Editing Maprotiline (section)

==Side effects==
The side-effect profile is comparable to other TCAs and TeCAS and many of the following are due to [[anticholinergic]] (which are less prominent than those of most TCAs) and [[antihistamine]] effects.<ref name = DrugDex /> Most often seen are:
* [[Dizziness]]
* Drowsiness
* [[Somnolence]]
* [[Fatigue (medical)|Fatigue]]
* [[Xerostomia|Dry mouth]] (and complications of long-term uncontrolled dry mouth such as [[dental caries]]) 
* [[Constipation]]
* [[Vertigo]]
* [[Nausea]] (rare, incidence of ~2%) and vomiting
* Increased appetite and weight gain
* [[Orthostatic hypotension]], [[hypertension]], [[sinus tachycardia]], [[heart-block]], [[arrhythmias]] and other cardiac effects
* [[Sexual dysfunction]] in men: [[erectile dysfunction|impotence]], [[priapism]], [[delayed ejaculation]], [[anejaculation]], [[Hypoactive sexual disorder|decreased libido]]
* Sexual dysfunction in women: decreased libido, [[vaginal dryness]], [[Dyspareunia|painful sexual intercourse]], [[anorgasmia]]
* Allergic skin reactions such as [[rash]] or [[urticaria]] (more often than with other antidepressants). Rarely, severe skin reactions such as [[erythema multiforme]] can occur.
* [[Photosensitivity]]
* Agitation, confusion
* Induction of [[hypomania]] or [[mania]] in patients with underlying [[bipolar affective disorder]]
* [[Psychotic]] symptoms
* [[Tremor]]
* [[Extrapyramidal symptoms]]
* [[Headache]]
* [[Seizure]]s (at high doses)
* Rare haematological complications: [[leukopenia]] and [[agranulocytosis]] (dangerous fall in white blood cells)
* [[Fever]]
* Urinary retention

Maprotiline causes a strong initial sedation (first 2 to 3 weeks of therapy) and is therefore indicated to treat agitated patients or those with suicidal risks. It causes [[anticholinergic]] side effects (dry mouth, constipation, urinary hesitancy, etc.) with much lower incidence than [[amitriptyline]]. Originally, the manufacturer claimed that maprotiline is better tolerated than other TCAs and TeCAs. However, seizures, leukopenia and skin reactions occur more often with maprotiline than with comparable drugs (e.g., amitriptyline, protriptyline, [[mirtazapine]]). Indeed, [[seizures]] are greater risk for concern with maprotiline than with all other tricyclic antidepressants<ref name="pmid6421394">{{cite journal | vauthors = Knudsen K, Heath A | title = Effects of self poisoning with maprotiline | journal = British Medical Journal (Clinical Research Ed.) | volume = 288 | issue = 6417 | pages = 601–3 | date = February 1984 | pmid = 6421394 | pmc = 1444313 | doi = 10.1136/bmj.288.6417.601 | url = }}</ref> (rising from 75&nbsp;mg, becoming significant at daily doses ≥ 200 m.g.), including [[clomipramine]]. It should thus be prescribed with particular, if not extreme, caution to people with a history of [[epilepsy]]/seizures of any other kind. In any case, the total daily dose should be kept to ≤ 225 milligrams.

Maprotiline has no known potential for abuse and psychological dependence.

===Withdrawal===
Withdrawal symptoms frequently seen when treatment with maprotiline is stopped abruptly (agitation, anxiety, insomnia, sometimes activation of mania or rebound depression) can be avoided by reducing the daily dose of maprotiline gradually by approximately 25% each week. If treatment has to be stopped at once for medical reasons, the use of a benzodiazepine (e.g., lorazepam, clonazepam, diazepam) for a maximum of 4 weeks as needed will usually suppress withdrawal symptoms.