Effects of Desipramine during pregnancy and breastfeeding

There is inadequate information about possible complications of using Desipramine during pregnancy. While some studies say that the risks to foetus are quite low whereas there a couple of reports saying that withdrawal effects are seen in new born babies who were exposed to Desipramine during pregnancy. These withdrawal effects include fast heart beat, weight loss, blue skin and sweating. Make sure you talk to your doctor to know the risks of using Desipramine during pregnancy.

Desipramine and Pregnancy

Taking Desipramine hydrochloride during pregnancy is not safe. Most doctors recommend new antidepressants instead of using Desipramine. Health care providers often recommend Desipramine during pregnancy if they feel the benefits are higher than the risk associated with the use of Desipramine. Health experts also claim that not treating depression in pregnant women is more harmful to the unborn baby than using Desipramine.

If you are already using Desipramine and you get pregnant, make sure you tell your doctor that you are pregnant so that your doctor can determine the possible benefits and risks of Desipramine to be used during pregnancy.

Desipramine and Breastfeeding

Desipramine secrets in breast milk in low amounts. Due to some effects that Desipramine may have on a breastfeeding baby, you should check with your doctor before using Desipramine while breastfeeding.
As far as it is concerned whether use of Desipramine is safe during breastfeeding, there are very less evidences available to show if Desipramine is secreted in breast milk or whether it leads to any complications in a breastfeeding baby.

It is better to discuss with your doctor as every case is different and based on your current health status, your doctor can judge whether you should continue taking Desipramine or not. Since there are no studies available, some people prefer to avoid use of Desipramine during breastfeeding and look out for alternative treatment to manage depression. You can speak to your doctor if he can suggest you an alternative treatment or medication that can help you control depression without causing harm to your baby.

Sometimes it becomes necessary to take Desipramine as it helps treating depression, anxiety, OCD, Chronic pain, eating disorders, panic attacks, migraine etc., in such situations you can speak to your doctor to advise you the right dosage of Desipramine.

Pregnant women and breastfeeding mother often face depression and to manage depression they need medicines like Desipramine, but make sure you do not use it in high doses or for a prolonged period. Since you don’t know how it is going to affect your baby, consult your doctor before you start using it during pregnancy or breastfeeding. If you notice any unusual symptoms in your baby’s health, talk to your doctor immediately.

Using antidepressant is not recommended during breastfeeding or pregnancy until and unless the benefits of the drug are higher than the risk to ensure the safety of mother and baby. Your doctor can examine you and suggest you if you can use Desipramine during pregnancy or breastfeeding.

Desipramine drug interactions that you must know about

Desipramine can interact with many other drugs. Knowing about the drug interactions can help you identify the possible side effects and seek medical help immediately. Some of the drugs that interact with Desipramine are

  • Amiodarone
  • pimozide
  • quinine
  • phenylephrine
  • sotalol
  • erythromycin
  • domperidone
  • ziprasidone
  • methadone
  • clarithromycin
  • butyrophenones
  • barbiturates
  • St. John’s Wort

If Desipramine hydrochloride is used with other psychotropic agents like sedatives, tranquilizers, hynotics, extra caution should be taken as sedative effects of this medication and benzodiazepines are highly additive. Both the anticholinergic and sedative effects of main tranquilizers are also additive same as those of Desipramine.

Do not use Desipramine with alcohol as it can be dangerous. Avoid exposure to tanning beds or sunlight. Taking Desipramine with other medications can make you drowsy. Check with your doctor before using Desipramine with narcotic medicine for pain, sleeping pills, and muscle relaxer, medicine for seizures or depression.

Before using Desipramine, inform your doctor if you have taken an SSRI antidepressant in last 5 weeks like fluoxetine, citalopram, fluvoxamine, escitalopram, sertraline or paroxetine.

Desipramine and Zolpidem

Taking Desipramine and Zolpidem together can increase dizziness, confusion, drowsiness and difficulty in concentrating. Some people especially senior citizens may notice impairment in motor coordination, judgement and thinking. You should not consume alcohol and do not perform activities that need you to be awake and alert. Discuss with your doctor if you are using any other medications like dietary supplement, vitamins or herbal preparations. Do not discontinue any medication before discussing with your doctor.

Desipramine and Duloxetine

Taking Desipramine and Duloxetine together can enhance the risk of rare but very serious condition known as serotonin syndrome, which includes symptoms like

  1. seizure
  2. confusion
  3. hallucination
  4. excessive sweating
  5. fever
  6. increased heart rate
  7. tremor
  8. muscle spasms
  9. muscle stiffness
  10. stomach cramp
  11. vomiting
  12. nausea
  13. in coordination
  14. shivering
  15. blurred vision

Seek medical help immediately if you notice these symptoms while you are using the medications. Your doctor might know about the risk factors already and he can guide you on how to prevent these symptoms or related complications.

Desipramine and Citalopram

Taking Desipramine and Citalopram together can enhance the risk of rare but very serious condition known as serotonin syndrome, which includes symptoms like seizure, fever, excessive sweating,     blurred vision, muscle spasms , muscle cramps, stomach cramp, vomiting nausea etc., Severe cases even result in death or coma. If you notice these symptoms during the treatment, call your doctor immediately. Also combination of these medications can result in increased heart rhythm that can be severe and life threatening, although this is a rare side effect. You can be susceptible to heart ailments like cardiac diseases, QT syndrome, electrolyte disturbances, and conduction abnormalities. Discuss with your doctor if you have any questions or doubts. You should immediately call your health care provider if you notice symptoms like fainting, sudden dizziness, heart palpitations and breathlessness during the treatment.

Desipramine dosage information for depression and other conditions

The Desipramine dosage, drug form and the dosage frequency entirely depends on the following factors

  • your age
  • the medical condition which is treated
  • how severe the medical condition is
  • other medical conditions
  • Your response to the initial dose

Desipramine Dosage information for depression

Normal dose for Adults

100-200mg to be taken orally on a daily basis

Maximum dose: 300 mg to be taken orally on a daily basis

Note: The dosage should be started with lowest possible dose and increased gradually based on patient’s tolerance and clinical response. In patients who suffer from severe illness, the dosage can be increased to 300mg/per day if required.

Patient who require 300mg dose should be treated initially in hospitals.

Normal Dose for depression- Geriatric Dose

25-100mg to be taken orally on a daily basis

Maximum dose: 150mg to be taken orally on a daily basis

Note: The dose should be increased gradually based on patient’s tolerance and clinical response.

Child dosage between age group 13-17 years- Depression

Normal dosage

25-100mg/day in split doses or in a single dose

Maintenance therapy

After the depression in your child improves, if they need treatment for a long term, the lowest possible dose should be taken. Once you get on maintenance dose, the daily dose prescribed can be taken once in a day.

Maximum dosage

The doctor may increase the dose gradually for your child to 100mg /day at home or to 150mg if your child is hospitalized.

Dosage for Senior citizens (65 years and above)

Normal dose

25-100mg/day in split doses or in a single dose

Maintenance therapy

After you see improvement in your depression and you need a treatment for a long term, the lowest possible dosages should be taken. Once you get on maintenance dose, the daily dose prescribed can be taken once in a day.

Desipramine- Over dosage and treatment

Desipramine over dosage can even lead to death. The death rate is higher in over dose of Desipramine as compared to other tricyclic antidepressants. Multiple drug intakes contribute to Desipramine overdose. In case of overdose the doctor’s are recommended to call poison control centre to seek information regarding treatment. Immediate hospitalization is required as the symptoms and signs of toxicity develop faster. There is no particular antidote for Desipramine over dosage.

Critical demonstrations of overdose include

  • convulsions
  • severe hypotension
  • cardiac dysrhythmias
  • CNS depression (coma in some cases)

Hostile supportive care as well as serum alkalinisation is the backbone of therapy.

ECG should be obtained and cardiac monitoring should be started immediately. Secure patient’s airway and start with gastric contamination.

Activated charcoal can be used to treat patients who reach early, post an overdose.

Over dose need immediate medical attention and patient should be hospitalized immediately so that he gets proper treatment. Timely treatment can help flush out the toxin out of the body and can prevent life threatening problems. It becomes difficult to save a patient’s life if the drug ingestion is detected after long hours.

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