Use of desipramine in depressed inpatients

Studies of desipramine in depressed inpatients are reviewed and indications for the use of the drug in clinical practice, as well as selection of patients for research, are discussed. The relationship between plasma desipramine concentrations and response is examined in melancholic and elderly patients, and in those with delusional depression. Major adverse reactions and subjective complaints during studies of desipramine treatment are reviewed. Few side effects were associated with elevated plasma desipramine levels. The clinical significance of 2-OH-desipramine levels was studied, but measurement of this metabolite did not enhance understanding of the drug's effects. A new technique for rapid dose adjustment is presented, for which desipramine appears to be particularly well suited.