) – these medications can cause severe high blood pressure and/or high fever when taken with Desipramine
9. Thyroid medications can increase the risk of heart rhythm disorders when taken with Desipramine

http://www.mentalhealth.com/drug/

http://www.psyweb.com/Drughtm/desipr.html

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title=Desipramine&cid=HT#GAUS

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