Maprotiline Hydrochloride

Indications

Maprotiline Hydrochloride is used for: Depression

Adult Dose

Oral Depression Adult: 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. Elderly: Initial: 25 mg daily. May increase slowly according to response to 50-75 mg daily if needed.

Child Dose

Safety and effecay not established

Renal Dose

Administration

May be taken with or without food.

Contra Indications

Preexisting CV insufficiency; epilepsy or lowered seizure threshold.

Precautions

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. Lactation: avoid during breastfeeding

Pregnancy-Lactation

Pregnancy Category: B Lactation: avoid during breastfeeding

Interactions

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.

Adverse Effects

Side effects of Maprotiline Hydrochloride : Common Fatigue, Sedation, Lethargy, Weakness, Constipation, Dry mouth, Blurred vision Less Common Agitation, Anxiety, Headache, Insomnia, Nausea, Vomiting, Sweating Infrequent Orthostatic hypotension, ECG changes, tachycardia Confusion, EPS, dizziness, paresthesia, tinnitus Rash, Incr LFTs, Sexual dysfunction Rare Seizure, Agranulocytosis, Thrombocytopenia, Eosinophilia, Leukopenia, SIADH Potentially Fatal: Seizures

Mechanism 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.