Desipramine First report of allergic skin reactions: 4 case reports *

Case 1 A 42-year-old woman with a 6-month history of primary major depressive disorder received desipramine titrated to 150mg at bedtime. No history of drug allergies was reported . After 4 days of desipramine treatment the patient developed a severe pruritic maculopapular rash over her entire body. Although desipramine was discontinued the rash became severe and generalised oedema and lymphadenopathy developed Antihistamines were unsuccessful but short term prednisolone resolved the symptoms

Case 2 Desipramine 150mg at bedtime was prescribed for a 12-month primary major depressive disorder In a 23-year-old woman . No prior history of drug allergies was noted . On the ninth day of desipramine treatment a pruritic maculopapular rash developed over the trunk , face and extremities

Spontaneous resolution followed within 5 days of desipramine withdrawal

Case 3 ' A 6-week primary malor depressive disorder with sUIcidal Ideation In a 27-year-old woman was treated with desipramine No history of drug allergies was reported After 10 days of treatment a pruritic maculopapular rash developed over her entire body Desipramine was discontinued but the rash only resolved after 10 days of antihistamine treatment

Case 4 A 34-year-old woman With an 18-month history of primary major depression received desipramine 200mg at bedtime after unsuccessful treatment With trlmlpramlne 250 mg/ night. The patient had several allerqles to drugs. On the tenth day of treatment a generalised maculopapular rash With severe prurltlS developed . An antihistamine was begun but the rash became worse Desipramine was discontinued after 3 days and the rash resolved after 1 further week of antihistamine treatment.

'None of the patients were receiving other medication, therefore, there is little doubt that desipramine was responsible for the allergic reaction in all cases.' This was believed to be the first speCifiC report of desipramine-Induced allergic skin reactions Joffe E Richter MA Canadian Journal of PsyChiatry 32 695-696 Nov 1987

0157-7271/88/0227-0005/ 0$01.00/ 0 © ADIS Press REACTIONS· 27 February 1988 5