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HelpTest ID: DESPR Desipramine, Serum
Useful For
Monitoring serum concentration of desipramine during therapy
Evaluating potential desipramine toxicity
May aid in evaluating patient compliance
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Desipramine, SSpecimen Type
Serum RedSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (Serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Collect specimen immediately before next scheduled dose (minimum 12 hours after last dose).
2. Centrifuge and aliquot serum into a plastic vial. Serum must be separated from cells within 2 hours of collection.
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 7 days |
Clinical Information
Desipramine is a tricyclic antidepressant and a metabolite of imipramine. These drugs have also been employed in the treatment of enuresis (involuntary urination) in childhood and severe obsessive-compulsive neurosis. Desipramine is the antidepressant of choice in patients where maximal stimulation is indicated.
The therapeutic concentration of desipramine is 100 to 300 ng/mL. About 1 to 3 weeks of treatment are required before therapeutic effectiveness becomes apparent.
The most frequent side effects are those attributable to anticholinergic effects: dry mouth, constipation, dizziness, tachycardia, palpitations, blurred vision, and urinary retention. These occur at blood concentrations more than 400 ng/mL, although they may occur at therapeutic concentrations in the early stage of therapy. Cardiac toxicity (first-degree heart block) is usually associated with blood concentrations more than 400 ng/mL.
Reference Values
Therapeutic concentration: 100-300 ng/mL
Note: Therapeutic ranges are for specimens collected at trough (ie, immediately before next scheduled dose).
Levels may be elevated in non-trough specimens.
Interpretation
Most individuals display optimal response to desipramine with serum levels of 100 to 300 ng/mL. Some individuals may respond well outside of this range or may display toxicity within the therapeutic range; thus, interpretation should include clinical evaluation. Risk of toxicity is increased with levels above 400 ng/mL.
Clinical Reference
1. Wille SM, Cooreman SG, Neels HM, Lambert WE. Relevant issues in the monitoring and toxicology of antidepressants. Crit Rev Clin Lab Sci. 2008;45(1):25-89
2. Thanacoody HK, Thomas SH. Antidepressant poisoning. Clin Med. 2003;3(2):114-118
3. Hiemke C, Bergemann N, Clement HW, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: Update 2017. Pharmacopsychiatry. 2018;51(1-02):9-62
4. Milone MC, Shaw LM. Therapeutic drugs and their management. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453.
Day(s) Performed
Monday, Wednesday, Friday
Report Available
3 to 5 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80299
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| DESPR | Desipramine, S | 3531-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 37123 | Desipramine, S | 3531-1 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
| mml-antidepressants, mml-drugmonitoring |