Generic Drug Therapeutic Class: Neurology-Psychiatry
active ingredients: Amoxapine
Box of 25
Major depressive episodes (that is to say characterized).
Dosage DEFANYL 50 mg Tablet Box of 25
The usual dosage for the treatment of depression ranges from 100 to 400 mg per day.
The initial dose is usually 100 mg, but can be individually adjusted to the recommended dose range. This dosage may be re-evaluated after 3 weeks of effective treatment at effective doses.
Administration mode :
The daily dose will be divided during the day into 1 to 3 doses, away from meals. Once the maintenance dosage has been established, the daily dose can be taken at once at bedtime.
Duration of the treatment :
Antidepressant treatment is symptomatic.
The treatment of an episode is several months (usually about 6 months) to prevent the risk of relapse of the depressive episode.
Associated Psychotropic Treatments:
The addition of a sedative or anxiolytic treatment may be useful at the beginning of treatment, to cover the occurrence or aggravation of manifestations of anxiety. However, anxiolytics do not necessarily protect against the lifting of the inhibition.
Populations at risk:
- Elderly :
Treatment will be initiated at a low dosage, that is, in practice at half the recommended minimum dosage (see pharmacokinetic properties). The increase in doses, if necessary, will be gradual, with clinical surveillance: the adverse effects of imipramines can have serious consequences for the elderly (falls, confusion).
- Hepatic and renal impairment :
Dosage should be decreased (see pharmacokinetic properties).
This medicine MUST NEVER BE prescribed in the following cases:
- Hypersensitivity to amoxapine.
- Known risk of glaucoma by closing the angle.
- Risk of urinary retention related to urethroprostatic disorders.
- Recent myocardial infarction.
- Association with non-selective MAOIs (iproniazid, nialamide) and sultopride (see interactions).
NOT RECOMMENDED :
- This medicine MUST NOT be prescribed in the following cases:
Association with MAOI-A (moclobemide, toloxatone), alcohol, clonidine and related, alpha and beta sympathomimetics (adrenaline, noradrenaline, dopamine for parenteral systemic action) (see interactions).
- Pregnancy: Maintaining a good maternal psychic balance is desirable throughout pregnancy. If medication management is necessary to ensure this balance, it should be instituted or continued in an effective dose throughout pregnancy and if possible in monotherapy. To date, although the data are very limited for amoxapine, they seem to exclude a particular malformation risk of imipramine antidepressants. In neonates of mothers treated at the end of pregnancy with an imipramine antidepressant, signs of impregnation (notably atropine) and / or withdrawal have sometimes been described: neurological disorders in the first week of life (hypotonia, hyperexcitability, tremulations, even exceptionally convulsions); respiratory disorders (polypnea, cyanosis, even exceptionally respiratory distress); digestive disorders (difficulty of starting the diet, delay in the emission of meconium and abdominal distension). All these signs appear in the first days of life and are most often of short duration and not severe. Given these data, it is best to avoid using amoxapine during pregnancy, regardless of the term. However, treatment should not be stopped abruptly to avoid a risk of withdrawal for the mother. If it is necessary to initiate or maintain amoxapine treatment during pregnancy, consider the effects described above for monitoring the newborn.
- Breast-feeding: The passage into breast milk is poorly known but probably weak; however, as a precaution, breastfeeding should be avoided during the course of treatment.
Defanyl side effects
They derive for the most part from the pharmacological properties of imipramine antidepressants.
- Related to the peripheral effects of the molecule: they are usually benign and usually give way to further treatment or a reduction in dosage.
. Anticholinergic effect (in order of decreasing frequency): dry mouth, constipation, accommodation disturbances, tachycardia, sweating, urination problems and possibly urinary retention;
- Adrenolytic effect: orthostatic hypotension, impotence. - related to central effects:. frequently observed: somnolence or sedation (antihistaminic effect), more marked at the beginning of treatment;
. much rarer: tremors, seizures on predisposed terrain, transient confusional states, serotonin syndrome (in combination).
- Related to the nature of depressive illness:
. removal of psychomotor inhibition, with suicidal risk;
. reversal of mood with onset of manic episodes;
. reactivation of delirium in psychotic subjects.
- Imipramine antidepressants may also result in: weight gain, . Conduction or rhythm disorders (with high doses),
. endocrine disorders: breast hypertrophy, galactorrhea, . hot flashes, . allergic skin reactions,
. exceptional cytolytic or cholestatic hepatitis, . haematological disorders: hypereosinophilia, leukopenia, agranulocytosis, thrombocytopenia,
Some of these side effects can be prevented or prevented by adjuvant or corrective therapies, or even reduction of the dosage.