Maprotiline: uses and side effects of this psychotropic drug

Depression is a severe problem that affects a high percentage of the world's population, causing great pain and impact in countless lives.

However, fortunately throughout history different types of treatments have been developed that present a relevant effectiveness when it comes to combating their symptoms, one of which is the synthesis and administration of drugs.

In this sense we have a wide variety of medications of various types, and it is about one of them that we are going to talk about in this article: maprotiline.

• Related article: "Psychotropic drugs: medications that act on the brain"

Maprotiline: what is it?

Maprotiline is one of the various antidepressants that exist, which are substances with psychoactive properties that alter brain chemistry to relieve symptoms of major depression and other problems with depressive symptoms.

Among antidepressants, it is classified or It is part of the group of tetracyclics, which are characterized by a four-ring structure and are derived from tricyclics (which in turn were one of the first groups of antidepressants to be synthesized, after the IMAOS).

The fact that it is tetracyclic means that it was developed years after tricyclics, so advances in scientific research managed to generate slightly safer products. They could be considered second generation tricyclics.

Tricyclic and tetracyclic drugs, including maprotiline, were for a time the treatment of choice in depressive symptoms, although with the passage of time have been displaced by specific serotonin reuptake inhibitors or SSRIs (which are safer and generate fewer side effects).

Maprotiline It is sold in the form of tablets or tablets and is administered orally.. Its effects, as with most antidepressants, can take around three weeks or a month to appear. It is metabolized in the liver and excreted through urine.

• You may be interested: "Types of antidepressants: characteristics and effects"

Mechanism of action

Maprotiline is an antidepressant whose main mechanism of action, that is, the way it affects the body, It is based on the inhibition of norepinephrine reuptake.

The inhibition of the reuptake of this neurotransmitter implies that when they are emitted by a neuron, it does not recapture what would be interpreted as the surplus, so it remains in the synaptic space and can be used by the following neurons: in other words, it causes higher levels of these hormones in the brain, so that they facilitate their effect. This generates an increase in the level of activation and reduces passivity and discomfort. typical of depression or a mood disorder.

Unlike other antidepressants in the same group, the action of this drug does not have a marked effect (although it also generates an inhibition of its reuptake) at the level of serotonin, its action being fundamentally focused on the norepinephrine.

However, in addition to this also alters acetylcholine levels, acting as an antagonist of this (although less powerful than what a tricyclic would generate). That is, it is a drug with anticholinergic action, and this usually leads to the possibility of side effects that can be annoying.

In addition to that has antihistamine action, which makes it easier for it to have a sedative action and relieve anxiety.

Main indications

Maprotiline, as an antidepressant, has its main indication in major depression. This indication occurs both when we are faced with reactive depression or melancholic or endogenous depression. Also It is effective in other disorders in which depressive symptoms exist, such as dysthymia, or even within the framework of a Bipolar disorder.

It is also effective in the treatment of depressive syndromes that present with anxiety, whether we are talking about a mixed episode or a mixed anxious-depressive disorder as if we are talking about depressive states derived from the wear and tear generated by the experience of anxiety continued. It not only reduces low mood and passivity but also helps reduce anxiety and agitation.

In addition to depression and anxiety, maprotiline can also be used in the treatment of enuresis in children, although with much more controlled doses and as long as they are over six years of age.

Side effects

The administration of this psychotropic drug can be useful when treating depressive symptoms, but despite this Its use may entail side effects and risks to be taken into account..

Among the most common are the appearance of tiredness and fatigue, nausea, dry mouth, blurred vision, anxiety and nervousness (and even could lead to hypomania), sleep problems (due to lack or excess), weakness, photosensitivity, constipation or diarrhea and retention urinary It can also cause tachycardia and/or hypotension. It can also cause lightheadedness and confusion, as well as headaches and weight gain.

Sometimes more dangerous symptoms may appear, although less frequent: it may cause the appearance of seizures, spasms, flu-like symptoms, arrhythmias or jaundice. Also suicidal thoughts, speech problems, motor incoordination or hallucinations.

It is also worth highlighting the risk of generating addiction and withdrawal syndromes. Although it is rather rare and unusual, there is also a risk of alteration (specifically loss) of the level of white blood cells, as well as the feared neuroleptic malignant syndrome which can become mortal.

Contraindications

As we have seen, the use of maprotiline can lead to annoying and even dangerous effects. These effects can be much more dangerous and put the safety of some sectors of the population at risk, for whom maprotiline is contraindicated.

Among these, the case of those people who have an allergy to maprotiline or its excipients stands out first. They should also avoid maprotiline those who suffer from liver, kidney or pancreatic problems. It is contraindicated or at least requires special caution for people with glaucoma, hyperprostatism or hyperthyroidism, epilepsy (or have a history of seizures), or dementia.

Those who also use other antidepressants should exercise caution and evaluate with their doctor the suitability of treatment with this drug. (especially dangerous is the combination with an MAOI), neuroleptics or anticonvulsants, among other drugs, or who are going to undergo a surgery.

It also cannot be consumed together with alcohol., and should be avoided in pregnant and lactating women who may use it, it is not recommended unless there is no other alternative. And given its sedative effects, caution should be maximized and one should not drive or use heavy machinery under its influence.