Ludiomil

Indications

Maprotiline Hydrochloride is an antidepressant used to treat depression, including depression with anxiety. It is a prescription medicine for adults.

How It Works

Maprotiline is a tetracyclic antidepressant. It mainly blocks the reuptake (recycling) of noradrenaline, a chemical messenger in the brain, so more of it stays active between nerve cells. Over several weeks this helps improve mood, sleep, energy and interest in daily life.

Dosage and Administration

Take exactly as prescribed. The doctor starts with a low dose and increases it slowly, then adjusts it to the lowest dose that works. It is usually taken once a day at night or in divided doses. It can take 2 to 4 weeks to feel the full benefit. Do not stop suddenly; the dose should be reduced gradually under medical advice.

Interactions

• Must not be taken with, or within 14 days of, MAO inhibitors such as Selegiline or Linezolid.
• Fluoxetine, Paroxetine, Cimetidine and some antipsychotics can raise its level.
• Alcohol, sleeping pills and antihistamines increase drowsiness.
• It may reduce the effect of some blood pressure medicines and increase effects of adrenaline-like drugs.
• Medicines that lower the seizure threshold, such as Tramadol, add to the risk of fits.

Contraindications

• Allergy to maprotiline.
• Epilepsy or a history of seizures.
• Recent heart attack or certain heart rhythm problems.
• Narrow-angle glaucoma, difficulty passing urine, severe liver or kidney disease.
• Use with MAO inhibitors.

Side Effects

Common: dry mouth, drowsiness, dizziness, blurred vision, constipation, weight gain, sweating and tremor. Less common: fast heartbeat, low blood pressure on standing, skin rash and seizures, especially at higher doses.

Get urgent medical help for a fit, fainting, a very fast or irregular heartbeat, inability to pass urine, a severe rash, or any thoughts of self-harm or suicide.

Pregnancy and Lactation

Use in pregnancy only if the doctor decides the benefit outweighs the risk; do not stop suddenly if you become pregnant, but speak to your doctor. It passes into breast milk, so breastfeeding should be discussed with the doctor.

Precautions and Warnings

• Antidepressants may increase suicidal thoughts in young people early in treatment; family members should watch for mood changes.
• May cause drowsiness; do not drive until you know how it affects you.
• Use with care in heart disease, thyroid disease, bipolar disorder and in older people.

Overdose

Overdose is dangerous and may cause seizures, severe heart rhythm problems, low blood pressure, coma and death. Go to hospital immediately.

Therapeutic Class

Tetracyclic antidepressant.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.