- See Tricyclic Antidepressant
- Desipramine is derived from demethylated Imipramine
- Adults
- Start: 50 mg orally daily for 3 days
- Next: 50 mg orally twice daily for 3 days
- Next: 100 mg orally at bedtime for 3 days
- Therapeutic dose: 150 mg orally at bedtime
- Maximum: 250 mg mg/day
- Teens and Elderly
- Start 25 mg orally at bedtime
- Advance to 50 to 100 mg orally daily or divided twice daily as tolerated and to effect
- Maximum: 150 mg/day
- Nocturnal Enuresis in Children
- Same dosing as with Imipramine
- Consider other measures for Nocturnal Enuresis first
- Consider baseline EKG before starting medication
- Initial dose
- Avoid in age <6 years
- Start at 10 mg orally nightly given one hour before bedtime
- Maximum dosing: up to 0.9 to 1.5 mg/kg
- Age 6-8 years
- May increase dose by 10 mg every 1-2 weeks as needed up to 25 mg per night one hour before bed
- Age 8-12 years
- May increase dose by 10 mg every 1-2 weeks as needed up to 50 mg per night one hour before bed
- Age over 12 years
- May increase dose by 10 mg every 1-2 weeks as needed up to 75 mg per night one hour before bed
- Age 6-8 years
- Discontinue after 3-6 months (some guidelines suggest maximum of 3 months)
- Taper to one half dose nightly for 2 weeks
- Taper to one half dose every other night for 2 weeks
- Serum Half Life: 21 hours
- Therapeutic plasma level: 125 to 300
- Unknown safety in pregnancy
- Safe in Lactation
- See Tricyclic Antidepressants
- Much less adverse effects than tertiary amines
- Moderate adverse effects
- See Tricyclic Antidepressants
- Serious cardiotoxicity in overdosage
- Activating
- Inexpensive
- Attention Deficit Hyperactivity Disorder effect
- (2023) Med Lett Drugs Ther 62(1592): 25-32
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 36-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia