This document provides information on various antidepressant medications, including tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRs). It lists several TCAs and SSRIs, and then provides details for each individual drug, including brand names, dosage forms, strengths, manufacturers, indications, contraindications, half-lives, and dosing information. The document is intended to educate about different antidepressant options and their proper use and dosing.

2. Presented by:
Group 2
Degree:
Pharm D
Topic:
Antidepressants
Presented to:
Dr. Abdul Aleem

3. ANTIDEPRESSANTS
TRICYCLIC ANTIDEPRESSANTS
(TCAs)
Nortriptyline
Maprotiline
Imipramine
Clomipramine
Amitriptyline
SELECTIVE SEROTONIN
REUPTAKE INHIBITORS (SSRIs)
Citalopram
Fluoxetine
Sertraline
Paroxetine

4. TRICYCLIC ANTIDEPRESSANTS
(TCAs)

5. 1. Nortriptyline
 Brand name:
Motival
 Dosage form:
Tablet
 Strength:
each tablet contain 10mg nortriptyline HCL and 0.5mg
fluphenazine HCL
 Company:
GlaxoSmithkline Pakistan Limited
 Indications:
For short term treatment of patients suffering from
moderate to severe symptoms of mixed anxiety and
depression.

6.  Contraindications:
during the acute recovery period after myocardial
infarction.
patients receiving large doses of CNS depressants
(narcotics, barbiturates, hypnotics)
In patients with liver damage or blood dyscrasias
first trimester of pregnancy
 Half life :
16-38 hours
 Dose:
in adults one tablet 3 times daily.
elderly persons should take one tablet twice daily.
children should not be given.

8. 2. Maprotiline
 Brand name:
LUDIOMIL
 Dosage form:
Tablet
 Strength:
25mg
 Company:
NOVARTIS PHARMA (PAK) LTD
 Indications:
primarily indicated in conditions like depression

9.  Contraindications:
epilepsy, mania, myocardial infarction, urinary retention,
narrow angle glaucoma
 Half life:
27-58 hours
 Dose:
For outpatients ( mild to moderate depression):
initial 75 mg per day for 2 weeks
increase by 25mg to effective dosage, not to exceed 150 mg/day
Geriatric:50-75 mg/day
For inpatient ( severe depression):
initial 100-150mg per day for 2 weeks
increase cautiously to effective dosage, not to exceed 225 mg/day
Geriatric: 50-75 mg/day

10. 3. Imipramine
 Brand name:
Tofranil, Imidol
 Dosage form:
Tablet
 Strength:
25mg
 Company:
Indus pharma, Siza international (Pvt.) Ltd
 Indications:
To treat depression
nocturnal enuresis ( urination while asleep) in children
anorexia nervosa ( eating disorder)

11.  Contraindications:
epilepsy, mania, hypersenstivity, post myocardial
infarction, urinary retention.
 Half life:
6-20 hours
 Dose:
PEDIATRIC
Enuresis: 10-25mg for 1-2 weeks
6-12years:not to exceed 50 mg/day
12-14 years: not to exceed 75 mg/day
Depression: 1.5mg/kg/day/; may increase3-4 days by 1 mg/kg;
not to exceed 5 mg/kg/day

12. ADULT
Depression: 75mg/day initially; may increase to 150 mg/day gradually;
not to exceed 200 mg/day ( outpatient)
100-150 mg/day; may increase gradually to 200 mg/day; if
no response after 2 weeks; may increase further to 250
-300 mg/day; not to exceed 300 mg/day (inpatient)
GERIATRIC
Depression: 5-50 mg/day; may increase after 3 days for inpatients and
weekly for outpatients; not to exceed 100 mg/ day

14. 4. Clomipramine
 Brand name :
Clomfranil
 Dosage form:
Tablet
 Strength:
10 mg, 25mg
 Company:
NOVARTIS PHARMA (PAK) LTD
 Indications:
Phobic states, obsessive compulsive disorder, depression

15.  Contraindications:
cardiac arrhythmia, mania, narrow angle
glaucoma, hypersensitivity, urinary retention.
 Half life:
32 hours
 Dose:
25 mg/day initially; gradually increase to 100 mg/day over 2
weeks ( adult and geriatric).
not recommended for pediatric.

16. 5. Amitriptyline
 Brand name:
Tryptanol
 Dosage form:
Tablet
 Strength:
25 mg
 company:
OBS
 Indications:
Depression, chronic pain, tension headache, enuresis.

17.  Contraindications:
Prostatic hypertrophy, myocardial infarction, glaucoma.
 Half life:
21 hours
 Dose:
ADULT
Depression:25-50 mg initially
increase by 25 mg every 5-7 days to 100-200 mg/day
(may divide doses throughout day or give at bedtime)
Migraine depression: 10-25 mg initially;10-400 mg dose range

18. PEDIATRIC
depression: recommended for 5-12 years children.
1 mg/kg/day.
chronic pain:0.5-2 mg/kg

19. SELECTIVE SEROTONIN
REUPTAKE INHIBITOBRS
(SSRIs)

20. 1. Citalopram
 Brand name:
Cipram, Citalo, Hapicit
 Dosage form:
Tablet
 Strength:
20 mg
 Company:
Lundbeck Pakistan (Pvt.) Ltd, Plantinium pharmaceuticals
(Pvt.) Ltd, Adamjee pharmaceuticals (Pvt.) Ltd

21.  Indications:
Citalopram is primarily indicated in conditions like;
alcohol dependence, depression, panic disorder,
obsessive compulsive disorder.
 Contraindications:
mania, epilepsy, psychosis, impaired hepatic
function, narrow angle glaucoma.
 Half life:
24-48 hours
 Dose:
initial dose 20 mg/day; if needed may increase to 40 mg/day
after at least 1 week ( adult).
For geriatric: don’t exceed 20 mg/day.

23. 2. Fluoxetine
Brand name:
Depex, Prozac, Flux, Zauxit
Dosage form:
Capsule
Strength:
20 mg
Company:
Martin Dow, Hilton Pharma (Pvt.) Ltd, ZAFA Pharmaceutical
Laboratories.
Indications:
control of muscarinic side effects of neostigmine, depression,
panic disorder, obsessive compulsive disorders.

24. Contraindications:
liver impairment, hypersensitivity, diabetes, mania,
stable epilepsy.
Half life:
1-4 days
Dose:
initial 20 mg/day; may gradually increase after several weeks
by 20 mg/day; not to exceed 80 mg/day ( adult)
Not recommended for children up to 8 years.
10-20 mg initially; not to exceed 20 mg/day ( above 8 years)
10 mg/day; do not take at night unless sedation occurs (geriatric)

26. 3. Sertraline
 Brand name:
Sert, Zoloft, Serlin
 Dosage form:
Tablet
 Strength:
100 mg, 50 mg
 Company:
Barrett Hodgson Pakistan (Pvt.) Ltd, Pfizer Laboratories
Ltd, Amarant Pharmaceuticals (Pvt.)
 Indications:
Depression, panic attack, post traumatic stress disorder

27.  Contraindications:
liver impairment, unstable epilepsy
 Half life:
24-48 hours
 Dose:
ADULT
Tablet:50 mg/day initial dose; may increase by 25 mg at
weekly intervals; not to exceed 200 mg/day.
Capsule: Don’t use to initiate treatment
recommended dosage 150-200mg/day; not to exceed
200 mg/day.

28. PEDIATRIC
6-12 years: 25 mg/day
12-17 years: 50 mg/day
GERIATRIC
25 mg/day initially; increase by 25 mg after 1 week;
not to exceed 200 mg.

29. 4. Paroxetine
 Brand name:
Paraxyl CR, Seroxat CR
 Dosage form:
Tablet
 Strength:
20 mg, 25 mg
 Company:
Consolidated chemical Laboratories (Pvt.) Ltd,
GlaxoSmithKline.
 Indications:
Depression, Obsessive compulsive disorder, post traumatic
stress disorder, social phobia.

30.  Contraindications:
heart failure, hypersensitivity, mania, epilepsy
seizures.
 Half life:
17-22 hours
 Dose:
Not recommended for pediatric and geriatric.
ADULT
Depression: 20 mg/day; not to exceed 62.5 mg/day
Social phobia: 12.5 mg/day; not to exceed 37.5 mg/day
Post traumatic stress: 20mg/day; up to 50 mg/day have
been used but no benefit seen at
doses >20 mg/day.