Generic Drug Therapeutic Class: Neurology-Psychiatry
active ingredients: Amoxapine
Bottle (+ measuring syringe graduated in mg) of 20 ml
Major depressive episodes (that is to say characterized).
Dosage DEFANYL 50 mg / ml Oral solution Bottle (+ measuring syringe graduated in mg) of 20 ml
Use the appropriate dosage of tablets (25, 50, 100 or 200 mg) or the solution form depending on the daily dose prescribed.
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 person (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).
- Breast-feeding: The passage into breast milk is poorly known, but probably poor; 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 most often give way to further treatment or a reduction in dosage:
- Anticholinergic effect (in order of decreasing frequency): dry mouth, constipation, accommodation difficulties, tachycardia, sweating, urination problems and possibly urinary retention.
- Adrenolytic effect: orthostatic hypotension, impotence.
Related to central effects :
- frequently observed: somnolence or sedation (antihistamine effect), more marked at the beginning of treatment.
- much rarer: tremor, convulsive 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;
- disorders of conduction or rhythm (with high doses);
- endocrine disorders: breast hypertrophy, galactorrhea;
- hot flashes;
allergic skin reactions;
- cytolytic hepatitis or exceptional cholestasis;
- hematological 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.