Protriptyline adverse effects

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. 

There are no accurate data on the worldwide use of the many tricyclic compounds listed in Table 1, and the availability of particular drugs varies from country to country. The dosage range for all these compounds is 50-300 mg/ day, with the exception of nortriptyline, which has an upper limit of 200 mg, and protriptyline, which is more potent (range 10-60 mg/day). Well-controlled comparisons are few, but it is clear that these drugs resemble each other more than they differ. Their adverse effects will be discussed for the class as a whole, with distinguishing features of specific compounds mentioned when appropriate. 

I. Antidepressants. The manufacturer notes that there was no pharmacokinetic interaction between sodium oxybate and protriptyline, but that the possibility of a pharmacodynamic interaction was not assessed.The UK manufacturer states that the rate of adverse effects was increased when sodium oxybate was given with tricyclic antidepressants. ... 

TCAs Once-a-day dosing may be prescribed for maintenance therapy. When the nurse administers the total daily dosage at night, the sedative effects promote sleep, and the adverse reactions appear less troublesome Because protriptyline may produce a mild stimulation in some patients, it is usually not given as a single bedtime dose... 

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