Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Desipramine(click to collapse)
1/4 selected
Desipramine
Norpramin
Tricyclic Antidepressant
FDA-approved indications
- Depression
Off-label uses
- ADHD
- Neuropathic pain
- Panic disorder
Half-life15 to 24 hours
Decision GuideWhen to pick each / when to consider an alternative
Desipramine
Consider when
- Activation or alertness required — least sedating and least anticholinergic TCA; best choice when sedation is unwanted
- Neuropathic pain with tolerability concerns — efficacy comparable to amitriptyline; NE selectivity is primary analgesic mechanism
- Elderly patient needing noradrenergic TCA — preferred over tertiary amines (less orthostasis, less anticholinergic) with nortriptyline
- Linear pharmacokinetics needed — favorable for TDM and dose adjustment vs imipramine's complex metabolism
- +1 more
Consider an alternative when
- Overdose risk present — highest case fatality rate of ALL TCAs (2–2.6× others); most dangerous TCA in overdose
- Pediatric patient — reports of sudden cardiac death in children; FDA: 'not recommended in children'
- On potent CYP2D6 inhibitor — extreme CYP2D6 dependence with up to 36-fold interindividual variability; 3–5× level increase with strong inhibitors
- Cardiac disease or conduction abnormality — contraindicated post-MI; arrhythmias, VT, VF on FDA label
- +1 more
| Axis | Desipramine TCA |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Agranulocytosis / severe neutropenia | |
| CNS | |
Sedation / somnolence | |
Seizure risk | |
| Metabolic | |
Weight gain | |
| Autonomic | |
Anticholinergic burden | |
Orthostatic hypotension | |
Sweating | |
| Cardiac | |
Cardiac conduction / AV block | |
Blood pressure elevation | |
Heart rate / tachycardia | |
| GI | |
Nausea / GI (general) | |
| Hepatic | |
Liver enzymes / hepatotoxicity | |
| Electrolytes | |
Hyponatremia / SIADH | |
| Sexual | |
Sexual dysfunction | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
Serotonin syndrome risk | |
CYP interactions / DDI profile | |
| Safety | |
Overdose toxicity | |
| Pregnancy | |
Lactation / breastfeeding safety | |