Desipramine Dosage

Usual Adult Dose for Depression

100 to 200 mg orally per day
Maximum dose: 300 mg orally per day

Comments:
-Dosage should be initiated at a lower level and increased according to tolerance and clinical response.
-In severely ill patients, dosage may be further increased to 300 mg per day if needed.
-Treatment of patients requiring as much as 300 mg should generally be initiated in hospitals.

Use: Treatment of depression

Usual Geriatric Dose for Depression

25 to 100 mg orally per day
Maximum dose: 150 mg orally per day

Comments:
-The dose should be gradually increased according to tolerance and clinical response.

Use: Treatment of depression

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

-Lower doses may be required when tricyclic antidepressants are used in combination with drugs that inhibit CYP450 2D6.
-Dose adjustment may be required when this drug is given concomitantly with anticholinergic or sympathomimetic drugs.

Precautions

BOXED WARNING(S):
Suicidality and Antidepressant Drugs
-Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of this drug or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
-Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24. There was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older.
-Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior.
-Families and caregivers should be advised of the need for close observation and communication with the prescriber.
-This drug is not approved for use in pediatric patients.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Initial therapy can be administered in divided doses or a single daily dose.

Storage requirements:
-Protect from moisture
-Protect from excessive heat

General:
-The best evidence of impending toxicity from very high doses is prolongation of the QRS or QT intervals.
-Symptoms of intolerance, especially drowsiness, dizziness, and postural hypotension, should alert the healthcare provider to the need for reduction in dosage.

Monitoring:
-Psychiatric: Patients should be monitored for worsening and emergence of suicidal thoughts.

Patient advice:
-This drug may impair mental and/or physical abilities needed for the performance of potentially hazardous tasks such as driving a car or operating machinery.