Amoxapine

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Information about Amoxapine[edit source]

Amoxapine is a tetracyclic antidepressant used for relief of symptoms of depression caused by either reactive or psychotic depression.


Liver safety of Amoxapine[edit source]

Amoxapine has been associated with a low rate of minor serum aminotransferase elevations during treatment and to very rare instances of clinically apparent acute liver injury.

Mechanism of action of Amoxapine[edit source]

Amoxapine (a mox' a peen) is a tetracyclic antidepressant belonging to the dibenzoxapine family, similar but somewhat distinct from classical tricyclic antidepressants. Amoxapine has been shown to be effective in both reactive and neurotic depression as well as in major, endogenous depressive disorders. As with other tricyclic antidepressants, the mechanism of action of amoxapine probably involves interruption of norepinephrine transmission. Amoxapine also blocks histaminic and cholinergic receptors which account for its mild sedative effects.

FDA approval information for Amoxapine[edit source]

Amoxapine was approved for use in the United States in 1992 and is available in tablets of 25, 50, 100 and 150 mg generically and previously under the brand name Ascendin.

Dosage and administration for Amoxapine[edit source]

Recommended doses are 50 mg two or three times daily initially, increasing based upon efficacy and tolerance and changing to once daily dosing, to as high as 300 mg once daily.

Side effects of Amoxapine[edit source]

Common side effects included drowsiness, dizziness, headache, blurred vision, dry mouth, and tremor. Less common and rare side effects include extrapyramidal signs and symptoms, tardive dyskinesia, suicidal ideation, heart arrhythmias and galactorrhea.

The following are antidepressant subclasses and drugs

MAO Inhibitors Isocarboxazid, Phenelzine, Tranylcypromine

SNRIs Duloxetine, Levomilnacipran, Venlafaxine

SSRIs Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Vilazodone, Vortioxetine

Tricyclics Amitriptyline, Amoxapine, Clomipramine, Desipramine, Doxepin, Imipramine, Nortriptyline, Protriptyline, Trimipramine

Miscellaneous Bupropion, Flibanserin, Mirtazapine, Nefazodone, Trazodone


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Contributors: Prab R. Tumpati, MD