Protriptyline

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Information about Protriptyline[edit source]

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.

Mechanism of action of Protriptyline[edit source]

Protriptyline (proe trip' ti leen) is a tricyclic antidepressant which acts by inhibition of serotonin and norepinephrine reuptake within synaptic clefts in the central nervous system, thus increasing brain levels of these neurotransmitters.

{{fda}] Protriptyline is indicated for therapy of major depression and was approved for this indication in the United States in 1967, but is no longer widely used, having been replaced by the selective serotonin reuptake inhibitors (SSRIs) and other better tolerated and more easily administered agents. Protriptyline, unlike other tricyclic antidepressants, tends to be energizing rather than sedating and is used off label for narcolepsy, sleep apnea and attention deficit disorder.

Dosage and administration for Protriptyline[edit source]

Protriptyline is available in generic forms and under the brand name of Vivactil in 5 and 10 mg tablets. The typical recommended dose for depression in adults is 15 to 40 mg daily in 3 to 4 divided doses.

Side effects of Protriptyline[edit source]

Common side effects include dizziness, headache, drowsiness, restlessness, confusion, tachycardia, gastrointestinal upset, increased appetite, weight gain, blurred vision, dry mouth and urinary retention.

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

Protriptyline Resources
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Contributors: Prab R. Tumpati, MD