Desipramine, sold under the brand name Norpramin among others, is a tricyclic antidepressant (TCA) used in the treatment of depression. It acts as a relatively selective norepinephrine reuptake inhibitor, though it does also have other activities such as modest antagonism at alpha1-adrenergic receptors and weak affinity for histamine H1 and muscarinic receptors; pharmacokinetically it is highly protein bound, is metabolized hepatically primarily via CYP2D6 to hydroxylated and N-oxide metabolites, and has an elimination half-life in the range of roughly 15 to 24 hours in most adults, which supports once or twice daily dosing depending on formulation and clinical factors.
![N-(3-(10,11-dihydro-5H-dibenzo[b,f]azepin-5-yl)propyl)-N-methylnitrous amide](https://veeprho.com/wp-content/uploads/2022/08/N-3-10-11-dihydro-5H-dibenzo-b-f-azepin-5-yl-propyl-N-methylnitrous-amide.png "N-(3-(10,11-dihydro-5H-dibenzo[b,f]azepin-5-yl)propyl)-N-methylnitrous amide")
Parent: Desipramine/ Imipramine/ Clomipramine
Parent: Desipramine
Parent: Desipramine
Parent: Desipramine/ Clomipramine
Parent: Desipramine/ Clomipramine
![1-(5-Nitroso-10,11-dihydro-5H-dibenzo[b,f]azepin-3-yl)ethan-1-one](https://veeprho.com/wp-content/uploads/2022/08/1-5-Nitroso-10-11-dihydro-5H-dibenzo-b-f-zepin-3-yl-ethan-1-one.png "1-(5-Nitroso-10,11-dihydro-5H-dibenzo[b,f]azepin-3-yl)ethan-1-one")
Parent: Desipramine
Parent: Desipramine
Typical pharmaceutical specifications for desipramine drug substance and finished product identify and control related compounds such as imipramine (parent tertiary amine), N-oxides, hydroxylated metabolites and positional isomers; assay purity is commonly specified at greater than 98.0 percent. Typical limits applied during manufacture and quality control follow ICH guidance ranges, for example specified related compounds often limited to 0.2 percent or less each, unspecified individual impurities reported at or above 0.05 to 0.10 percent, and total impurities usually kept below about 1.0 percent, with the final limits set by product specific pharmacopeial monographs and regulatory filings; routine impurity profiling is performed by HPLC with LC-MS confirmation for unknowns and by appropriate stability stress testing.
Desipramine primarily inhibits the norepinephrine transporter, increasing synaptic norepinephrine concentration; it has relatively low affinity for the serotonin transporter compared with many other antidepressants, and additionally produces measurable antagonism at alpha1-adrenergic receptors and weak H1 and muscarinic blockade, which contribute to its side effect profile and clinical effects.
Some patients experience weight gain during treatment with desipramine, but the effect is variable; compared with certain tertiary amine TCAs and some antipsychotics, desipramine tends to have less antihistaminic and anticholinergic activity and therefore may cause less sedation related appetite increase, yet long term use can still be associated with weight changes.
Desipramine is marketed under the brand name Norpramin among others and is also chemically referred to as N-desmethylimipramine.
Desipramine can reduce anxiety symptoms when they occur as part of depressive illness and has been used in certain anxiety-related conditions, but it is not the first line choice for many primary anxiety disorders; treatment response depends on the anxiety subtype and individual tolerability, and clinicians often prefer SSRIs or SNRIs for primary anxiety disorders because of tolerability and established efficacy data.
