Brands, Medical Use, Clinical Data
- Norepinephrine-Reuptake Inhibitors
Brands / Synonyms
Amimetilina; Anafranil; Apo-Amitriptyline; Apo-Imipramine; Apo-Trimip; Asendin; Aventyl; Impril; Levate; Norpramin; Novo-Doxepin; Novo-Tripramine; Novopramine; Novotriptyn; Pertofrane; Protriptyline; Protryptyline; Rhotrimine; Sinequan; Surmontil; Tofranil; Triadapin 5; Triptil; Vivactil; Vivactil
For the treatment of depression and obsessive-compulsive disorders.
Protriptyline is a tricyclic antidepressant. It was thought that tricylic antidepressants work by inhibiting the re-uptake of the neurotransmitters norepinephrine and serotonin by nerve cells. However, this response occurs immediately, yet mood does not lift for around 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: a1 and b1 receptors are sensitized, a2 receptors are desensitised (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.
Mechanism of Action
Protriptyline acts by decreasing the reuptake of norepinephrine and serotonin (5-HT).
Side effects include anxiety, blood disorders, confusion, decreased libido, dizziness, flushing, headache, impotence, insomnia, low blood pressure, nightmares, rapid or irregular heartbeat, rash, seizures, sensitivity to sunlight, stomach and intestinal problems.
Biotrnasformation / Drug Metabolism
If Protriptyline is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Patient should check with doctor before combining Protriptyline with the following:
Antidepressants that boost serotonin, including Paxil, Prozac, and Zoloft
Antipsychotic medications such as Mellaril and chlopromazine
Barbiturates such as Nembutal and Seconal
Certain blood pressure medications such as guanethidine
Decongestants such as Sudafed
Drugs that quell spasms, such as Donnatal and Levsin
Narcotic painkillers such as Percodan and Vicodin
Other antidepressants such as Elavil and Tofranil
Tranquilizers and sleep aids such as Halcion, Valium, and Xanax
Protriptyline must never be combined with monoamine inhibitors such as Nardil and Parnate.