Protriptyline is a type of drug referred to as a tricyclic antidepressant. It is often prescribed for depression. In the United States, it is commonly marketed under the brand name Vivactil®. This medication works by increasing natural chemicals in the brain to restore mental balance.
Patients taking protriptyline should carefully follow the doctor's dosing instructions. Typically, this drug is taken three times daily. Adults will normally take a total of 15 to 40 milligrams (mg) per day. Dosages do not usually exceed 60 mg. Teenagers and seniors may start with a 15 mg total daily dose, which may be increased as needed under a doctor's supervision.
Some teenagers and young adults became suicidal while taking antidepressants during clinical studies. The patient should monitor himself carefully for signs of worsening depression, suicidal thoughts, and aggressive behavior. A patient's caregivers or family should also be aware of these possible developments so they can get help immediately if they notice these signs.
People taking protriptyline are typically expected to meet with a doctor regularly. The physician will usually monitor the patient's progress and evaluate the efficacy of the drug. Any side effects the patient experiences should be disclosed.
Some possible side effects that protriptyline may cause include nausea, vomiting, and diarrhea, as well as weight changes and stomach pain. It may also cause dizziness, drowsiness, and flushing or sweating. Serious side effects — such as difficult speech, numbness, and irregular heartbeat — require immediate medical attention. The drug may also cause uncontrollable shaking, hallucinations, and blurred vision, as well as fever, confusion, and severe chest pain.
Not everyone is a suitable candidate for protriptyline. Patients who have diabetes, heart disease, and bipolar disorder may be unable to use this drug. Those who have recently suffered a heart attack, or who have glaucoma, urination problems, or schizophrenia may also need to consider an alternative medication.
Protriptyline can cause a life-threatening reaction if the patient uses it within 14 days of taking the drug cisapride or a monoamine oxidase (MAO) inhibitor. Examples of MAO inhibitors are selegiline, rasagiline, and tranylcypromine. In addition, patients who are planning surgery should notify the surgeon about their medications. Protriptyline may need to be discontinued for a period of time prior to the surgery.
This drug can interact with alcohol. Patients should avoid consuming alcoholic drinks while taking it. They should also avoid grapefruit, grapefruit juice, and other grapefruit products. Protriptyline may also interact with cold medicines, muscle relaxers, and pain medications, causing the patient to become very sleepy.
Those who wish to discontinue using this medication should check with a doctor first. A gradual decrease in dosage may be necessary. Withdrawal effects may result if the medication is abruptly discontinued. These symptoms can include malaise, nausea, and headaches.