Protriptyline action

Protriptyline is a powerful antidepressant, the mechanism of action of which is not known. It is not a MAO inhibitor and does not stimulate the CNS. It begins to act much faster and acts much longer than imipramine or amitriptyline. Protriptyline does not possess sedative tranquilizing properties. It is used in clinical conditions for treating severe depression. The most common synonyms are concordin, triptil, and vivactil. 

Relief of symptoms of depression (except clomipramine). The activating properties of protriptyline make it particularly suitable for withdrawn and anergic patients. Agents with significant sedative action may be useful in depression associated with anxiety and sleep disturbances. The activating properties of protriptyline make it particularly suitable for withdrawn and anergic patients. 

FIGURE 7—40. Adrenergic combo 1 Bupropion plus norepinephrine reuptake inhibitor (NRI). Here the NE actions of bupropion are double-boosted by the NRI (either selective reboxetine or nonselective desipramine, maprotilene, nortriptyline, or protriptyline). Dopamine is single-boosted by bupropion only. 

These result from the drug s sympathoplegic actions. The major adverse effect is postural hypotension. This effect can be almost totally prevented by concomitant administration of a tricyclic antidepressant agent such as protriptyline. Nausea and vomiting may occur after the intravenous administration of a bolus of bretylium. 

CNS and cardiovascular actions of d,l-methylphenidate could theoretically be enhanced by combination with agents that block norepinephrine reuptake, such as the tricyclic antidepressants desipramine or protriptyline, venlafaxine, duloxetine, atomoxetine, milnacipran, and reboxetine... 

Protriptyline exhibits high selectivity for the NE transporter, but with less potenoy than desipramine. Its mechanism of action is similar to that of desipramine. Minimal effect on 5-HT reuptake has been observed. 

Sham rage produced by brain stem transection in cats is accompanied by changes in brain stem norepinephrine. Rage is increased by protriptyline that increases the action of norepinephrine, and by haloperidol that depresses its action. 

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