Desipramine

Adults
1. Start: 50 mg orally daily for 3 days
2. Next: 50 mg orally twice daily for 3 days
3. Next: 100 mg orally at bedtime for 3 days
4. Therapeutic dose: 150 mg orally at bedtime
5. Maximum: 250 mg mg/day
Teens and Elderly
1. Start 25 mg orally at bedtime
2. Advance to 50 to 100 mg orally daily or divided twice daily as tolerated and to effect
3. Maximum: 150 mg/day

Same dosing as with Imipramine
Consider other measures for Nocturnal Enuresis first
Consider baseline EKG before starting medication
Initial dose
1. Avoid in age <6 years
2. Start at 10 mg orally nightly given one hour before bedtime
Maximum dosing: up to 0.9 to 1.5 mg/kg
1. Age 6-8 years
  1. May increase dose by 10 mg every 1-2 weeks as needed up to 25 mg per night one hour before bed
2. Age 8-12 years
  1. May increase dose by 10 mg every 1-2 weeks as needed up to 50 mg per night one hour before bed
3. Age over 12 years
  1. May increase dose by 10 mg every 1-2 weeks as needed up to 75 mg per night one hour before bed
Discontinue after 3-6 months (some guidelines suggest maximum of 3 months)
1. Taper to one half dose nightly for 2 weeks
2. Taper to one half dose every other night for 2 weeks