Depression Preexisting CV insufficiency; epilepsy or lowered seizure threshold.

Tricyclic Anti-depressant

The mechanism of action of maprotiline is not precisely known. It does not act primarily by stimulation of the central nervous system and is not a monoamine oxidase inhibitor. The postulated mechanism of maprotiline is that it acts primarily by potentiation of central adrenergic synapses by blocking reuptake of norepinephrine at nerve endings. This pharmacologic action is thought to be responsible for the drug's antidepressant and anxiolytic effects.

Administration: May be taken with or without food. 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

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.

Preexisting CV insufficiency; epilepsy or lowered seizure threshold.

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

Pregnancy Category B. Reproduction studies have been performed in female laboratory rabbits, mice, and rats at doses up to 1.3, 7, and 9 times themaximum daily human dose respectively and have revealed no evidence of impaired fertility or harm to the fetus due to maprotiline. There are, however, no adequate and well controlled studies in pregnant women. Be cause animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.Labor and Delivery: Although the effect of maprotiline on labor and delivery is unknown, caution should be exercised as with any drug with CNS depressant actionNursing Mothers: Maprotiline is excreted in breast milk. At steady-state, the concentrations in milk correspond closely to the concentrations in whole blood. Caution should be exercised when maprotiline hydrochloride is administered to a nursing woman.

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. Lactation: avoid during breastfeeding

Deaths may occur from overdosage with this class of drugs. Multiple drug ingestion (including alcohol) is common in deliberate overdose. As the management is complex and changing, it is recommended that the physician contact a poison control center for current information on treatment. Signs and symptoms of toxicity develop rapidly after overdose. There fore, hospital monitoring is required as soon as possible.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Tricyclic Anti-depressant

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.

Pregnancy Category B. Reproduction studies have been performed in female laboratory rabbits, mice, and rats at doses up to 1.3, 7, and 9 times the maximum daily human dose respectively and have revealed no evidence of impaired fertility or harm to the fetus due to maprotiline. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.Labor and Delivery: Although the effect of maprotiline on labor and delivery is unknown, caution should be exercised as with any drug with CNS depressant action.Nursing Mothers: Maprotiline is excreted in breast milk. At steady-state, the concentrations in milk correspond closely to the concentrations in whole blood. Caution should be exercised when maprotiline hydrochloride is administered to a nursing woman.