Drug reference

Desipramine

TCA · Antidepressant

TCAAntidepressant

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

incl. contraindicated

PREGNANCY

—

not curated

Top interactionssee all 12 →

MoclobemideContraindicatedTextbookG&G 14e
AdrenalineSevereTextbookKDT 7e · p57
ArtemisininsSevereTextbookKDT 7e · p816-835
Meglumine AntimoniateSevereTextbookHarrison 22e · p1740

Mechanism

Desipramine selectively inhibits the neuronal norepinephrine transporter (NET), blocking the reuptake of norepinephrine and to a lesser extent dopamine, thereby prolonging their synaptic dwell time and enhancing their effects in the central and peripheral nervous system. NET's major role is to limit the synaptic dwell time of norepinephrine and terminate its actions.

Indications

Depressionpsychotic depression (with first-generation antipsychotics)pain conditionsFunctional dyspepsia (when symptoms persist despite PPI therapy)Functional heartburn (if PPI therapy is ineffective)Functional chest pain (if PPI therapy is ineffective)Depression in cancer patients

Dosing

Adult: simple passive diffusion. If the goal is to accelerate excretion of the drug (eg, in a case of drug overdose), it is important to prevent its reabsorption from the tubule. This can often be accomplished by adjusting urine pH to make certain that most of the drug is in the ionized state, as shown in Figure 1–5. As a result of this partitioning effect, the drug is “trapped” in the urine.…

Pharmacokinetics

Half-life

30 hours

Metabolism

Metabolized by CYP2D6.

Side effects

Common

sedationcognitive dullingblurred visiondry mouthtachycardiaconstipationdifficulty urinatingorthostatic hypotensionweight gaindrowsinesscardiac conduction delaymemory impairmenturinary retention

Serious