II. Indications
III. Adverse Effects
- See Tricyclic Antidepressant
- Significant Anticholinergic effects, including sedation
IV. Safety
- Unknown safety in pregnancy
- Avoid in Lactation
V. Mechanism
- See Tricyclic Antidepressant
- Primarily affects Norepinephrine reuptake
VI. Dosing (Adults and Age over 12 years)
-
Mood Disorders (Major Depression, Anxiety Disorder)
- Start: 75 mg orally at bedtime
- Titrate to 50 to 150 mg/day as tolerated and to effect
- Max: 300 mg/day (divide higher doses, above 150 mg/day, twice daily)
-
Insomnia
- Adult: 6 mg orally 30 min before bed
- Elderly (over age 65 years): 3 mg orally 30 min before bed
- May advance to 6 mg orally as needed
-
Pruritus
- Start 10 to 25 mg orally at bedtime
- Titrate to 10 to 100 mg/day as tolerated and to effect
VII. Resources
VIII. References
- (2023) Med Lett Drugs Ther 62(1592): 25-32
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 38-9
- Hamilton (2020) Tarascon Pocket Pharmacopoeia