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Drug Interactions between desipramine and dexmethylphenidate

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

desipramine dexmethylphenidate

Applies to: desipramine and dexmethylphenidate

MONITOR: The coadministration with methylphenidate may increase the serum concentrations of tricyclic antidepressants (TCAs). Case reports involving primarily methylphenidate and imipramine have suggested favorable as well as unfavorable clinical effects from this combination. In vitro studies suggest that methylphenidate may inhibit the metabolism of imipramine and other TCAs, although the extent is probably subject to considerable interindividual variation.

MANAGEMENT: Pharmacologic response to TCAs should be monitored more closely whenever methylphenidate (racemic) or dexmethylphenidate (the more pharmacologically active d-enantiomer) is added to or withdrawn from therapy, and the TCA dosage adjusted as necessary.

References (7)
  1. Meyers B (1978) "Treatment of imipramine-resistant depression and lithium-refractory mania through drug interactions." Am J Psychiatry, 135, p. 1420-1
  2. Zeidenberg P, Perel JM, Kanzler M, Wharton RN, Malitz S (1971) "Clinical and metabolic studies with imipramine in man." Am J Psychiatry, 127, p. 1321-6
  3. Wharton RN, Perel JM, Dayton PG, Malitz S (1971) "A potential clinical use for methylphenidate with tricyclic antidepressants." Am J Psychiatry, 127, p. 1619-25
  4. Cooper TB, Simpson GM (1973) "Concomitant imipramine and methylphenidate administration: a case report." Am J Psychiatry, 130, p. 721
  5. Grob CS, Coyle JT (1986) "Suspected adverse methylphenidate-imipramine interactions in children." J Dev Behav Pediatr, 7, p. 265-7
  6. Gwirtsman HE, Szuba MP, Toren L, Feist M (1994) "The antidepressant response to tricyclics in major depressives is accelerated with adjunctive use of methylphenidate." Psychopharmacol Bull, 30, p. 157-64
  7. Burke MS, Josephson A, Lightsey A (1995) "Combined methylphenidate and imipramine complication." J Am Acad Child Adolesc Psychiatry, 34, p. 403-4

Drug and food interactions

Moderate

desipramine food

Applies to: desipramine

GENERALLY AVOID: Concomitant use of ethanol and a tricyclic antidepressant (TCA) may result altered TCA plasma levels and efficacy, and additive impairment of motor skills, especially driving skills. Acute ethanol ingestion may inhibit TCA metabolism, while chronic ingestion of large amounts of ethanol may induce hepatic TCA metabolism.

MANAGEMENT: Patients should be advised to avoid alcohol during TCA therapy. Alcoholics who have undergone detoxification should be monitored for decreased TCA efficacy. Dosage adjustments may be required.

References (7)
  1. Dorian P, Sellers EM, Reed KL, et al. (1983) "Amitriptyline and ethanol: pharmacokinetic and pharmacodynamic interaction." Eur J Clin Pharmacol, 25, p. 325-31
  2. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  3. Sandoz M, Vandel S, Vandel B, Bonin B, Allers G, Volmat R (1983) "Biotransformation of amitriptyline in alcoholic depressive patients." Eur J Clin Pharmacol, 24, p. 615-21
  4. Ciraulo DA, Barnhill JG, Jaffe JH (1988) "Clinical pharmacokinetics of imipramine and desipramine in alcoholics and normal volunteers." Clin Pharmacol Ther, 43, p. 509-18
  5. Seppala T, Linnoila M, Elonen E, Mattila MJ, Makl M (1975) "Effect of tricyclic antidepressants and alcohol on psychomotor skills related to driving." Clin Pharmacol Ther, 17, p. 515-22
  6. Ciraulo DA, Barnhill JG, Jaffe JH, Ciraulo AM, Tarmey MF (1990) "Intravenous pharmacokinetics of 2-hydroxyimipramine in alcoholics and normal controls." J Stud Alcohol, 51, p. 366-72
  7. Ciraulo DA, Alderson LM, Chapron DJ, Jaffe JH, Subbarao B, Kramer PA (1982) "Imipramine disposition in alcoholics." J Clin Psychopharmacol, 2, p. 2-7

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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