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PubMed1975

A double-blind trial of maprotiline (Ludiomil) and amitriptyline in depressed outpatients.

The results of a double-blind trial of a tetracyclic antidepressant, maprotiline (Ludiomil) and a conventional tricyclic, amitriptyline (Elavil), in 67 ambulatory depressives are reported. Hamilton's Rating Scale for Depression was the main outcome criterion. No statistically significant differences were found between the drugs in onset of action, efficacy, side effects or predictors of response. Patients on either drug showed a significant reduction in symptoms after 1 week of treatment and at the end of the trial. Both drugs were tolerated well. A review of double-blind comparisons of maprotiline and tricyclic antidepressants, spanning 13 countries, and including over 900 patients, both ambulatory and inpatient, shows essentially similar results. The main outcome criterion in all these studies was manifest psychopathology assessed on the Hamilton Rating Scale for Depression by the treating physician. The absence of additional types of outcome criteria or assessment techniques, which may have detected differences in motor activity or drive as originally postulated, may have obscured results which were expected to be subtle.

Adult↗

PubMed1984

Attenuation of the post-decapitation convulsions after repeated treatment of rats with desipramine, imipramine and maprotiline.

The effects of repeated treatment of rats with the antidepressant or potential antidepressant agents alaproclate, citalopram, clomipramine, desipramine, imipramine, maprotiline, mianserin and zimeldine on the convulsions released by decapitation were examined. The noradrenaline uptake inhibitors desipramine, imipramine and maprotiline increased significantly the latency of onset of the post-decapitation convulsions (PDC's) after repeated administration of 10 mumol/kg orally twice daily, or 66 mumol/kg orally once daily (desipramine), for 15 days. The duration of the PDC's was slightly prolonged by these agents. A single acute dose of desipramine (20 mg/kg) administered at various time intervals before decapitation (1 to 24 hours) had no effect on the PDC's nor did repeated treatment with the other compounds examined, alaproclate, citalopram, clomipramine, mianserin and zimeldine, have any effect upon the PDC latency. The results are interpreted as evidence for noradrenaline receptor subsensitivity following chronic treatment.

Alanine↗

PubMed1988

Therapeutic effect of maprotiline and chlorimipramine: controlled study.

A study was done on 40 outpatients suffering from major affective disorders (uni- and bipolar). Chlorimipramine or maprotiline was administered alternatively (means = 116.25 and 116.75 mg/day, respectively). The therapeutic effect of both antidepressive drugs is very similar, but maprotiline improves the gastrointestinal somatic symptoms faster and seems to be more effective in bipolar patients. It also produces less side effects than chlorimipramine.

Adult↗

PubMed1977

Maprotiline-a double-blind study of a new tetracyclic antidepressant in severe depression.

A double-blind study was carried out comparing the antidepressant properties of maptotiline (a new tetracyclic antidepressant) and amitriptyline. Twenty-one hospitalized severely depressed patients, selected on the basis of clinical and psychometric criteria, completed the trial period of 28 days. The new drug was found to have an order of effectiveness similar to that of amitriptyline and both drugs were effective in agitated as well as retarded forms of depression. For both, the "day of effect", intended as the timing of sharp clinical improvement, tended to occur during the second week of treatment. Both drugs were well tolerated by most patients but one of the maprotiline patients presented a generalized rash which resolved after discontinuation of the drug. In conclusion, maprotiline is seen as an interesting addition to the group of major antidepressant drugs.

Adult↗

PubMed1996

A double-blind, multicentre study of paroxetine and maprotiline in major depression.

OBJECTIVE: This study was performed to compare the clinical efficacy, side effects, and safety of paroxetine and maprotiline, the latter being the most frequently prescribed antidepressant in Switzerland. METHOD: Seventy-one patients (in and outpatients) with major depression were randomly allocated to treatment with paroxetine (20 to 40 mg daily) or with maprotiline (50 to 150 mg daily). Efficacy was measured by means of the Hamilton Psychiatric Rating Scale for Depression, the Montgomery-Asberg Depression Rating Scale, the Clinical Global Impression, and the Hopkins Symptom Checklist. RESULTS: The 2 components showed a similar efficacy. The adverse effect profile was comparable in the 2 treatment groups, although the findings showed a nonsignificant trend pointing in the direction of lower side effects with paroxetine. CONCLUSION: In the moderate dose regimens tested, the 2 components seemed to be of similar efficacy, with comparable profiles of side effects and safety.

Adolescent↗

PubMed1984

Fatal maprotiline intoxication.

We report a fatal case of drug toxicity associated with torsade de pointes following an overdose of the tetracyclic antidepressant, maprotiline (Ludiomil). Tissue and plasma levels were obtained at autopsy and are noted. In addition, the cardiovascular effects, pharmacokinetics, and toxicity of maprotiline are reviewed and compared with that of tricyclic antidepressants.

Adult↗

PubMedDate not supplied

A case of neuroleptic malignant syndrome with acute renal failure after the discontinuation of sulpiride and maprotiline.

A 46-year-old man developed neuroleptic malignant syndrome with acute myoglobinuric renal failure after the discontinuation of sulpiride and maprotiline treatment. He showed the characteristic features of hyperpyrexia, altered consciousness, muscle rigidity, and autonomic dysfunction. Laboratory data showed lysis of skeletal muscle cells and renal impairment. Muscle biopsy revealed necrosis and regenerative changes in muscle fibers. Renal biopsy showed focal tubulitis and interstitial infiltration of small inflammatory cells. The combination of sulpiride and maprotiline has not previously been reported to be the cause of neuroleptic malignant syndrome and acute myoglobinuric renal failure.

Acute Kidney Injury↗

PubMed1985

Isolation and identification of hydroxylated maprotiline metabolites.

Lipophilic maprotiline metabolites were extracted from human urine and animal excreta, with or without prior enzymic hydrolysis, purified by repeated t.l.c. and their structures determined by u.v., n.m.r. and mass spectrometry. Urine from patients under treatment with maprotiline contained the isomeric phenols, 2- and 3-hydroxymaprotiline, the 2,3-dihydrodiol, and an alcoholic metabolite, besides smaller quantities of the corresponding N-demethylated compounds. In dog urine and/or faeces the same products of aromatic hydroxylation were present as in human urine and in addition 3-hydroxy-2-methoxymaprotiline; alcohols were not detected. The only metabolites identified in rabbit urine and rat bile were 3-hydroxy- and 3-hydroxy-2-methoxymaprotiline.

Animals↗

PubMed2002

Simultaneous quantification of citalopram, clozapine, fluoxetine, norfluoxetine, maprotiline, desmethylmaprotiline and trazodone in human serum by HPLC analysis.

We describe an analytical procedure for the simultaneous quantification of citalopram (seropram), clozapine (leponex), fluoxetine (fluctine), norfluoxetine, maprotiline (ludiomil), desmethylmaprotiline and trazodone (trittico) in human serum within a period of 11.5 minutes using reversed phase HPLC. After 2 liquid/liquid extractions in the sample preparation phase, the drugs and metabolites were separated on a C18 column using a mobile phase consisting of acetonitrile/buffer (30/70, v:v) at 70 degrees C, a flow rate of 1.5 m/min and haloperidol as internal standard. Absorption and native fluorescence signals of the eluted compounds were detected simultaneously at 260 nm and 227/300 nm (excitation/emission), respectively. The calibration ranges for citalopram, clozapine, fluoxetine, norfluoxetine, maprotiline, and desmethylmaprotiline ranged from 50-400 microg/l and for trazodone from 50-3,200 microg/l. The CVs varied between 0.6% and 5.5% (within-run) and between 3.2% and 7.1% (between-run). Recoveries were > 90% for all pharmaceuticals. We noticed no interferences from several commonly used drugs.

Antidepressive Agents, Second-Generation↗

PubMed1991

[A randomized controlled trail of maprotiline treatment of depressive disorder].

In order to evaluate the clinical effects of maprotiline (home made), the authors made a clinical comparison with Ludimil (Cida-Geigy) 96 cases (66 endogenous depression and 30 neurotic depression) meet the CMA diagnostic criteria (1984) were analysed. The patients' symptoms were assessed with HAMD, side effects with TESS. The study group included 72 patients treated with chinese product, the rest cases as control group treated with Ludimil. No significant differences of efficacy in terms of age, sex and duration of symptoms were found in both groups. After the six-week course of Maprotiline treatment, the authors found the dosage, therapeutic effect and adverse reaction in both groups are very similar. It is concluded that the chinese product is safe and effective.

Depressive Disorder↗

PubMedDate not supplied

[Treatment of depression with intravenous infusions of clomipramine and maprotiline].

28 patients aged from 31 to 69 years with endogenous depression were studied. All cases were drug-resistant i.e. they did not improve after a treatment with tricyclic antidepressants and in four cases also after electroconvulsive therapy. The group were managed with intravenous infusions of clomipramine or maprotiline followed by oral administration of the drug. Clomipramine was given i.v. at doses 75-300 mg daily for 7 to 16 days and maprotiline at 75-200 mg daily for 6 to 20 days. Remission of depressive symptoms was observed in 43% of cases and the first signs of improvement were observed on tenth day of the treatment. Tolerance to both drugs given parenterally in majority of cases was satisfactory. Half of the group did not show any untoward events. The rest of the group displayed local tissue reactions, both increased and decreased blood pressure, weakness, drowsiness, anxiety, vertigo, hyperpyretic reactions. Four patients had the treatment discontinued because of local tissue reactions or increased blood pressure or hyperpyretic reactions.

Administration, Oral↗

PubMed1989

Moclobemide and maprotiline in the treatment of inpatients with major depressive disorder.

A double-blind study with the substituted benzamide moclobemide, a novel reversible, short acting MAOI with predominant inhibition of MAO-A, and maprotiline, the most selective noradrenaline reuptake inhibitor available at present has been conducted in n = 40 severely depressed inpatients suffering from predominantly endogenous depressions. No significant differences between the two drugs were found using global HRSD, HAMA and self rating scales. Regarding the clinical profile moclobemide seemed to be more effective in retarded depressives, maprotiline was superior in alleviating depressive agitation and sleep disturbances. The latter symptoms were responsible for three cases of treatment withdrawal in the moclobemide group. No case of hypertensive crisis could be registered, though patients were not subject to food restrictions. Maximal concentrations of moclobemide in CSF were reached two hours after oral application, compared to tricyclic antidepressants a high CSF/plasma ratio could be detected.

Anthracenes↗

PubMed1977

[Clinical and experimental experiences with maprotiline, clomipramine, sydnocarb and mefexamide in mentally-ill patients and in healthy persons].

In the present paper we studied the clinical effects of psychotropic drugs. In the experimental part we studied their effects on our patients and normal subjects and compared it with the results obtained with the placebo treatment. We studied the effect on attention (A), efficiency (E) psychomotor rate (PR), numerical quadrate, Bourdon test, tapping and some functions of the vegetative nervous system, the mean orthostatic acceleration (MOA), the clinostatic retardation (CR), the tonus of the sympathetic (TS) and of the vagus (TV). Sydnocarb is an effective psychostimulating agent. The is no evident influence on VN in doses between 5 and 15 mg (23 patients). It accelerated psychomotor rate (24 patients). E, A, PR are only slightly increased by Mephexamid (40 patients). Maprotiline (20) patients caused an increase in E, PR and slightly in A. Under the influence of Sydnocarb, Mephexamid and Maprotiline the value of MOA, CR, TS, TV remained unchanged. Clomipramin was administered in 20 patients in the experimental part and in 40 patients in the clinical part of our study. In the course of the clinical trial we discovered that Clomipramine decreased the irritability of the vegetative nervous system and through this effect causes deserved general sedation of the organism.

Adult↗

PubMed1979

Maprotiline in adult depressed patients. A study of the relation between clinical efficacy and serum concentrations after repeated intravenous and peroral administration.

Maprotiline was administered initially i.v. and then p.o. to 15 adult depressive in-patients daily for three weeks in various dosages. Serum concentrations were monitored in an attempt to find a correlation to clinical response. The steady-state serum concentration attained is independent of the dosage administered. The results suggest that patients who maintain a high serum concentration will show a better therapeutic response to the drug. In 11 out of 14 patients evaluated after three weeks of daily maprotiline therapy the clinical response could be described as excellent or very good. The drug was well tolerated when given by either route.

Administration, Oral↗

PubMed1985

Maprotiline in pain-depression.

A group of 25 patients treated with maprotiline was studied to test the question of second-generation antidepressant effectiveness in chronic pain. Of this group, 18 (72%) responded with a greater than 50% reduction in their pain syndrome. It appears that maprotiline is as effective as earlier antidepressants in the treatment of pain. The enkephalin induction hypothesis is discussed as an explanation for the mechanism of action of antidepressants in chronic pain.

Adult↗

PubMed1977

Maprotiline (Ludiomil) in depression: a multicentre assessment of onset of action, efficacy and tolerability.

Although open studies have a built-in bias of optimism the results from this study, made valid by the large numbers of patients involved, support the findings reported with smaller numbers in controlled series of studies showing an early onset of action with maprotiline (Ludiomil). The method used in this study to detect unwanted effects indicates that maprotiline is well tolerated. In summary, the efficacy of once daily dosage, the good response in differing types of depressive illness, the early onset of effectiveness without serious side-effects in a wide age range of patients suggests that this drug will be a useful addition for the treatment of depressive illness in general practice.

Adjustment Disorders↗

PubMed1984

Maprotiline poisoning: a case of cardiotoxicity and myoclonic seizures.

A 64-year-old man ingested 4500 mg of maprotiline hydrochloride. He developed major motor myoclonic seizures, first-degree AV block, intraventricular conduction delay, hypotension, and urinary retention. Myoclonic seizures have not been previously reported with maprotiline toxicity.

Aged↗

PubMed1982

Maprotiline and seizures.

Maprotiline has been reported to be less likely to cause epileptic seizures than the tricyclic antidepressants. The authors describe two cases in which patients suffered their first epileptic attacks while on therapeutic doses of maprotiline. They recommend that the newer antidepressants, as well as the tricyclics, should not be used with the aliphatic neuroleptics because of a possible additive or synergistic epileptic effect. If patients are to be withdrawn from C.N.S. depressants, then this should be accomplished prior to initiation of antidepressant therapy. Patients who are predisposed to seizures should have lower initial doses of antidepressants.

Adult↗