A tricyclic-related antidepressant
Maprotiline
An older, sedating antidepressant used for depression, related to the tricyclics.
What is Maprotiline?
Maprotiline is an older antidepressant, closely related to the tricyclic antidepressants, used to treat depression. It tends to be sedating, which can help when depression disturbs sleep, but it also causes 'anticholinergic' effects such as dry mouth, constipation and blurred vision. It can lower the seizure threshold and is dangerous in overdose, so it is used carefully. Like all antidepressants, it should not be stopped suddenly and takes a few weeks to work.
Education and reference only. This is a plain-language guide to Maprotiline — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Maprotiline is an antidepressant from an older family of medicines related to the tricyclics. It is used to treat depression and tends to have a calming, sedating quality. Because newer antidepressants are often better tolerated and safer in overdose, maprotiline is now used less often, but it still has a place for some people. It is taken by mouth, usually every day, and takes a few weeks to show its full effect.
How it works
Maprotiline increases the activity of the brain chemical noradrenaline by slowing its reabsorption into nerve cells, which is thought to help lift mood in depression. Its effects on other body chemical systems explain its 'anticholinergic' side effects, such as dry mouth and constipation, and its sedating, calming quality. The same broad activity is why it can lower the seizure threshold and be dangerous if too much is taken.
Company & origin
Originated / developed by: Generic (originally Novartis).
An older, tricyclic-related antidepressant used in the UK for depression, known for being sedating.
What it treats
Conditions Maprotiline is used for
Practical use
How to take Maprotiline
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it as prescribed, often at night because it can make you drowsy.
- Keep taking it even if you do not feel better at first, as it can take a few weeks to work.
- Do not stop it suddenly; it is reduced gradually to avoid withdrawal effects.
- Be careful with driving or machinery until you know how drowsy it makes you, and avoid alcohol.
- Tell your prescriber promptly about new or worsening low mood, agitation or thoughts of self-harm.
- Mention any fits, a fast or irregular heartbeat, eye pain or difficulty passing urine straight away.
Weighing it up
Advantages & disadvantages of Maprotiline
Advantages
- Its sedating quality can help people whose depression disturbs their sleep.
- A long-established medicine with a well-understood profile.
- An option when newer antidepressants have not suited a particular person.
Disadvantages
- Causes anticholinergic effects such as dry mouth, constipation and blurred vision.
- Can lower the seizure threshold, making fits more likely in susceptible people.
- Dangerous in overdose, which limits how much is supplied at a time.
Practical use
Good to know
Maprotiline often causes drowsiness, which is why it is sometimes taken at night and can suit people whose depression disturbs sleep. It commonly causes anticholinergic effects: dry mouth, constipation, blurred vision and difficulty passing urine. Two important cautions are that it can lower the seizure threshold (making fits more likely, particularly at higher amounts or in people prone to seizures) and that it is dangerous in overdose, so only the amount needed is usually supplied. It should not be stopped suddenly. As with all antidepressants, watch for new or worsening low mood or thoughts of self-harm early on, and tell your prescriber about heart problems, glaucoma or prostate trouble.
Who should not take it / use with caution
- People who have recently had a heart attack or have certain heart-rhythm problems should not take it.
- It should be avoided in uncontrolled epilepsy and used cautiously where seizures are a risk.
- It is used with caution in glaucoma, an enlarged prostate or significant urinary problems.
Monitoring
- Reviewing mood, response and any thoughts of self-harm, especially in the first weeks.
- Watching for anticholinergic effects, drowsiness and any sign of fits or heart-rhythm changes.
- Planning a gradual reduction when the time comes to stop.
Side effects
- Drowsiness, dry mouth, constipation, blurred vision and weight gain are common.
- Dizziness, a faster heartbeat or difficulty passing urine in some people.
- Rarely, seizures, heart-rhythm changes, or thoughts of self-harm, especially early in treatment.
Key interactions
- Should not be combined with MAOI antidepressants, and care is needed when switching antidepressants.
- Medicines that affect the heart rhythm or lower the seizure threshold add to its risks.
- Alcohol and other sedating medicines increase its drowsiness, so tell your prescriber what you take.
Available as: Tablets taken by mouth.
Answers
Maprotiline: frequently asked questions
Why does maprotiline make me sleepy?
It is a sedating antidepressant, which is why it is often taken at night; this can be helpful if depression disturbs your sleep, but take care with driving until you know how it affects you.
Is it dangerous in overdose?
Yes. Like the tricyclics it is dangerous if too much is taken, so usually only the amount needed is supplied; seek urgent help if an overdose is suspected.
Can it cause seizures?
It can lower the seizure threshold, making fits more likely in people who are prone to them, so tell your prescriber if you have ever had a seizure.
Why do I have a dry mouth and constipation?
These are common anticholinergic effects of maprotiline; sipping water and a high-fibre diet can help, and your prescriber can advise if they are troublesome.
Can I stop it suddenly?
No. Stopping suddenly can cause withdrawal effects, so it is reduced gradually under your prescriber's guidance.
The wider class
About Tetracyclic (tricyclic-related) antidepressant
Maprotiline belongs to the tetracyclic (tricyclic-related) antidepressant class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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