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NERVOUS SYSTEM › PSYCHOANALEPTICS › ANTIDEPRESSANTS › Non-selective monoamine reuptake inhibitors
protriptyline
N06AA11
Forms & Strengths
- Oral tablets: 5 mg
- Oral tablets: 10 mg
Adult Dosing
- Depression: Initial 15 to 40 mg daily in 3 to 4 divided doses, titrated up to a maximum of 60 mg daily.
Pediatric Dosing
- Safety and efficacy not established in pediatric patients under 12 years of age; use generally not recommended.
Indications
- Treatment of symptoms of mental depression
Mechanism of Action
- Tricyclic antidepressant that inhibits the reuptake of norepinephrine and, to a lesser extent, serotonin by the presynaptic neuronal membrane, increasing their concentration in the synaptic cleft.
Contraindications
- Hypersensitivity to protriptyline or other dibenzazepine derivatives
- Concurrent use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuation
- Acute recovery phase following myocardial infarction
Adverse Reactions
- Anticholinergic effects (dry mouth, blurred vision, constipation, urinary retention)
- Cardiovascular effects (tachycardia, orthostatic hypotension, ECG changes, arrhythmias)
- Central nervous system effects (drowsiness, dizziness, tremor, anxiety, insomnia)
- Metabolic/Endocrine (weight gain, sexual dysfunction)
Drug Interactions
- MAOIs: risk of severe, sometimes fatal reactions including serotonin syndrome and hypertensive crisis
- CNS depressants (alcohol, barbiturates, benzodiazepines): potentiation of CNS depression
- CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): increased plasma concentrations and toxicity risk of protriptyline
- Antihypertensives: may block the antihypertensive response of guanethidine and similar agents
Curated Content: Needs Vetting Before Put to Clinical Use