Generic
Maprotiline Hydrochloride
1 brands available in the market
At a glance
Maprotiline Hydrochloride is a tetracyclic antidepressant used for the treatment of depressive illness and anxiety associated with depression. It works by inhibiting the re-uptake of noradrenaline at nerve endings.
Description
Maprotiline is a tetracyclic antidepressant pharmacologically similar to the tricyclic antidepressants. Its antidepressant effects appear to be due principally to inhibition of the re-uptake of noradrenaline at the neuronal membrane. It is effective for depressive neurosis (dysthymic disorder) and manic depressive illness (major depressive disorder).
Indications
- Depressive illness (depressive neurosis/dysthymic disorder)
- Manic depressive illness (major depressive disorder)
- Relief of anxiety associated with depression
Therapeutic class
Tricyclic Antidepressant
Pharmacological class
Tetracyclic Antidepressant
Pharmacology
Maprotiline potentiates central adrenergic synapses by blocking reuptake of norepinephrine at nerve endings, which is responsible for its antidepressant and anxiolytic effects.
Mechanism of action
Increases norepinephrine levels in the brain by blocking its re-uptake.
Dosage
Adult Dose (Oral):
- Mild-moderate depression (outpatients): Initial 75 mg daily; may increase in 25 mg increments up to 150 mg daily
- Severe depression (hospitalized): 100-150 mg daily; max 225 mg daily
- Maintain initial dose for 2 weeks
Elderly (>60 years): Initial 25 mg daily; maintenance 50-75 mg daily
Administration
- Swallow tablets whole
- May be taken with or without food
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Side effects
Common Side Effects:
- Fatigue, sedation, lethargy, weakness
- Constipation, dry mouth, blurred vision
- Dizziness, tremor
- Nausea, vomiting
Less Common:
- Anxiety, agitation, insomnia
- Orthostatic hypotension, ECG changes
- Rash, elevated liver enzymes
Precautions & warnings
- Caution in urinary retention, prostatic hyperplasia, chronic constipation, untreated angle-closure glaucoma
- Caution in hyperthyroidism
- Risk of suicide (especially early in treatment)
- May precipitate mania or psychotic symptoms
- Withdraw gradually
- May impair ability to operate machinery
Contraindications
- Hypersensitivity to maprotiline
- Known or suspected seizure disorders
- Concomitant use with MAO inhibitors (wait 14 days after discontinuation)
- Acute myocardial infarction
- Pre-existing CV insufficiency
Drug interactions
- MAOIs: Do not co-administer (14-day washout)
- Alcohol: Increased sedative effect
- Antidiabetics: Increased effect
- Propranolol, risperidone: Increased maprotiline concentrations and toxicity
- Phenothiazines: Increased risk of seizures
- Cimetidine, fluoxetine: Increased plasma concentrations
Food interactions
Alcohol may increase sedative effect with Maprotiline.
Use in pregnancy
Use in Pregnancy: Maprotiline is considered safe during pregnancy (Category B); animal studies have shown no fetal harm. Use only if clearly needed.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Maprotiline is excreted in breast milk; caution is advised during breastfeeding; avoid use.
Pediatric use
Safety and efficacy not established in children.
Geriatric use
Lower doses recommended for elderly patients (50-75 mg/day maintenance).
Renal / hepatic impairment
Renal Impairment: No specific data; caution needed.
Hepatic Impairment: Dose adjustment may be needed with hepatic enzyme inhibitors/inducers.
Overdose effects
Overdose may cause seizures, cardiovascular toxicity, CNS depression; symptomatic treatment.
Storage conditions
Store below 30°C, away from light and moisture; keep out of reach of children.
Chemical structure
Maprotiline Hydrochloride