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Drug Approvals
(BANM, US Adopted Name, rINNM)
International Nonproprietary Names (INNs) in main languages (French, Latin, and Spanish):
Pharmacopoeias. In Europe and US.
European Pharmacopoeia, 6th ed. (Desipramine Hydrochloride). A white or almost white crystalline powder. Soluble in water and in alcohol. Protect from light.
The United States Pharmacopeia 31, 2008(Desipramine Hydrochloride). A white to off-white crystalline powder. Soluble 1 in 12 of water, 1 in 14 of alcohol, and 1 in 3.5 of chloroform insoluble in ether freely soluble in methyl alcohol. Store in airtight containers.
Adverse Effects, Treatment, and Precautions
As for tricyclic antidepressants in general (see Amitriptyline).
Breast feeding. For comments on the use of tricyclic antidepressants in breast feeding patients, see under Precautions for Amitriptyline.
Interactions
For interactions associated with tricyclic antidepressants, see Amitriptyline.
Pharmacokinetics
Desipramine is the principal active metabolite of imipramine.
Uses and Administration
Desipramine, the principal active metabolite of imipramine, is a dibenzazepine tricyclic antidepressant with actions and uses similar to those of amitriptyline. It is one of the less sedating tricyclics and its antimuscarinic effects are mild. Desipramine is used as the hydrochloride.
In the treatment of depression, desipramine hydrochloride is given orally in daily doses of 100 to 200 mg higher doses of up to 300 mg daily may be required in severely depressed patients in hospital. Lower doses should be used in adolescents and the elderly and are usually 25 to 100 mg daily up to 150 mg daily may be required for severe depression. Initial doses should be low and gradually increased according to tolerance and clinical response. Therapy may initially be given as a single daily dose or in divided doses maintenance therapy may be given as a single daily dose usually at night.
Desipramine should be withdrawn gradually to reduce the risk of withdrawal symptoms.
Cocaine dependence. Since dopamine depletion may be the cause of the depression often associated with cocaine craving and with relapse, drugs such as desipramine that interact with dopaminergic systems have been tried in managing cocaine withdrawal symptoms. However, a systematic review was unable to find evidence to support the use of antidepressants in the treatment of cocaine dependence although the efficacy of desipramine was suggested in some individual studies.
Hyperactivity. When drug therapy is required for attention deficit hyperactivity disorder tricyclic antidepressants such as imipramine or desipramine are usually reserved for patients who fail to respond to, or who are intolerant of, stimulants. They may also be of use for selected patients with co-existing disorders such as Tourette’s syndrome, anxiety, and enuresis.
Pain. Antidepressants, usually amitriptyline or another tricyclic, are useful in alleviating some types of pain (see Choice of Analgesic) when given in subantidepressant doses.
Preparations
British Pharmacopoeia 2008: Desipramine Tablets
The United States Pharmacopeia 31, 2008: Desipramine Hydrochloride Tablets.
Proprietary Preparations
Argentina: Nebril †
Austria: Pertofran
Belgium: Pertofran †
Canada: Norpramin
Chile: Distonal
France: Pertofran †
Germany: Pertofran † Petylyl
Israel: Deprexan
Italy: Nortimil
Mexico: Norpramin
New Zealand: Pertofran
Poland: Petylyl
USA: Norpramin.
Synonyms of Amitriptyline:
Amitriprolidine, Amitriptylin, Amitriptyline HCL, Amitriptyline Hydrochloride, Amitryptiline, Amitryptyline, Amytriptiline
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Therapeutic classes of Amitriptyline:
Adrenergic Uptake Inhibitors, Analgesics, Non-Narcotic, Antidepressive Agents, Tricyclic
Dosage forms of Amitriptyline:
| Form | Route | Strength |
|---|---|---|
| Tablet, film coated | Oral | 10 mg |
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| Tablet, film coated | Oral | 150 mg |
| Tablet, film coated | Oral | 25 mg |
| Tablet, film coated | Oral | 50 mg |
| Tablet, film coated | Oral | 75 mg |
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