Indication

Depression

Administration

May be taken with or without food.

Adult Dose

Oral\r\nDepression\r\nAdult: As hydrochloride: 25-75 mg daily in 3 divided doses, gradually increased in 25 mg increments at 1-2 wk intervals to 150 mg/day if necessary. Up to 225 mg/day in severely depressed patients.\r\nElderly: Initial: 25 mg daily. May increase slowly according to response to 50-75 mg daily if needed.

Child Dose

Safety and effecay not established

Contraindication

Preexisting CV insufficiency; epilepsy or lowered seizure threshold.

Mode of Action

Maprotiline is a tetracyclic antidepressant pharmacologically similar to the tricyclic antidepressants. It's antidepressant effects appear to be due principally to inhibition of the re-uptake of noradrenaline at the neuronal membrane.

Precaution

Urinary retention, prostatic hyperplasia, chronic constipation, untreated angle-closure glaucoma; hyperthyroidism; risk of suicide; may precipitate mania or psychotic symptoms; withdraw gradually; may impair ability to operate machinery. Pregnancy and lactation; elderly.\r\n\r\nLactation: avoid during breastfeeding

Side Effect

Common\r\nFatigue,Sedation,Lethargy,Weakness,Constipation,Dry mouth,Blurred vision\r\n\r\nLess Common\r\nAgitation,Anxiety,Headache,Insomnia,Nausea,Vomiting,Sweating\r\n\r\nInfrequent\r\nOrthostatic hypotension, ECG changes, tachycardia\r\nConfusion, EPS, dizziness, paresthesia, tinnitus\r\nRash,Incr LFTs,Sexual dysfunction\r\n\r\nRare\r\nSeizure,Agranulocytosis,Thrombocytopenia,Eosinophilia,Leukopenia,SIADH\r\n\r\nPotentially Fatal: Seizures

Interaction

MAOIs. Increase in sedative effect with alcohol. Increased effect of antidiabetics. Maprotiline concentrations and toxicity increased by propranolol, risperidone. Risk of seizures increased with phenothiazines.