Tricyclic antidepressant (TCA), more noradrenergic than serotonergic

Norpramin (desipramine) Withdrawal

Desipramine (Norpramin) has a milder discontinuation profile than the more sedating TCAs like amitriptyline because it has lower anticholinergic activity. Most patients can taper without significant difficulty.

By Dr. Ben Soffer, DO — board-certified physician, at-home ketamine therapy in Florida and New Jersey.

Half-life

~12-30 hours.

Withdrawal timeline

Onset— 1-3 days after dose reduction

Symptoms emerge within a few days.

Peak— Week 1

Symptoms peak in the first week.

Resolution— 2-3 weeks

Most patients return to baseline within 2-3 weeks.

Common symptoms

  • Sleep disturbance
  • Headache
  • Anxiety
  • Return of underlying condition

Less common

  • Mild nausea
  • Sweating

Tapering guidance

  • A typical taper reduces by 25 mg every 1-2 weeks.
  • Coordinate the taper with the prescribing physician.

Where ketamine therapy fits

Desipramine can be used with at-home ketamine therapy with closer cardiovascular monitoring. Continue desipramine as prescribed during ketamine treatment unless the prescribing physician advises otherwise.

Check ketamine therapy eligibilityMedication safety with ketamine

Frequently asked questions

How long does desipramine withdrawal last?

Most patients return to baseline within 2-3 weeks. Symptoms tend to be milder than with more anticholinergic TCAs.

Is desipramine compatible with ketamine therapy?

Generally yes, with closer cardiovascular monitoring.

Important: This page is informational and does not constitute medical advice or a recommendation to start, stop, or change any medication. Tapering psychiatric medications should always be coordinated with the prescribing physician. Compounded ketamine for anxiety, depression, PTSD, and chronic pain is not FDA approved.

Browse all medication withdrawal guides.