Desipramine

Desipramine, is this a new drug for depression?
I have a long history of not tolerating the SSRI meds. Most mental health docs are trying to get me to try something new. The only medication that comes close to working for anxiety and depression are the Benzo’d which recently have been targeted as drugs that doctors should ween their patients off of.
When my PCP was changed he refused to refill my klonopin. I went 3 months without and had the shakes for the whole three months. I tried suing the VA but that’s a near impossible thing to do these days. In fact medical malpractice itself is no longer something lawyers are willing to take on.
Sorry for drifting off topic

@mlpbob @olman Desipramine is an older antidepressant that has been around since before the SSRIs like Prozac became available.

Mayo Clinic: Desipramine

— https://www.mayoclinic.org/drugs-supplements/desipramine-oral-route/description/drg-20071955

I was prescribed despiramine in the 1990’s by my psychiatrist. It worked for me as I was depressed and having panic attacks. I still experienced some anxiety but the desipramine brought the anxiety down to a very manageable level for me. The only side effect I experienced was feeling thirsty as this medication and others like it have an anticholinergic effect much like you might have experienced if you ever took Benadryl.

How are you feeling on the desipramine?

I’m still so anxious and depressed. Have increased heart rate, dry mouth and constipation. Just started week 6 and increased to 30mg. Going slow due to nausea.

It’s an old med. Has more side effects than ssris and snris but less likely to cause nausea which has been a struggle for me.

A tricyclic from the last century. Replaced by ssri s. Anticholinergic effects are more than dry mouth. I was on dys and imipramine (tricyc s) Zombified, feeling weak and sick. Instead of looking at the meds, they told me I was "Refractory to treatment." Musta' been my fault. Then the SSRI s came along. Sertraline works for me now. Goodbye to tricyclics ... until the SSRI s don't work.
The Klonopins and benzos were not intended for more than two weeks use. I knew a guy taking valium long term. He maxed out, couldn't take anymore or anything else.
They worked for anxiety, so why stop taking them? Because you build up a resistance and keep needing higher dosages. Sounds like addiction.

Are you still taking it or are you on a different med? Thank you for responding.

@mlpbob It sounds like your prescribing physician is starting you on a low dose. Dry mouth and constipation are the side effects I'd expect from this kind of medication that is anticholinergic.

Here are the side effects of desipramine and other similar medications which are called "tricyclic antidepressants". Scroll to the bottom of the page and you will see that the side effects you describe are on this list.

-- Tricyclic Antidepressants Cleveland Clinic:

-- https://my.clevelandclinic.org/health/treatments/25146-tricyclic-antidepressants

Have you talked with your prescribing physician about your concerns?

@shmerdloff When you mention addiction are you referring to benzodiazepine medication which does have the potential for addiction? I'd like to share what I have learned and experienced through my journey with depression/anxiety and medications.

The older medications - tricyclics such as desipramine (Trade name is Norpramine) are not addictive. I think the confusion is that some people experience withdrawal effects from stopping antidepressants but this is not the same as addiction. One does not crave, build up resistance and need higher doses with antidepressant medication. This is also the case for the newer antidepressants (SSRI, SNRI) such as Prozac, Zoloft and Cymbalta. Once a person reaches the therapeutic dose by working in collaboration with their physician the person often reports that their symptoms diminish. That was and is my experience. It is the case that for some people their prescribed medication does not work well for them over time - my doctor used to refer to this as "pooping out". But this is not addiction. I am talking from experience with taking desipramine and with SSRI and SNRI medication. This is also documented in the research and medical literature.

Here are some useful definitions and websites. I included websites that have valid and reliable information from Mayo Clinic, Cleveland Clinic, and the Canadian national agency for addiction and mental health.

Mayo Clinic: Tricyclic Antidepressants:

-- https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983

Mayo Clinic: Drug Addiction

-- https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112

Centre for Addiction and Mental Health in Canada:

--https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/antidepressant-medications

I hope this helps to explain what antidepressant medication does and does not do. I have found that the best thing to do is to find a physician who will work closely with you. I was fortunate to have that kind of health care relationship with my physician.

Yes he is not concerned.

@mlpbob If I'm understanding this correctly, you stopped Paxil on the advice of a new primary care physician? And then this same physician prescribed desipramine? Did this new physician share with you why they thought desipramine was a good choice for you to try? I ask this because after 6 weeks I'd think you would see some benefit.

When I was prescribed desipramine many years ago I worked with a psychiatrist. I do not recall the starting dose but I do recall feeling energized and having insomnia for the first week or so. Over time, those side effects went away and the only one I had was the dry mouth/thirst that I mentioned. I recall, though, that my psychiatrist met with me frequently and that my dose was higher than your present dose.

Would you like to get another opinion from a different medical provider?