In clinical investigations, a tiny proportion of youngsters, teenagers, and young adults (up to 24 years old) who took mood-elevating antidepressants like desipramine developed suicidal thoughts (thinking about harming or killing oneself or planning or trying to do so). Antidepressants may increase the risk of suicidality in children, adolescents, and young adults who are depressed or suffering from other mental diseases as compared to those who do not take these medications. To what extent this risk should be taken into account when determining whether or not a kid or adolescent should take an antidepressant, however, is unclear to experts. Normally, desipramine should not be administered to anybody under the age of 18, however in some circumstances, a doctor may determine that desipramine is the most effective treatment for a child’s disease.

Even if you are an adult above the age of 24, you should be aware that taking desipramine or other antidepressants may cause your mental health to change in unexpected ways. Suicidal thoughts may come to mind, especially at the start of treatment and whenever your dose is changed. Any of the following symptoms should prompt you, your family, or your carer to call your doctor immediately away: Depression that is either new or getting worse, thoughts of self-harm or suicide, plans or attempts to do so, excessive worry, agitation, panic attacks, trouble falling or staying asleep, aggressive behaviour, irritability, acting without thinking, extreme restlessness, and frenzied abnormal excitement. Make sure your family or carer is aware of any symptoms that could be significant so they can contact the doctor on your behalf if you are unable to call for help.

If you are taking desipramine, your doctor will want to visit you frequently, especially at the start of your treatment. Make sure to show up for all of your doctor’s appointment times.

When you start desipramine therapy, your doctor or pharmacist will provide you the patient information sheet (Medication Guide) from the manufacturer. If you have any questions, carefully read the material and contact your doctor or pharmacist. The FDA website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) also offers the Medication Guide.

No of your age, you, your parent, or your carer should discuss the advantages and disadvantages of treating your disease with an antidepressant or with alternative treatments with your doctor before starting an antidepressant. The dangers and advantages of not treating your ailment should also be discussed. You should be aware that your chance of committing suicide is significantly increased if you suffer from depression or any mental disorder. This risk is increased if you or a family member currently has, or previously had, bipolar disorder (depression followed by periods of extreme excitement) or mania (frenzied, abnormally excited mood), or if you have ever considered or tried suicide. Discuss your ailment, symptoms, and personal and family medical history with your doctor. The best course of therapy for you will be decided by you and your doctor.

Depression is treated with desipramine. Tricyclic antidepressants are a class of drugs that includes desipramine. It functions by boosting the levels of specific organic compounds in the brain that are necessary for mental equilibrium.

To be taken orally, desipramine is available as a tablet. It can be taken with or without food and is often taken one or more times per day. Every day, take desipramine around the same time(s). Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the medication’s directions precisely. Never take it in larger or less amounts or more frequently than directed by your doctor.

Your doctor might prescribe you a low dose of desipramine and then gradually raise it.

You might not experience all of the benefits of desipramine for two to three weeks. Despite feeling fine, keep taking desipramine. Never stop taking desipramine without consulting your doctor first. Desipramine withdrawal symptoms, including nausea, headaches, and weakness, may occur if you stop taking it abruptly. Your doctor will likely want to progressively reduce your dose.

Ask your doctor or pharmacist for more details if you’re interested in using this drug for any other conditions.

Before taking desipramine,

• If you have an allergy to desipramine, clomipramine (Anafranil), imipramine (Tofranil), trimipramine (Surmontil), any other drugs, or any of the substances in desipramine tablets, inform your doctor and pharmacist right away. For a list of the ingredients, ask your doctor or pharmacist.
• Inform your doctor if you are currently using an MAO inhibitor, such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate), or if you have just discontinued taking one. Most likely, your doctor will advise against using desipramine. You should wait at least 14 days after stopping desipramine before starting an MAO inhibitor.
• Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, herbal remedies, and dietary supplements you are now taking or intend to use. Incorporate any of the following: Antihistamines, blood-thinning medications including warfarin (Coumadin); estrogens, flecainide (Tambocor), fluoxetine (Prozac), guanethidine (Ismelin), levodopa (Sinemet, Larodopa), lithium (Eskalith, Lithobid), cimetidine (Tagamet), guanethidine, and oestrogens; phenobarbital, propafenone (Rythmol), methylphenidate (Ritalin), muscle relaxants, oral contraceptives, Parkinson’s disease, diabetes, mental illness, nausea, asthma, colds, or allergy medications; sedatives, sleeping pills, quinidine, fluoxetine (Prozac, Sarafem), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft) are examples of selective serotonin reuptake inhibitors (SSRIs); tranquillizers and thyroid medicines. Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects. If you haven’t used fluoxetine for the past five weeks, your doctor might advise against using desipramine.
• If you’ve suffered a heart attack recently, let your doctor know. Your doctor might advise against taking desipramine.
  Inform your doctor if anyone in your family has ever experienced a sudden death or has an abnormal heartbeat. Additionally, let your doctor know if you have or have ever had heart or blood vessel disease, such as high blood pressure, atherosclerosis (artery hardening), angina (chest pain), an irregular heartbeat, or a heart attack; an enlarged prostate (a male reproductive gland); difficulty urinating; diabetes; seizures; an overactive thyroid gland; schizophrenia (a mental illness that results in distorted or unusual thinking, loss of interest in life, and strong or inappropriate emotions);
• Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. Call your doctor if you become pregnant while taking desipramine.
• If you are 65 years of age or older, discuss the advantages and disadvantages of taking desipramine with your doctor. Desipramine is typically not recommended for usage in older adults since it is less reliable and less efficient than alternative drugs that can be used to treat the same disease.
• You should let your doctor or dentist know if you are taking desipramine if you are undergoing surgery, including dental surgery.
• You should be aware that this medicine may cause you to feel sleepy. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
• Inquire with your doctor if drinking is okay for you to do while taking this medicine.
• If you use tobacco products, let your doctor know. Smoking cigarettes may make this medication less effective.
• The possibility of desipramine inducing angle-closure glaucoma should be noted (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Ask your doctor if you should get your eyes checked before beginning this medicine. Call your doctor or get emergency medical attention right away if you are experiencing nausea, eye pain, changes in your vision, such as seeing coloured rings around lights, or swelling or redness in or around your eyes.

Keep eating normally unless your doctor instructs you otherwise.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

Desipramine may have unwanted side effects. If any of the following symptoms worsen or do not go away, contact your doctor:

• Nausea
• Drowsiness
• Fatigue or weakness
• Nightmares
• Arid mouth
• Skin more sun sensitive than usual
• Alterations in appetite or weight
• Constipation
• Urinating difficulties
• Urination on a regular basis
• Alterations in sexual drive or ability
• Sweating excessively

Some of the side effects can be severe. Call your doctor or seek emergency medical attention if you experience any of the following symptoms, or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections:

• Muscle spasms in the jaw, neck, and back
• Speech that is slow or difficult
• Shuffle walk
• Uncontrollable shaking or movement of a body part
• Fever
• Breathing or swallowing difficulties
• Serious rash
• Skin or eye discoloration
• Erratic heartbeat
• Seizures
• Sore throat, fever, and other infection symptoms

If you have a serious side effect, you or your doctor can report it to the FDA’s MedWatch Adverse Event Reporting programme online or by phone (1-800-332-1088).

Keep this medication in its original container, tightly closed, and out of reach of children. Keep it at room temperature and away from sources of extreme heat and moisture (not in the bathroom).

It is critical to keep all medication out of children’s sight and reach because many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are easily opened by young children. To keep young children safe from poisoning, always lock the safety caps and immediately place the medication in a safe location out of their sight and reach. http://www.upandaway.org

Unwanted medications should be disposed of in a specific manner so that pets, children, and other people cannot consume them. You should not, however, flush this medication down the toilet. Instead, a medicine take-back programme is the best way to dispose of your medication. Learn about take-back programmes in your community by speaking with your pharmacist or contacting your local garbage/recycling department. If you do not have access to a take-back programme, visit the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information.

In the event of an overdose, dial 1-800-222-1222 for poison control. There is also information available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, is having difficulty breathing, or cannot be awakened, dial 911 immediately.

Overdose symptoms may include the following:

• Erratic heartbeat
• Seizures
• Coma (loss of consciousness for a period of time)
• Confusion
• Hallucination (seeing things that do not exist)
• Enlarged pupils (dark circles in the middle of the eyes)
• Drowsiness
• Agitation
• Fever
• Body temperature that is too low
• Muscle stiffness
• Vomiting

Keep all of your doctor’s appointments.

Allow no one else to take your medication. If you have any questions about refilling your prescription, ask your pharmacist.

It is critical that you keep a written record of all prescription and nonprescription (over-the-counter) medications you are taking, as well as any vitamins, minerals, or other dietary supplements. You should bring this list with you whenever you go to the doctor or are admitted to the hospital. It is also important to have this information on hand in case of an emergency.