Table 35.4—Tricyclic Antidepressants for Older Adults

Generic (Trade) Name

Initial Dosage

Final Dosage

Sedative Potential

Precautions

Advantages

Desipramine (Norpramin)

10–25 mg hs

25–150 mg hs

Low

May be fatal in overdose

May exacerbate glaucoma, anticholinergic effects

Therapeutic plasma level 115–200 ng/mL

May have stimulant properties

Nortriptyline (Pamelor, Aventyl)

10–25 mg hs

25–100 mg hs

Moderate

Lower final dose

May be fatal in overdose

May exacerbate glaucoma, anticholinergic effects

Therapeutic window for plasma levels of 50–150 ng/mL

NOTE: hs = hora somni or at bedtime.