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What is the most important information I should know about protriptyline?

Do not use protriptyline if you have recently had a heart attack, or if you have taken cisapride (Propulsid) or used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What is protriptyline?

Protriptyline is in a group of drugs called tricyclic antidepressants. Protriptyline affects chemicals in the brain that may become unbalanced.

Protriptyline is used to treat symptoms of depression.

Protriptyline may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking protriptyline?

Do not use this medication if you are allergic to protriptyline, or if you have recently had a heart attack. Do not use protriptyline if you have taken cisapride (Propulsid) or used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take protriptyline before the MAO inhibitor has cleared from your body.

Before taking protriptyline, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;

• a history of heart attack, stroke, or seizures;

• bipolar disorder (manic-depression);

• schizophrenia or other mental illness;

• diabetes (protriptyline may raise or lower blood sugar);

• glaucoma; or

• problems with urination.

If you have any of these conditions, you may not be able to use protriptyline, or you may need a dosage adjustment or special tests during treatment.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether protriptyline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to anyone under 18 years old without the advice of a doctor.