Suicidality and Antidepressant Drugs
Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of maprotiline or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Maprotiline is not approved for use in pediatric patients. (See WARNINGS: Clinical Worsening and Suicide Risk, PRECAUTIONS: Information for Patients and PRECAUTIONS: Pediatric Use.)
MAPROTILINE HYDROCHLORIDE TABLETS, USP
Maprotiline hydrochloride, USP is a tetracyclic antidepressant, available as 25 mg, 50 mg and 75 mg tablets for oral administration.
Maprotiline hydrochloride tablets are indicated for the treatment of depressive illness in patients with depressive neurosis (dysthymic disorder) and manic-depressive illness, depressed type (major depressive disorder). Maprotiline is also effective for the relief of anxiety associated with depression.
Media Articles Related to Maprotiline
CMS Panel to Discuss Tx-Resistant Depression
Source: MedPageToday.com - medical news plus CME for physicians [2016.04.22]
(MedPage Today) -- Establishing a standard definition for treatment-resistant depression could impact clinical trials and coverage determinations
Screening Moms for Depression: A Job for Pediatrics
Source: Medscape Family Medicine Headlines [2016.04.19]
Less than one half of pediatric providers screen for maternal depression during a child's visit. How can this be improved?
Morning Break: Mental Health Pulitzer; VA Wait-Listing Redux; DBS in Depression
Source: MedPage Today Psychiatry [2016.04.19]
(MedPage Today) -- Health news and commentary from around the Web, gathered by the MedPage Today staff
Depression Yet Another Side Effect of ADT?
Source: Medscape Hematology-Oncology Headlines [2016.04.18]
Older men (age 65 and older) with localized prostate cancer may be at increased risk of developing depression.
Medscape Medical News
CardioBreak: MRI-Safe Afib Monitor; Missing Depression Meds; Hopping in HF
Source: MedPage Today Psychiatry [2016.04.18]
(MedPage Today) -- Recent developments of interest in cardiovascular medicine
Published Studies Related to Maprotiline
Comparisons of glucose-insulin homeostasis following maprotiline and fluoxetine treatment in depressed males. [2007.11]
BACKGROUND: To investigate the effects of antidepressants on glucose-insulin homeostasis, we provided homogenous situation and performed standard procedures to assess the interactions of antidepressants and glucose regulation during hospitalization... CONCLUSIONS: The results suggest that the beta-cell function is hyperbolic in order to offset the insulin resistance following maprotiline treatment. Our findings imply that norepinephrine reuptake inhibitor (NRI) antidepressants might attenuate insulin sensitivity.
Clinical Trials Related to Maprotiline
Pharmacovigilance in Gerontopsychiatric Patients [Recruiting]
The purpose of this multicenter-study is to investigate safety of psychopharmacological
treatment and rates of adverse drug reactions in gerontopsychiatric inpatients. Elderly
people are at higher risk for developing side effects under pharmacological treatment due to
an altered metabolic situation, higher comorbidity rates and often polypharmacy. Furthermore
gerontopsychiatric patients can often not articulate their symptoms clearly, for example due
to pronounced cognitive impairment.
The aim of the study is to gain valid data of possible adverse drug reaction rates, their
potential risk factors and outcome, as well as medical prescription practises.
To assess these outcomes an intensive pharmacovigilance-monitoring will be conducted at the
five participating study sites.
At Baseline demographic data, previous and present disorders, use of drugs, previous and
present medication, quality of life, cognitive function, physical examination results,
laboratory results and ECG will be assessed.
Afterwards patients are visited weekly and screened for possible adverse drug reactions. All
adverse drug reactions will be coded in the MedDRA-system.
In case of a possible serious adverse drug reaction serum levels of all psychotropic
substances applicated will be assessed. Drug combinations will be analysed using an
established advanced bioinformatic tool (mediQ). Diagnosis, medication intake and possible
adverse drug reactions are documented continually.
2 weeks after discharge from the ward, patients will be contacted by phone to assess
Treatment-Resistant Depression, Hippocampus Atrophy and Serotonin Genetic Polymorphism [Completed]
Reduction of volume of the hippocampus has been associated with major depression in many
studies. It has been suggested that antidepressants may protect against hippocampus volume
loss in humans associated with multiple episodes of depression and may also reverse the
reduction of volume caused by the depression. In addition, genetic markers for serotonin are
implicated with depression, and may be an indication of reduced response to antidepressant
This study aims to enroll patients who are defined as having treatment resistant depression
(no remission after at least 2 treatments trials with an antidepressant). They will receive
an MRI scan at the initial visit and either 6 months after sustained remission or 12 months
after they enter the study for non-remitters. They will also be asked to give a blood sample
for genotyping. They will be matched by age and handedness to healthy volunteers with no
personal history of depression who will also receive an MRI scan and genotyping.
The first aim is to compare hippocampal volume of depressed subjects to healthy controls. It
is anticipated that subjects will initially have smaller hippocampal volume but of those who
sustain remission, there will be a small increase in hippocampal volume. It is also
anticipated that specific genetic markers will be related to individuals response to
Page last updated: 2016-04-22