Test Code IMIPQ Imipramine and Desipramine, Serum
Useful For
Monitoring serum concentration during therapy
Evaluating potential toxicity
The test may also be useful to evaluate patient compliance
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Imipramine and Desipramine, SSpecimen Type
Serum RedSpecimen Required
Container/Tube: Red top
Specimen Volume: 1 mL
Collection Instructions:
1. Draw specimen immediately before next scheduled dose (minimum 12 hours after last dose).
2. Serum must be separated from cells within 2 hours of draw.
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 |
Reject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Clinical Information
Imipramine and its metabolite desipramine are tricyclic antidepressants used to treat endogenous depression requiring 1 to 3 weeks of treatment before therapeutic effectiveness becomes apparent. Desipramine is used for treatment of endogenous depression when the patient needs a drug with significant stimulatory side effects. These drugs have also been employed in the treatment of enuresis (involuntary urination) in childhood and severe obsessive-compulsive neurosis.
Imipramine:
The optimal dosage of imipramine yields trough (just before the next dose) blood levels of imipramine and desipramine combined from 175 to 300 ng/mL. If desipramine is given, no imipramine should be detected and the therapeutic concentration for desipramine alone is 100 to 300 ng/mL.
Toxicity associated with imipramine is characterized by QRS widening leading to ventricular tachycardia and asystole. In some patients, toxicity may manifest at lower concentrations, or at therapeutic concentrations in the early state of therapy. Cardiac toxicity (first-degree heart block) is usually associated with blood concentrations in excess of 400 ng/mL.
Desipramine:
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 in excess of 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 in excess of 400 ng/mL.
Reference Values
IMIPRAMINE AND DESIPRAMINE
Total therapeutic concentration: 175-300 ng/mL
DESIPRAMINE ONLY
Therapeutic concentration: 100-300 ng/mL
Note: Therapeutic ranges are for specimens drawn at trough (ie, immediately before next scheduled dose). Levels may be elevated in non-trough specimens.
Day(s) and Time(s) Performed
Monday, Wednesday, Friday; Varies
Analytic Time
2 daysPerforming Laboratory

Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
80335
G0480 (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
IMIPR | Imipramine and Desipramine, S | 43123-9 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
63508 | Imipramine | 3690-5 |
37121 | Desipramine | 3531-1 |
37122 | Imipramine and Desipramine | 9627-1 |
NY State Approved
YesForms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Cardiovascular Test Request Form (T724)
-Therapeutics Test Request (T831)
Computer Interface Code
PDM # 5915021