Desipramine is a tricyclic antidepressant (TCA) medication that belongs to a class of drugs known as selective norepinephrine reuptake inhibitors (SNRIs). It is primarily used to treat depression, but it can also be prescribed for other conditions such as attention deficit hyperactivity disorder (ADHD), panic disorder, and chronic pain.

Desipramine works by balancing certain chemicals in the brain that affect mood. It increases the levels of norepinephrine, a neurotransmitter associated with mood regulation, thereby alleviating symptoms of depression and other related disorders.

Warnings and Precautions

While desipramine can be effective in managing depressive symptoms, it is essential to be aware of the warnings and precautions associated with its use.

Medical History

Before starting desipramine, it is crucial to inform your healthcare provider about your complete medical history, especially if you have any of the following conditions:

  • Heart problems or a recent heart attack
  • Liver or kidney disease
  • Seizures or epilepsy
  • Bipolar disorder or a history of mania
  • Thyroid problems
  • Glaucoma
  • Difficulty urinating due to an enlarged prostate or any other reason
  • Diabetes
  • History of drug or alcohol abuse

Informing your doctor about your medical history helps them determine if desipramine is suitable for you and if any adjustments to the dosage are necessary.

Suicide Risk

Antidepressant medications, including desipramine, may increase the risk of suicidal thoughts and behaviors, particularly in young adults and adolescents. It is crucial to closely monitor individuals starting desipramine for signs of worsening depression or unusual changes in behavior. If you or someone you know experiences thoughts of self-harm or suicide while taking desipramine, seek immediate medical attention.

Allergic Reactions

Some individuals may be allergic to desipramine or other tricyclic antidepressants. If you develop symptoms of an allergic reaction, such as rash, itching, swelling, severe dizziness, or difficulty breathing, seek medical help immediately. Allergic reactions can be life-threatening and require prompt attention.

Drug Interactions

Desipramine can interact with various medications and substances, leading to potentially harmful effects. Inform your doctor about all the medications, herbal supplements, and recreational drugs you are taking.

Pregnancy and Breastfeeding

If you are pregnant or planning to become pregnant, it is important to discuss the potential risks and benefits of using desipramine with your doctor. The medication may pose certain risks to the fetus, especially when used during the first trimester. Similarly, desipramine can pass into breast milk and may affect a nursing infant. Consult your healthcare provider for guidance on using desipramine while pregnant or breastfeeding.

Side Effects

Desipramine may cause several side effects, ranging from mild to severe. Common side effects include drowsiness, dizziness, dry mouth, constipation, blurred vision, and weight changes. While these side effects are generally temporary and subside over time, inform your doctor if they become persistent or significantly impact your daily life.

Side Effects

As with any medication, desipramine can have various side effects, which can range from common and mild to rare and severe. It is essential to be aware of these potential side effects to make informed decisions regarding its use.

Common Side Effects

  • Dry Mouth: One of the most commonly reported side effects of desipramine is a dry mouth. This can cause discomfort and an increased risk of dental problems. Staying hydrated and using sugar-free gum or lozenges can help alleviate this symptom.
  • Drowsiness: Desipramine can cause drowsiness or fatigue in some individuals. It is advisable to avoid activities that require alertness, such as driving or operating machinery, until you know how the medication affects you. If drowsiness persists, consulting your healthcare provider is recommended.
  • Constipation: Desipramine may affect the normal bowel movements, leading to constipation. Increasing dietary fiber, staying hydrated, and engaging in regular physical activity can help alleviate this side effect.
  • Blurred Vision: Some individuals may experience blurred vision while taking desipramine. It is essential to inform your doctor if this side effect persists or worsens.

Rare Side Effects

  • Orthostatic Hypotension: Desipramine can cause a sudden drop in blood pressure upon standing up, resulting in dizziness or lightheadedness. This is known as orthostatic hypotension. Changing positions slowly and avoiding sudden movements can help minimize this side effect.
  • Heart Rhythm Changes: In rare cases, desipramine may cause changes in the heart’s rhythm, known as arrhythmias. This can manifest as palpitations or irregular heartbeat. If you experience any heart-related symptoms, it is crucial to seek immediate medical attention.
  • Allergic Reactions: Although rare, some individuals may develop allergic reactions to desipramine. Signs of an allergic reaction include rash, itching, swelling, severe dizziness, or difficulty breathing. If you experience any of these symptoms, seek emergency medical assistance.

Severe Side Effects

  • Suicidal Thoughts: Desipramine, like other antidepressants, may increase the risk of suicidal thoughts, particularly in young adults. It is crucial to monitor changes in mood, behavior, or any worsening of depression symptoms while taking this medication.
  • Serotonin Syndrome: Serotonin syndrome is a potentially life-threatening condition that can occur when there is an excessive accumulation of serotonin in the body. Symptoms may include agitation, hallucinations, rapid heartbeat, fever, muscle stiffness, and seizures. Prompt medical attention is essential if you suspect serotonin syndrome.
  • Liver Problems: Desipramine may rarely cause liver problems, such as hepatitis or jaundice. If you experience symptoms such as dark urine, persistent nausea or vomiting, abdominal pain, or yellowing of the skin or eyes, seek immediate medical attention.
  • Manic Episodes: Desipramine can trigger manic episodes in individuals with bipolar disorder. If you have a history of bipolar disorder or experience symptoms such as increased energy, reckless behavior, or a decreased need for sleep, consult your healthcare provider.

Drug Interactions

Like any other medication, desipramine can interact with various drugs, potentially leading to adverse effects or reduced efficacy. It is crucial to understand these interactions to ensure the safe and effective use of desipramine.

Monoamine Oxidase Inhibitors (MAOIs)

Desipramine should not be taken with MAOIs, a class of antidepressant medications. Concurrent use of desipramine and MAOIs can result in a dangerous condition called serotonin syndrome. Serotonin syndrome is characterized by symptoms such as agitation, confusion, rapid heartbeat, high blood pressure, and dilated pupils. If you are currently taking an MAOI or have recently stopped taking one, inform your healthcare provider before starting desipramine.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Combining desipramine with SSRIs, another class of antidepressants, may increase the risk of serotonin syndrome. SSRIs, such as fluoxetine and sertraline, work by increasing serotonin levels in the brain. When used together with desipramine, the serotonin levels can become too high, leading to serotonin syndrome. Your doctor will carefully monitor you if both medications are required, adjusting the doses accordingly.

Anticholinergic Drugs

Desipramine has anticholinergic properties, meaning it inhibits the activity of acetylcholine, a neurotransmitter. When taken with other medications that also have anticholinergic effects, such as certain antihistamines, muscle relaxants, and medications for overactive bladder, the cumulative anticholinergic effects can intensify. This can result in symptoms like dry mouth, blurred vision, constipation, and urinary retention. Be sure to inform your healthcare provider about all the medications you are taking to avoid this interaction.


Desipramine can enhance the effects of central nervous system (CNS) depressants, including alcohol, benzodiazepines, and opioids. Combining desipramine with CNS depressants can lead to increased sedation, respiratory depression, and impaired cognitive function. It is important to exercise caution and avoid or minimize the use of CNS depressants while taking desipramine.


Cimetidine, a medication used to treat stomach ulcers and acid reflux, can inhibit the metabolism of desipramine, leading to increased levels of the drug in the body. This can potentially result in an overdose of desipramine and an increased risk of adverse effects. If you are prescribed both desipramine and cimetidine, your doctor may need to adjust the desipramine dosage to prevent any complications.


As with any medication, it is important to understand the correct dosing of desipramine to ensure its effectiveness and minimize the risk of side effects.

Starting Dose

The usual starting dose of desipramine for adults is 25 to 50 milligrams (mg) taken one to three times per day. Your healthcare provider may start you at a lower dose and gradually increase it based on your response to the medication. This approach helps minimize the risk of side effects.

Maintenance Dose

Once the desired therapeutic effect is achieved, your healthcare provider may adjust your dose to the maintenance level. The typical maintenance dose of desipramine for adults is 100 to 200 mg per day, divided into multiple doses. Your healthcare provider will determine the appropriate maintenance dose based on your individual needs.

Maximum Dose

The maximum recommended dose of desipramine is generally 300 mg per day for adults. However, some individuals may require higher doses under close medical supervision. It is crucial to follow your healthcare provider’s instructions regarding the maximum dose and not exceed it without their approval.

Dosing for Elderly Patients

Elderly patients may require lower doses of desipramine due to age-related changes in metabolism and increased sensitivity to medications. Your healthcare provider will carefully assess your needs and adjust the dose accordingly to ensure safety and effectiveness.

Overdose of Desipramine

An overdose of desipramine can be life-threatening and requires immediate medical attention. If you suspect an overdose or have accidentally taken more than the prescribed dose, call emergency services or your local poison control center right away. Symptoms of an overdose may include:

  • Severe drowsiness
  • Rapid or irregular heartbeat
  • Agitation or confusion
  • Hallucinations
  • Seizures
  • Difficulty breathing
  • Blurred vision
  • Dilated pupils
  • Fever

It is crucial to store desipramine in a safe place, out of reach of children and pets, to prevent accidental ingestion. Never share your medication with others, even if they have similar symptoms. Prompt medical attention is essential in the case of an overdose to prevent complications.

Missed Dose of Desipramine

If you miss a dose of desipramine, take it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.

To help you remember taking your medication consistently, it may be helpful to set a daily alarm or use a pill organizer. If you have any concerns or questions about missed doses, always consult your healthcare provider for guidance.


  • Storing Desipramine at the Right Temperature: To ensure the stability of desipramine, it is important to store it at the appropriate temperature. The ideal temperature range for desipramine storage is between 68°F (20°C) and 77°F (25°C). Avoid exposing the medication to extreme temperatures, as this can compromise its effectiveness. It is recommended to keep desipramine away from direct sunlight and sources of heat, such as radiators or stoves.
  • Protecting Desipramine from Humidity: Humidity can negatively impact the quality of desipramine. It is advisable to store the medication in a dry place with low humidity levels. Bathrooms, where humidity tends to be high due to showers and baths, should be avoided for desipramine storage. Instead, choose a cool, dry location, such as a bedroom or a cupboard.
  • Keeping Desipramine Away from Light: Exposure to light, especially sunlight or fluorescent light, can degrade the potency of desipramine. To protect the medication from light, store it in its original container, which is usually amber-colored or opaque. These containers are designed to shield the drug from light exposure. It is also important to keep the container tightly closed when not in use.
  • Choosing the Right Storage Location: When considering where to store desipramine, prioritize safety and accessibility. Make sure to keep the medication out of reach of children and pets to prevent accidental ingestion. Furthermore, avoid storing desipramine near chemicals, cleaning agents, or food items, as contamination may occur.
  • Proper Handling and Disposal of Desipramine: Apart from storage, proper handling and disposal of desipramine are equally important. Always wash your hands before and after handling the medication to prevent cross-contamination. If the medication has expired or is no longer needed, do not flush it down the toilet or throw it in the trash. Instead, follow local guidelines for safe disposal of unused medications or consult a pharmacist.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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