Norpramin (desipramine), a tricyclic antidepressant, belongs to a class of drugs used to treat major depression. Major depression refers to a persistent episode of a depressed mood that usually alters and interferes with daily activities. In some cases, this medication may also be prescribed to treat panic attacks and has been used in “off-label” (prescribed for a purpose not listed on the product’s FDA label) treatment for insomnia, neuropathic pain, and attention-deficit hyperactivity. The structure of this medication is similar to that of phenothiazines.
How Does Norpramin Work?
Norpramin inhibits the recycling of serotonin and norepinephrine—two important neurotransmitters. Serotonin, which is an inhibitory neurotransmitter, maintains a balance between the inhibition and excitement of the brain. It is necessary to maintain mood, sleep cycle, digestion, and the immune system. Norepinephrine is an excitatory (meaning it stimulates the brain) neurotransmitter that also functions to regulate mood, sleep, and digestion. By blocking the reuptake of serotonin and norepinephrine, this medication relieves symptoms associated with depression. Norpramin also inhibits Histamine-1 and Alpha-1 adrenergic and muscarinic receptors, which sometimes causes a sedative and hypnotic effect.
- What is a normal dose of this medication?
For the treatment of depression, the prescription is started at a low dose of 75 to 150 mg daily depending on the condition of the patient or severity of the condition. Dose can be increased to 300 mg daily. Doses higher than 300 mg are not recommended although some hospitalized individuals may receive a higher dose. Individuals 65 years of age or older are typically given a low dose of 25 mg to 50 mg to start. Due to postural hypotension, care must be taken with this age group. Additional monitoring of kidney and liver functioning should be performed while treating geriatric individuals with this drug.
- How does my body process this drug?
Norpramin is soluble in water and is very well absorbed from the gastrointestinal tract. It will reach a peak blood plasma concentration in four to six hours. It is metabolized in the liver to an active metabolite, 2-hydroxydesipramin, which retains this drug’s ability to block the reuptake of serotonin and norepinephrine. This active metabolite has some cardiac depressant effects too. The half-life of this drug ranges from 7 to 65 hours and it is mainly excreted from the body in the urine.
- Is it safe to use this drug if I am pregnant or become pregnant while being treated?
Although there is no data on the effects of Norpramin during human pregnancy, the class of drugs that Norpramin belongs to (tricyclic antidepressants) did cause abnormalities in animal studies. These abnormalities included embryotoxic effects, intrauterine deaths, still births, and underweight births. Tricyclic antidepressants may also cause limb deformities and developmental delays. This drug may be secreted in the mother’s milk. All benefits and risks should be thoroughly weighed before prescribing this drug to someone who is pregnant or continuing treatment if someone becomes pregnant.
- How can I get the most out of my treatment with this drug?
Norpramin is prescribed for several conditions that also show positive results when treated with psychotherapy. If you are prescribed this drug for depression or panic attacks, consider finding a qualified therapist or counselor to help you better understand what you are experiencing, work on a self-care routine, and help you develop strategies for a better, longer-lasting mental health outcome than you might experience with medication alone.