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Antidepressant medications are prescribed for managing depression and various mental or mood disorders. They can be effective in reducing suicidal thoughts and providing other significant benefits. However, research indicates that a small subset of individuals, particularly those under 25, may experience intensified symptoms of depression, other mental or mood changes, or suicidal thoughts when using these medications. It is crucial to discuss the potential risks and benefits of antidepressant use with a healthcare provider, especially for those younger than 25, even if the medication is prescribed for non-mental health conditions.

• Immediately inform your doctor if you observe any signs of worsening depression, changes in psychiatric conditions, or unusual behavioral changes, such as potential suicidal thoughts or attempts.
• Be attentive to any mental or mood alterations including increased anxiety, panic attacks, sleep disturbances, irritability, hostility, impulsivity, severe restlessness, or excessively rapid speech.
• This vigilance is particularly important when initiating a new antidepressant or adjusting the dosage.

When taking this medication, you may experience mild side effects such as headache, nausea, dizziness, drowsiness, nervousness, trouble sleeping, blurred vision, increased appetite, weight gain, constipation, and dry mouth. These are generally not severe, but if they persist or worsen, it's important to inform your healthcare provider. For dizziness or lightheadedness, rising slowly from sitting or lying down can help, and for dry mouth, consider sipping water or using sugarless candy or gum.

While many people do not experience serious side effects, it's crucial to be aware of them. Contact your healthcare provider immediately if you notice mental or mood changes like confusion or hallucinations, unusual breast changes, menstrual irregularities, ringing in the ears, sexual dysfunction, tremors, numbness, limb swelling, difficulty urinating, easy bruising, signs of infection, severe abdominal pain, dark urine, or yellowing of the eyes or skin.

Seek emergency medical attention for very serious side effects, which include chest pain, irregular heartbeat, seizures, fainting, speech difficulties, weakness on one side of the body, eye pain or swelling, and vision changes. This medication may also increase serotonin levels, leading to serotonin syndrome, especially if combined with other serotonin-increasing drugs. Symptoms include a fast heartbeat, hallucinations, loss of coordination, severe gastrointestinal issues, muscle twitching, fever, or agitation.

Rarely, this drug can cause neuroleptic malignant syndrome, a serious nervous system disorder, with symptoms such as muscle stiffness, high fever, increased sweating, rapid heartbeat, sudden mental changes, or signs of kidney problems. Additionally, a severe allergic reaction is rare, but seek immediate help if you experience rash, itching, swelling, severe dizziness, or trouble breathing. Always communicate with your healthcare provider about any concerns or unusual symptoms.

Some medications can interact with this drug, potentially affecting how it works. These include Disopyramide, certain blood pressure medications like Clonidine, Digoxin, thyroid supplements, and Valproic Acid. Using MAO inhibitors with this drug can lead to a severe, possibly life-threatening reaction. Avoid MAO inhibitors, such as isocarboxazid, Linezolid, and others, while on this medication, and for two weeks before and after treatment. Consult your doctor about when to start or stop taking this medication.

The risk of serotonin syndrome, a potentially serious condition, increases if you are taking other drugs that raise serotonin levels. These include recreational drugs like MDMA, St. John's wort, and certain antidepressants like SSRIs (e.g., Fluoxetine, paroxetine) and SNRIs (e.g., Duloxetine, Venlafaxine). The risk is higher when these drugs are started or their dosages are increased.

Some medicines can change how desipramine is removed from your body, impacting its effectiveness. Examples include barbiturates like Phenobarbital, Cimetidine, Haloperidol, heart rhythm drugs like Flecainide, and others. Smoking can lower the blood levels of this medication, so inform your doctor if you smoke or have recently quit.

Many drugs can affect heart rhythm (QT prolongation), such as Amiodarone, Dofetilide, and certain antibiotics like Erythromycin. Inform your doctor of all the medicines you are taking before using desipramine.

Let your doctor know if you are taking other substances that cause drowsiness, including alcohol, marijuana, antihistamines like Cetirizine, sleep or anxiety medications like Alprazolam, muscle relaxants like Cyclobenzaprine, and opioid pain relievers like codeine. Check all medicine labels for ingredients that cause drowsiness and consult your pharmacist for safe use.

Desipramine is very similar to imipramine; avoid taking imipramine-containing medications while on desipramine.