Amoxapine

DEA Class;  Rx

Common Brand Names; Asendin

  • Antidepressants, TCAs

Norepinephrine reuptake inhibitor with dopamine antagonist properties
Used for the treatment of major depression in adults, including depression with psychotic features, concurrent anxiety, or agitation
Requires close monitoring in pediatrics and young adults due to increased risk of suicidality during the initial stages of treatment

Indicated for the treatment of major depression.

Hypersensitivity

Severe cardiovascular d/o

Uncorrected narrow angle glaucoma

Within 14 day of MAOIs (risk of serotonin syndrome); if linezolid or IV methylene blue (MAOIs) must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity; may resume 24 hr after last linezolid or methylene blue dose, or after 2 weeks of monitoring, whichever comes first

Any drugs or conditions that prolong QT interval

Acute recovery post-MI

  • Constipation (12-14%)
  • Dry mouth (12-14%)
  • Sedation (12-14%)
  • Anxiety
  • Ataxia
  • Blurred vision
  • Confusion
  • Dizziness
  • Edema
  • Headache
  • Fatigue
  • Nausea
  • Nervousness/restlessness
  • Prolactin levels increased
  • Rash
  • Sweating
  • Tremor
  • Weakness
  • Agranulocytosis
  • Diarrhea
  • ECG changes
  • EPS
  • Flatulence
  • Galactorrhea
  • Hypertension
  • Leukopenia
  • Menstrual irregularity
  • Mydriasis
  • Orthostatic hypotension
  • Seizure
  • Urinary retention
  • Urticaria
  • Vomiting
  • Tachycardia

BPH, urinary/GI retention, incr IOP, hyperthyroidism, opne angle glaucoma, seizure d/o, brain tumor, respiratory impairment, hyperthyroidism

Clinical worsening & suicide ideation may occur despite medication in adolescents & young adults (18-24 yo)

Risk of anticholinergic side effects

Possibility of tardive dyskinesia & NMS

Pregnancy Category: C

Lactation: enters breast milk; use with caution

Adults

400 mg/day PO outpatients; 600 mg/day PO inpatients.

Geriatric

300 mg/day PO, but lower doses (i.e., 150 mg/day PO) often adequate.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Infants

Not indicated.

Amoxapine

tablet

  • 25mg
  • 50mg
  • 100mg
  • 150mg

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