Amitriptyline/Perphenazine

DEA Class;  Rx

Common Brand Names; 

  •  Psychotherapeutic Combos

Oral combination phenothiazine antipsychotic and tricyclic antidepressant
Used for schizophrenia and for moderate to severe anxiety/agitation and associated depressive symptoms
Boxed warning for increased risk of suicidality in children, adolescents, and young adults during early treatment phase and increased mortality risk in elderly patients with dementia-related psychosis

Indicated for the treatment of depression in patients with moderate to severe anxiety and/or agitation.

For the treatment of schizophrenia in patients who have associated depressive symptoms.

Tricyclic Antidepressant (amitriptyline): hypersensitivity, severe cardiovascular disorder, narrow angle glaucoma, within 14 days of MAOIs (risk of serotonin syndrome), any drugs or conditions that prolong QT interval, acute recovery post-MI

Antipsychotic (perphenazine): hypersensitivity, CNS depression, neuroleptic malignant syndrome, poorly controlled seizure disorder, subcortical braine damage, coma, severe obtundation, high dose CNS depressants, blood dyscrasia, myelosuppression, liver damage

Myocardial infarction

Heart failure

Stroke 

Ventricular tachycardia

Seizures 

Coma 

Retinopathy

Visual impairment

Laryngeal edema 

Pregnancy Category: D

Lactation: excreted in breast milk; not recommended

Adults

The usual maximum is 16 mg/day PO perphenazine and 200 mg/day PO amitriptyline.

Geriatric

16 mg/day PO perphenazine and 200 mg/day PO amitriptyline.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Amitriptyline hydrochloride/perphenazine

tablet

  • 10mg/2mg
  • 25mg/2mg
  • 10mg/4mg
  • 25mg/4mg
  • 50mg/4mg

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