Some of the most frequently prescribed tricyclics are amitriptyline (Elavil), desipramine (Norpramin), clomipramine (Anafranil), doxepin (Sinequan), imipramine, (Tofranil), nortriptyline (Pamelor, Aventyl), protriptyline
(Vivactil) and trimipramine (Surmontil).
The medications were classified as selective serotonin reuptake inhibitors (SSRIs) (citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline); serotonin norepinephrine reuptake inhibitors (venlafaxine); tricyclics (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, maprotiline, nortriptyline, protriptyline
, and trimipramine); newer and atypical agents (mirtazapine, nefazodone, and trazodone); and monoamine oxidase inhibitors (moclobemide, phenelzine, and tranylcypromine).
Routinely used TCAs include protriptyline
, desipramine, and imipramine.
Correlation of clinical features of depressed outpatients with response to amitriptyline and protriptyline
Patient Age [greater than Antidepressant or equal to]65 <65 Sertraline 25 50 Paroxetine 10 20 Citalopram * 20 20 Fluoxetine 10 20 Fluvoxamine * 100 100 Amitriptyline NR 50 Desipramine 25 100 Doxepin 30 75 Imipramine 30 75 Nortriptyline 30 75 Protriptyline
15 15 Trimipramine 50 75 Clomipramine 75 75 Trazodone 25 150 Buproprion 50 200 Phenelzine 45 45 Tranylcypromine 20 20 Maprotiline 25 75 Nefazodone 100 200 Venlafaxine 50 75 Mirtazapine 15 15 Amoxapine 50 100 * These antidepressants were not addressed in 1997 Department of Veterans Affairs depression guidelines; minimum daily dosage for these medications derived from expert consensus.
One category includes tricyclic antidepressants, such as imipramine (Tofranil), desipramine (Norpramin), clomipramine (Anafranil) and protriptyline
Amitriptylines (Elavil, Endep), one in a class of antidepressants that include doxepin (Adapin), nortriptyline (Aventyl) and protriptyline
A naturalistic assessment of protriptyline
for attention deficit hyperactivity disorder.
Wroblewski B, Glenn M, Comblatt R, et al: Protriptyline
as an alternative stimulant medication in patients with brain injury: A series of case reports.
appears to ameliorate OSA via two mechanisms: 1) it tends to suppress REM sleep, the stage in which muscle hypotonia and OSA severity might be at their greatest, and 2) it increases pharyngeal neural activity and dilates the pharyngeal airway.
For example, amitriptyline (Elavil) may make people feel drowsy, while protriptyline
(Vivactil) hardly does this at all and, in some people, may have an opposite effect, producing feelings of anxiety and restlessness.
Those include mirtazapine, xylometazoline, fluticasone, paroxetine, pantoprazole, steroids, acetazolamide, and protriptyline