Maprotiline Dosage

Applies to the following strengths: 25 mg; 50 mg; 75 mg

Usual Adult Dose for Depression

Outpatients with Mild to Moderate Depression:

Inpatients with Moderate to Severe Depression:

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

Outpatients with Mild to Moderate Depression:

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

Data not available

Data not available

Pathological neutrophil depression: Discontinue therapy.

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.

Data not available

Administration advice:

Storage requirements:

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.