Maprotiline Dosage

Usual Adult Dose for Depression

Outpatients with Mild to Moderate Depression:

• Initial dose: 75 mg orally once a day or in divided doses
• Maintenance dose: 75 to 150 mg/day
• Maximum dose: 225 mg/day

Inpatients with Moderate to Severe Depression:

• Initial dose: 100 to 150 mg orally once a day or in divided doses
• Maintenance dose: 75 to 150 mg/day
• Maximum dose: 225 mg/day

Comments:

• Patients with mild to moderate depression should remain on the initial dose for at least 2 weeks. Titration should gradually increase in 25 mg increments.
• Therapeutic efficacy may be reached by most outpatients at 150 mg/day; however, hospitalized and/or severely depressed patients may require doses up to 225 mg/day.

Uses:

• Treatment of depressive illness in patients with dysthymic disorder/depressive neurosis and major depressive disorder/manic depressive illness, depressed type
• Relief of anxiety related to depression

Usual Geriatric Dose for Depression

Outpatients with Mild to Moderate Depression:

• Initial dose: 25 mg orally once a day or in divided doses
• Maintenance dose: 50 to 75 mg/day

Comment:

• Patients over the age of 60 years had a satisfactory response with a maintenance dose of 50 to 75 mg/day; this range should be considered for all patients, and especially in those who cannot tolerate higher doses.

Uses:

• Treatment of depressive illness in patients with dysthymic disorder/depressive neurosis and major depressive disorder/manic depressive illness, depressed type
• Relief of anxiety related to depression

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Pathological neutrophil depression: Discontinue therapy.

Precautions

US BOXED WARNING:

• SUICIDALITY AND ANTIDEPRESSANT DRUGS: Increased risk of suicidal thinking and behavior has been observed in children, adolescents, and young adults less than 24 years old. Patients should be monitored and closely observed for clinical worsening, suicidality, or unusual changes in behavior. Caregivers and family members should be advised of the need for close observation and communication with the healthcare provider.

Safety and efficacy have not been established in children.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• See manufacturer product information.

Storage requirements:

• See manufacturer product information.

General:

• Clinical improvement may take up to 2 to 3 weeks, though some patients have shown clinical improvement in 3 to 7 days.

Monitoring:

• Leukocyte and WBC with differential, especially in patients who develop fever and/or sore throat
• Vision examination, especially in patients with narrow angle glaucoma and/or increased intraocular pressure
• Clinical worsening or suicidality

Patient advice:

• Warn patients to avoid abrupt discontinuation of this drug.
• Tell patients to immediately report any signs/symptoms of neutropenia/leukopenia, neuroleptic malignant syndrome, or tardive dyskinesia.
• Advise patients, and families/caregivers to monitor and report signs/symptoms of suicidality, and/or unusual behavior immediately to their healthcare provider (e.g., agitation, irritability,anxiety, panic attacks, insomnia, hostility, aggressiveness, impulsivity, akathisia, hypomania/mania).
• Patients should be advised to report all concurrent prescription and nonprescription medications or herbal products they are taking.
• Inform patients that this drug may cause drowsiness, and they should avoid driving or operating machinery until the full effects of the drug are known.
• Patients should be advised to speak to a healthcare provider if they are pregnant, intend to become pregnant, or are breastfeeding.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer