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NERVOUS SYSTEM › PSYCHOANALEPTICS › ANTIDEPRESSANTS › Non-selective monoamine reuptake inhibitors
dimetacrine
N06AA18
Adult Dosing
- Initial: 75 mg to 150 mg daily in divided doses
- Maintenance: Up to 300 mg daily based on clinical response and tolerability
Pediatric Dosing
- Safety and efficacy not established in pediatric patients; use not recommended
Indications
- Treatment of major depressive disorder and depressive states
Mechanism of Action
- Tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin into presynaptic nerve terminals, increasing their concentrations in the synaptic cleft
Contraindications
- Hypersensitivity to dimetacrine or other tricyclic antidepressants
- Recent myocardial infarction
- Concomitant use with monoamine oxidase inhibitors (MAOIs)
- Severe hepatic impairment
- Arrhythmias and severe heart block
Adverse Reactions
- Anticholinergic effects (dry mouth, blurred vision, constipation, urinary retention)
- Central nervous system effects (drowsiness, dizziness, tremor, confusion)
- Cardiovascular effects (orthostatic hypotension, tachycardia, ECG changes, QT prolongation)
- Weight gain
- Sexual dysfunction
Drug Interactions
- Monoamine oxidase inhibitors (MAOIs): Risk of severe serotonin syndrome, hypertensive crisis, and hyperpyrexia
- Central nervous system depressants (alcohol, barbiturates, benzodiazepines): Enhanced sedation and respiratory depression
- Sympathomimetic agents (epinephrine, norepinephrine): Potentiation of cardiovascular effects
- CYP2D6 inhibitors: May increase plasma concentrations of dimetacrine
Curated Content: Needs Vetting Before Put to Clinical Use