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Desipramine for ADHD


Desipramine for ADHD

Desipramine is a metabolite of imipramine
Trade names: Pertofran, Petylyl

Desipramine is no longer available in Switzerland.1

1. Mechanism of action of desipramine:

  • Norepinephrine reuptake inhibitor
  • Serotonin reuptake inhibitor
  • Dopamine reuptake inhibitor
  • Alpha-Adrenerg
  • Acts as a FIASMA (functional inhibitor of acid sphingomyelinase)
  • Antinociceptive: suppresses the perception of pain by acting on the nociceptors

Acts as an alpha-2 adrenoreceptor agonist, thereby facilitating dopamine metabolism in the mesolimbic system (reward center).2
Serotonin and dopamine transporter binding is stronger than with imipramine, nortriptyline, protriptyline, amitriptyline, or doxepin.3
According to other opinions, the noradrenergic effect predominates.4

2. Use of desipramine

Desipramine is recommended for comorbid tics.5

Cortisol decreases ACTH formation and thus inhibits the HPA axis through which cortisol release was initiated (negative feedback loop). Desipramine reverses this negative feedback into a positive one, Resipin reverses the reversal in Cushing’s disease.6
We do not consider inhibition of HPA axis shutdown to be beneficial in ADHD.

3. Possible side effects of desipramine

  • May prolong QT time
  • Micturition disorders (disorders during urination)
  • Inner restlessness
  • Feeling thirsty
  • Sedative (weak)
  • States of confusion (occasionally)
  • Intestinal paralysis / intestinal obstruction (occasional)
  • Urinary retention (occasional)