Desipramine Addiction Treatment

You may have been prescribed desipramine if you are trying to overcome a cocaine addiction or if you are suffering from depression. This antidepressant drug can help to reduce cravings and elevate mood.

What Is Desipramine?

Desipramine is a drug that is used to treat a variety of conditions, but it is primarily used in the treatment of depression. It is an antidepressant drug that works by restoring the balance of certain chemicals in the brain. It is also used to treat conditions that include panic disorder, attention-deficit hyperactivity disorder (ADHD), sleep disorders, and binge eating.

Desipramine has also been used to treat cocaine withdrawal but there is still insufficient evidence to its efficacy; it is, for this reason, it is not widely used for this purpose. However, because one of the main withdrawal symptoms associated with a cocaine detox is depression, desipramine can help to elevate mood and to make the detox process more comfortable.

Brand Names

  • Norpramin
  • Pertofran
  • Nebril
  • Pertofrane
  • Petylyl
  • Irene

History of Desipramine

Desipramine is a tricyclic antidepressant that was derived from imipramine. The first mention of desipramine was in 1959, and it was patented by Geigy in 1962. It has been in use since 1964 when it was approved for use by the US FDA.

What Substance Abuse/Addictions Is Desipramine Used to Treat?

  • Cocaine Addiction

Is Desipramine Addictive?

Desipramine is considered to be low risk for abuse. However, sudden withdrawal of this medication can cause symptoms, so it is important to speak to a doctor before you stop taking it. It is safe for use both short- and long-term.

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What Is the Mechanism of Action?

Evidence suggests that depression is the result of a chemical imbalance in the brain. Deficiency of neurotransmitters, such as serotonin and norepinephrine, can result in low levels of essential fluids within the brain, which is speculated can lead to depressive conditions.

While the mechanism of action of desipramine is not fully understood, it is believed that it works to block the reuptake of serotonin and norepinephrine within the central nervous system. In doing this, it helps to restore the chemical balance within the brain and relieves symptoms of depression.

How Long Does It Take for Desipramine to Work?

The length of time that it takes for desipramine to work varies from one person to the next and depends on the condition being treated. For the treatment of anxiety and insomnia, there may be immediate improvements. However, the onset of therapeutic actions typically takes around two to four weeks.

If there is no improvement in depression after around six to eight weeks, it may be necessary for the dosage to be adjusted.

Does Desipramine Have Any Interactions?

Desipramine is known to interact with a total of 1054 drugs, of which 278 cause a major interaction, 708 a moderate interaction, and 68 – a minor interaction. Using desipramine with alcohol is not recommended as it can increase the side effects.

There are several illnesses that desipramine can interact with, including:

  • cardiovascular disease
  • pheochromocytoma
  • anticholinergic effects
  • seizure disorders
  • depression
  • acute myocardial infarction recovery
  • bone marrow suppression
  • liver disease
  • renal disease
  • diabetes
  • bipolar disorder
  • glaucoma
  • neutropenia
  • tardive dyskinesia
  • acute alcohol intoxication
  • thyroid disorders
  • schizophrenia
  • urinary retention
  • hyper or hypoglycaemia

Should Any Precautions Be Taken?

Desipramine should not be taken fourteen days after or before you have taken an MAO inhibitor such as rasagiline, linezolid, methylene blue injection, selegiline, phenelzine, tranylcypromine, or isocarboxazid.

You should advise your doctor of any medication you are taking. As desipramine is known to have over a thousand drug interactions, you will need to make sure you tell your doctor about any medication you are taking, including herbal products and vitamin supplements as well as birth control pills.

If you have recently had a heart attack, you should not take desipramine. It is also important that you inform your doctor if you have or have ever suffered from any of the following:

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  • heart disease
  • bipolar disorder
  • schizophrenia
  • liver disease
  • diabetes
  • a history of mental health problems
  • psychosis
  • a family history of sudden death due to heart problems
  • heart attack
  • stroke
  • seizures
  • glaucoma
  • urinary problems

It is important to be aware that use of desipramine can cause some young people to suffer suicidal thoughts when first taking the medication. Being alert to the risk of these thoughts is important and any incidence should be reported to a doctor. Your family members and friends should also be advised to be on the lookout for changes in your mood that could indicate such feelings or thoughts.

As it is not known with certainty whether desipramine could harm an unborn baby, it is recommended that you tell your doctor if you are pregnant before taking this medication. You should also tell your doctor if you are planning to become pregnant or if you fall pregnant while taking it.

Breastfeeding mothers should not use desipramine as it can pass into breast milk and cause harm to the feeding baby.

What Are the Side Effects of Desipramine?

It is common for desipramine to cause side effects, which may be more pronounced when the medication is first taken. With continued use of the drug, most symptoms will subside. Below are some of the more common side effects, which typically do not require medical attention:

  • Constipation
  • Stomach cramps
  • Bloating
  • Diarrhoea
  • Difficulty passing urine
  • Decrease in urinary frequency
  • Pain passing urine
  • Increase or decrease in sexual desire
  • Erection problems
  • Swelling or soreness of the breasts
  • Dilated pupils
  • Irritability
  • Dry mouth
  • Faintness
  • Loss of appetite
  • Sweating
  • Restlessness
  • Nightmares

If any of the above symptoms become severe or persist, even at the very appearance of any of them, it is important to speak to a doctor. You may also experience other symptoms that are not included in the above list. If you are worried, you are advised to seek medical attention.

You should also be aware of the possibility of allergic reaction to desipramine. Should you experience difficulty breathing, a rash, hives, or swelling of the face, mouth, lips tongue, or throat, call emergency services immediately.

Can You Just Stop Taking Desipramine?

Although addiction to desipramine is unlikely, withdrawal symptoms can occur when you stop taking the drug. It is important to taper your dose before quitting for good. Speak to your doctor if you want to stop taking desipramine. He or she will advise you on how to reduce your dosage.

You should also be aware that, even when the dosage of desipramine is reduced gradually, some symptoms may occur within the first two weeks.

Typical dose reduction is 50% less for the first three days, followed by a further 50% reduction for another three days, before quitting completely. If you do experience withdrawal symptoms during reduced dosage, your doctor may recommend a slight increase in dose to stop the symptoms. You can then work on a much slower dosage reduction.


Facts/Statistics

  • Desipramine is commonly used as a substrate for drug-drug interactions.
  • Desipramine is quickly and completely absorbed by the body when taken in oral form.
  • Desipramine is metabolised almost entirely within the liver.
  • Environmental factors such as chronic alcohol use and smoking can have an impact on how desipramine is metabolised.
  • The usual dose of desipramine is 100-200 mg per day.
  • Most people will begin with a lower dose, which will be increased gradually over a period of weeks.
  • It may take up to two weeks before you notice an improvement in your symptoms.
  • Desipramine has also been used for the treatment of chronic pain, diabetic neuropathies, bulimia nervosa and anorexia nervosa.
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