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Desipramine
Systematic (IUPAC) name
3-(10,11-dihydro-5H-dibenzo[b,f]azepin-5-yl)- N-methylpropan-1-amine
Identifiers
CAS number 50-47-5
ATC code N06AA01
PubChem 2995
DrugBank APRD00022
ChemSpider 2888
Chemical data
Formula C 18H22N2  
Mol. mass 266.381
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability 73-92%
Metabolism Hepatic
Half life 21-23 hours
Excretion Renal
Therapeutic considerations
Pregnancy cat. X (US)
Legal status Rx only
Routes oral
 Yes check.svgY(what is this?)  (verify)

Desipramine is a tricyclic antidepressant (TCA) that inhibits the reuptake of norepinephrine and serotonin and to a lesser extent dopamine. It is sold under the brand names Norpramin and Pertofrane. It is used to treat depression, but not considered a first line treatment since the introduction of SSRI antidepressants. Desipramine is an active metabolite of imipramine.

Along with other tricyclics, desipramine has found use in treating neuropathic pain. The mechanism of action seems to involve the activation, through norepinephrine reuptake inhibition, of descending pathways in the spinal cord that block pain signals from ascending to the brain. Desipramine is one of the most potent and selective medications in this respect. It may also be used to treat symptoms of Attention Deficit Disorder, as the underproduction of norepinephrine has been increasingly linked to symptoms associated with Attention Deficit Disorder. It may also be used to treat symptoms of cocaine withdrawal.

Contents

Genotoxicity

Desipramine has been shown to be genotoxic in fruit flies and associated with an increased risk of breast cancer in women.[1]

Increases Death Risk in Patients With Family History of Sudden Cardiac Death, Dysrhythmias

On December 2, 2009, the US Food and Drug Administration (FDA) and Sanofi-Aventis are warning healthcare professionals to use caution when prescribing the antidepressant desipramine hydrochloride (Norpramin) in patients with a family history of dysrhythmias or sudden cardiac death.

"The new safety information states that extreme caution should be used when this drugs given to patients who have a family history of sudden death, cardiac dysrhythmias, and cardiac conduction disturbances," according to an alert sent today from MedWatch, the FDA's safety information and adverse event reporting program.

The FDA and the manufacturer also warn that some patients may have seizures before cardiac dysrhythmias and death. Desipramine overdose is more likely to result in death than overdose with other tricyclic antidepressants, notes a company letter sent to healthcare professionals.[2]

The "warnings" and "overdosage" sections of the drug's labeling are being changed to reflect these potential adverse events.

See also

References

  1. ^ British Journal of Cancer 2002: volume 86, pages 92-97
  2. ^ http://www.medscape.com/viewarticle/713305?sssdmh=dm1.563907&src=ddd&uac=122237BK

External links








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