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.
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.
Norpramin has several adverse effects of which to be aware. These include the following:
Anticholinergic effects: Dry mucous due to sublingual inflammation, blurred vision due to the dilation of the pupil (mydriasis), paralysis of the ciliary muscles which may reduce the eye’s ability to focus, and ocular hypertension occur. Dilation of the urinary tract, constipation, delayed micturition, and urinary retention have also been experienced.
Nervous system effects: Effects include drowsiness, weakness, fatigue, lethargy, nightmares, restlessness, and insomnia. These may precipitate depression. Suicidal ideation may also increase. In some cases, increased paranoia and exacerbation of psychosis in schizophrenia have been reported.
Cardiovascular effects: Postural hypotension may occur. Make sure to stand up slowly as this is a common side effect of many antidepressant medications. This drug can also cause palpitations, increased heart rate (tachycardia), sudden death, stroke, and congestive heart failure.
Hepatic (liver) effects: Norpramin may disrupt the liver function test of those being treated with it. It can cause an increase in transaminase concentration, changes in serum alkaline phosphatase concentration, obstructive jaundice, and hepatitis, which is allergic in nature.
Gastrointestinal effects: This drug may lead to nausea, vomiting, diarrhea, and abdominal cramps. Black tongue and a specific and peculiar taste are also experienced by some in treatment with this drug.
Norpramin may worsen depression and suicidal ideation for some individuals in treatment. Please inform your doctor if you experience sudden episodes of agitation or drastic changes in mood while taking this drug.
This drug may lower the threshold for seizures and the use of this drug should be monitored for people with a background of seizures.
This drug is contraindicated in patients during the recovery phase of myocardial infarction. People with a family history of sudden death and cardiac arrhythmias should use this drug with extreme caution.
The use of Norpramin should be discontinued several days before surgery.
Norpramin may have an interaction with the following agents:
Be sure to discuss your entire health history, medications, and any supplements you regularly take with your doctor and/or pharmacist before using this drug.
If you stop taking this drug abruptly, you may experience nausea, persistent headaches, fatigue, and general malaise. To minimize the severity and occurrence of withdrawal symptoms, develop a safe plan with your health care provider to slowly taper off your dose of this medication.
Page content reviewed by James Pendleton, ND
Last Update: 04-20-2015
Articles about Norpramin (Desipramine)