Desipramine

DEA Class;  Rx

Common Brand Names; Norpramin

Hypersensitivity

Acute recovery post-MI

Within 14 days of taking MAO inhibitor

Common

• Fatigue

• Lethargy

• Sedation

• Weakness

• Constipation

• Dry mouth

• Blurred vision

Less Common

• Agitation

• Anxiety

• Headache

• Insomnia

• Nausea

• Vomiting

• Sweating

Infrequent

• ECG changes, orthostatic hypotension, tachycardia

• Confusion, dizziness, paresthesia

• Extrapyramidal symptoms

• Rash

• Elevated LFTs

• Sexual dysfunction

• Tinnitus

Rare

• Seizure

• Agranulocytosis

• Eosinophilia

• Leukopenia

• Thrombocytopenia

• SIADH

Use caution in BPH and respiratory impairment

Risk of anticholinergic side effects

Clinical studies did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects; other reported clinical experience has not identified differences in responses between the elderly and younger patients

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function; because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function

Use caution in patients with cardiovascular disease, because of possibility of conduction defects, arrhythmias, tachycardias, strokes, and acute myocardial infarction

Caution in patients who have a family history of sudden death, cardiac dysrhythmias, or cardiac conduction disturbances

Use caution in patients with a history of urinary retention or glaucoma, because of the anticholinergic properties of the drug

Caution in patients with thyroid disease or those taking thyroid medication, because of possibility of cardiovascular toxicity, including arrhythmias

Caution in patients with a history of seizure disorder, because this drug has been shown to lower seizure threshold; seizures precede cardiac dysrhythmias and death in some patients

The pupillary dilation that occurs following use of many antidepressant drugs may trigger an angle-closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy

The patient should be cautioned that this drug may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery

There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy

Safe use during lactation has not been established; therefore, if it is to be given to pregnant patients, nursing mothers, or women of childbearing potential, the possible benefits must be weighed against possible hazards to mother and child