Maprotiline

Maprotiline Brand Name– Ludiomil

What is Maprotiline

Maprotiline is an oral tetracyclic antidepressant drug of dibenzo-bicyclo-octadiene derivation.

It is used for various types of depressive disorder such as unipolar depression, depressive neurosis, and the depressive phase of bipolar disorder. Most references consider maprotiline similar to traditional tricyclic antidepressants.

Maprotiline is also effective in treating anxiety associated with depression.

Maprotiline was approved for use by the FDA in 1980.

On October 15, 2004 the FDA directed manufacturers of all antidepressants to include a Black Box warning, expanded warning statements, and clinical trial results detailing the increased risk of suicidality in children and adolescents.

The warning was subsequently revised to include data on the increased risk of suicidality in young adults.

Indications

  • depression

Side Effects

  1. abdominal pain
  2. agitation
  3. agranulocytosis
  4. akathisia
  5. alopecia
  6. anxiety
  7. ataxia
  8. AV block
  9. blurred vision
  10. breast enlargement
  11. confusion
  12. constipation
  13. depression
  14. diarrhea
  15. dizziness
  16. drowsiness
  17. dysarthria
  18. dysgeusia
  19. dysphagia
  20. edema
  21. EEG changes
  22. elevated hepatic enzymes
  23. eosinophilia
  24. fatigue
  25. fever
  26. flushing
  27. galactorrhea
  28. gynecomastia
  29. hallucinations
  30. headache
  31. heart failure
  32. hyperglycemia
  33. hyperhidrosis
  34. hypersalivation
  35. hypertension
  36. hypoglycemia
  37. hypotension
  38. ileus
  39. impotence (erectile dysfunction)
  40. increased urinary frequency
  41. insomnia
  42. jaundice
  43. libido decrease
  44. libido increase
  45. mania
  46. memory impairment
  47. mydriasis
  48. myocardial infarction
  49. nasal congestion
  50. nausea
  51. nightmares
  52. ocular hypertension
  53. orthostatic hypotension
  54. palpitations
  55. paresthesias
  56. peripheral neuropathy
  57. petechiae
  58. photosensitivity
  59. pneumonitis
  60. PR prolongation
  61. pruritus
  62. psychosis
  63. purpura
  64. QT prolongation
  65. rash
  66. restlessness
  67. seizures
  68. sinus tachycardia
  69. Stevens-Johnson syndrome
  70. stomatitis
  71. stroke
  72. suicidal ideation
  73. syncope
  74. testicular swelling
  75. thrombocytopenia
  76. tinnitus
  77. tongue discoloration
  78. torsade de pointes
  79. toxic epidermal necrolysis
  80. tremor
  81. urinary retention
  82. ventricular tachycardia
  83. vomiting
  84. weakness
  85. weight gain
  86. weight loss
  87. xerostomia

Monitoring Parameters

  • blood pressure
  • ECG
  • heart rate
  • LFTs
  • thyroid function tests (TFTs)

Contraindications

  • abrupt discontinuation
  • acute myocardial infarction
  • agranulocytosis
  • anticholinergic medications
  • apheresis
  • AV block
  • bipolar disorder
  • bradycardia
  • breast-feeding
  • bundle-branch block
  • cardiac disease
  • cardiomyopathy
  • celiac disease
  • children
  • closed-angle glaucoma
  • contact lenses
  • driving or operating machinery
  • electroconvulsive therapy (ECT)
  • ethanol ingestion
  • females
  • fever
  • geriatric
  • heart failure
  • hepatic disease
  • human immunodeficiency virus (HIV) infection
  • hyperparathyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • increased intraocular pressure
  • long QT syndrome
  • mania
  • MAOI therapy
  • myocardial infarction
  • neonates
  • neutropenia
  • pheochromocytoma
  • poor metabolizers
  • pregnancy
  • prostatic hypertrophy
  • QT prolongation
  • radiographic contrast administration
  • rheumatoid arthritis
  • seizure disorder
  • seizures
  • sickle cell disease
  • sleep deprivation
  • stroke
  • suicidal ideation
  • sunlight (UV) exposure
  • surgery
  • systemic lupus erythematosus (SLE)
  • tricyclic antidepressant hypersensitivity
  • urinary retention

Interactions

  • Abarelix
  • Abiraterone
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
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