| Note |
when the path to therapeutic success is beset by certain problems… start antidepressant therapy with norpramin (desipramine hydrochloride tablets NF) to east the patient's path. Helps relieve the sleep disturbances that often accompany depression. Improvement in sleep patterns may begin within one week in some patients. As the depression is relieves, difficulty in falling asleep, restlessness, and early morning awakening diminish. The patient is helped to remain calm yet active, although the physician should caution the patient about driving or operating heavy machinery if drowsiness occurs. Less anticholinergic activity. Studies of animal tissues and normal human subjects have shown that desipramine has less anticholinergic activity than amitriptyline f doxepin. The single bond side chain of desipramine may be associated with less anticholinergic activity than is the double bond side chain of amitriptyline or doxepin. This may mean less dry mouth, less blurred vision, less urinary retention, less constipation. Potent blocker of norepinephrine re-uptake. Current evidence suggests depression results from inadequate levels of norepinephrine or serotonin here, at the synaptic cleft. If your patient is unresponsive to treatment with one tricyclic, consider switching to a tricyclic that blocks the re-uptake of a different neurotransmitter. Electron micrograph of human synaptic cleft, postulated site of tricyclic antidepressant activity |
