Maprotiline Dosage
This dosage information may not include all the information needed to use Maprotiline safely and effectively. See additional information for Maprotiline.
The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.
Usual Adult Dose for:
Usual Geriatric Dose for:
Additional dosage information:
Usual Adult Dose for Depression
For outpatients with mild to moderate depression:
Initial Dose: 75 mg orally as a single or divided daily dose.
For severely depressed hospitalized patients:
Initial Dose: 100 mg to 150 mg orally as a single or divided daily dose.
Maintenance Dose: May be reduced to 75 to 150 mg orally as a single or divided daily dose, with subsequent adjustment depending on therapeutic response.
Usual Geriatric Dose for Depression
For outpatients with mild to moderate depression:
Initial Dose: 25 mg per day orally
Maintenance Dose: 50 to 75 mg as a single or divided daily dose is usually satisfactory for patients over 60 years of age.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Dose Adjustments
Because of the long half-life of maprotiline, the initial dosage should be maintained for two weeks. The dose may then be increased in 25 mg increments as needed and as tolerated.
While a maximum dose of 150 mg per day should result in therapeutic efficacy for most outpatients, dosages as high as 225 mg per day may be required for use in the most severely depressed patients. Daily doses of 225 mg should not be exceeded.
Dosage during prolonged maintenance therapy should be kept at the lowest effective level.
Precautions
Children, adolescents, and young adults (18 to 24 years of age) with major depressive disorder and other psychiatric disorders may be at an increased risk of suicidal thinking and suicidality with antidepressant use, particularly during the first few months of treatment. Medical evidence has not shown this increased risk to exist in adults older than 24 years of age, but adults 65 years of age and older taking antidepressants appear to have a decreased risk of suicidality. The results of a meta-analysis indicate an overall favorable risk-to-benefit profile for the use of antidepressants (i.e., selective serotonin and/or norepinephrine reuptake inhibitors) in the treatment of pediatric patients (less than 19- years- old) with major depressive disorders (MDD), obsessive-compulsive disorder (OCD), or non- OCD anxiety disorders. Although this study also reports an overall increased risk of suicidal ideation/suicide attempt associated with the use of antidepressants in pediatric patients, the risk may be less than originally estimated. Additional prospective studies are warranted in order to confirm these findings.
Worsening of depression and/or increased suicidal thinking or behavior may always be a possibility in patients treated with antidepressant medications, particularly those being treated for depression. Anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia (severe restlessness), hypomania, and mania have been reported in patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. It is unknown if these symptoms are a precursor to either worsening of depression or the emergence of suicidal impulses; however, there is concern that patients who experience one or more of these symptoms may be at increased risk for worsening depression or suicidality. Although the FDA has not concluded that antidepressant drugs cause worsening depression or suicidality, health care providers should be aware that worsening of symptoms could be due to the underlying disease or might be a result of drug therapy.
Health care providers should carefully monitor patients receiving antidepressants for possible and/or persistent worsening of depression or emergent suicidality, especially at the beginning of therapy or when the dose either increases or decreases. If symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms, the health care provider will need to determine what intervention, including discontinuing or modifying the current drug therapy, is indicated. Prescriptions should be written for small quantities of drug to reduce the risk of an attempt to overdose. Health care providers should instruct patients, their families and their caregivers to be alert for the emergence of agitation, irritability, and the other symptoms described above, as well as the emergence of suicidality and worsening depression, and to report such symptoms immediately to their health care provider.
Because antidepressants are believed to have the potential for inducing manic episodes in patients with bipolar disorder, there is a concern about using antidepressants alone in this population. Therefore, patients should be adequately screened to determine if they are at risk for bipolar disorder before initiating antidepressant treatment so that they can be appropriately monitored during treatment. Such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression.
Dialysis
Data not available
Other Comments
Therapeutic effects are sometimes seen within 3 to 7 days. However, as long as 2 to 3 weeks may be necessary.
