Brand Name (Manufacturer)
Type of Drug
Protriptyline is used for the relief of symptoms of mental depression.
Protriptyline belongs to a class of drugs known as tricyclic antidepressants. It is chemically unrelated to other classes of antidepressants, including monoamine oxidase (MAO) inhibitors. It is thought to work by increasing the concentrations of neurotransmitters called serotonin and norepinephrine in the brain.
To prevent side effects, the dosage of the drug should initially be low and increased as necessary until improvement, as long as there are no serious side effects.
The recommended initial dosage for treatment of depression in adults is 15 to 40 mg a day, divided into three or four doses. When satisfactory improvement has been reached, the dosage should be reduced to the smallest amount that will maintain relief of the symptoms. Lower doses (15 mg per day to start) are recommended for elderly adults.
Cautions and Warnings
Protriptyline should not be used by anyone with a known allergy to it. It should also not be used by people recovering from heart attacks. Because of the risk of serious side effects, protriptyline should not be used in combination with antidepressants of the monoamine oxidase (MAO) inhibitor class.
Protriptyline should be used with caution in people with a history of seizures, difficulty urinating, or glaucoma. People with thyroid disease or those receiving thyroid medication should not use protriptyline because of the risk of heart toxicity.
The most common side effects of protriptyline include rapid heartbeat, fainting when getting up quickly, sedation, blurred vision, disorientation, confusion, hallucinations, muscle spasms, seizures, dry mouth, constipation, difficulty urinating, and sensitivity to bright light or sunlight.
Protriptyline has not been formally studied in pregnant women. Protriptyline crosses the placenta. There have been reports of birth defects when the drug was taken during the first three months of pregnancy and severe side effects in newborns whose mothers took the drug during delivery. Pregnant women are encouraged to discuss the benefits and potential risks of protriptyline with their physician before deciding to use the drug.
Use In Children
Protriptyline is not recommended for children because its safety and efficacy has not been formally established for them in clinical trials.
Use in the Elderly
Older adults may be more susceptible to the side effects of protriptyline. If they use the drug, it is usually at reduced dosages, as described above.
Protriptyline may interfere with the effect of blood-pressure medications such as guanethidine or clonidine. Taking protriptyline and thyroid drugs together may intensify the effects of both drugs.
Protriptyline may be taken with or without food.
Other Drugs Used for Similar Conditions
For treatment of depression, there are many options, including other tricyclic antidepressants (desipramine, amitriptyline, nortriptyline, amoxapine, maprotiline, imipramine, trimipramine, doxepin), MAO inhibitors (tranylcypromine, phenelzine, isocarboxazid), serotonin reuptake inhibitors (fluoxetine, paroxetine, and sertraline), and stimulants such as methylphenidate. The appropriate choice varies from person to person and depends on age, physical health and condition, and other drugs being concurrently used.
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