Protriptyline; Uses, Side Effects, Interactions, Pregnancy

Protriptyline, Protriptyline; Uses, Side Effects, Interactions, Pregnancy, Rx Harun
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Protriptyline is a tricyclic antidepressant that was previously widely used in the therapy of major depression. Most of the tricyclic antidepressants have been shown to cause a low rate of mild and transient serum enzyme elevations and rare cases of clinically apparent acute cholestatic liver injury. The potential hepatotoxicity specifically of protriptyline, however, has not been well defined.

Protriptyline hydrochloride is a dibenzocycloheptene-derivative tricyclic antidepressant (TCA). TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, protriptyline does not affect mood or arousal but may cause sedation. In depressed individuals, protriptyline exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. In addition, TCAs down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission.

Mechanism of Action of Protriptyline

Protriptyline acts by decreasing the reuptake of norepinephrine and serotonin (5-HT). Protriptyline is a tricyclic antidepressant. It was thought that tricyclic antidepressants work by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin by nerve cells. However, this response occurs immediately, yet mood does not lift for approximately two weeks. It is now thought that changes occur in receptor sensitivity in the cerebral cortex and hippocampus. The hippocampus is part of the limbic system, a part of the brain involved in emotions. Presynaptic receptors are affected: α1 and β1 receptors are sensitized, α2 receptors are desensitized (leading to increased noradrenaline production). Tricyclics are also known as effective analgesics for different types of pain, especially neuropathic or neuralgic pain. A precise mechanism for their analgesic action is unknown, but it is thought that they modulate anti-pain opioid systems in the CNS via an indirect serotonergic route. They are also effective in migraine prophylaxis, but not in abortion of acute migraine attack. The mechanism of their anti-migraine action is also thought to be serotonergic.

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Indications of Protriptyline

Contra Indications of Protriptyline

Dosage of protriptyline

Strengths: 5 mg; 10 mg

Depression

  • 15 to 40 mg orally per day divided into three or four doses
  • Maximum dose: 60 mg/day

Geriatric Dose for Depression

  • 5 mg orally 3 times a day, increasing gradually if necessary

Side Effects of protriptyline

The most common

Common 

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Rare

Drug Interaction of Protriptyline

Protriptyline may interact with following drugs, or suppliment & change thr efficacy of drugs

This is not a complete list of protriptyline drug interactions. Ask your doctor or pharmacist for more information.

Pregnancy & Lactation of protriptyline

FDA Pregnancy catagory C

Pregnancy

Protriptyline has not been classified into one of these categories because safe use in pregnancy has not been established. The use of protriptyline in pregnant women or women who may become pregnant requires that possible benefits be weighed against possible hazards to the mother and child.

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 Lactation
Tell your doctor if you are breastfeeding or plan to breastfeed. Safe use of protriptyline during breastfeeding has not been established. The use of protriptyline in nursing women requires that possible benefits be weighed against possible hazards to the mother and child.

References

 

Protriptyline, Protriptyline; Uses, Side Effects, Interactions, Pregnancy, Rx Harun

Protriptyline, Protriptyline; Uses, Side Effects, Interactions, Pregnancy, Rx Harun

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