Melitracen – Tricyclic Antidepressant for Anxiety and Depression

Melitracen is an antidepressant from the tricyclic compound group (TCA), characterized by a bipolar pharmacological profile. The drug combines a moderate thymoanaleptic (mood-enhancing) action with a pronounced activating and energizing effect. Its mechanism of action is based on the non-selective inhibition of monoamine reuptake, primarily norepinephrine and serotonin, in the synaptic cleft of central nervous system neurons. This leads to enhanced neurotransmission and correction of the biochemical imbalance typical of depressive states.

The uniqueness of melitracen lies in its ability to rapidly eliminate retardation, apathy, and lack of initiative, which distinguishes it from many sedative antidepressants of the same group. In clinical practice, it is rarely used as monotherapy. Most often, melitracen is used in a fixed-dose combination with the neuroleptic flupentixol. This combination achieves a synergistic effect: melitracen provides a boost in mood and vitality, while low doses of the neuroleptic counteract potential anxiety and psychomotor agitation that may arise from activation. The drug is well absorbed orally and has a long half-life, ensuring a stable therapeutic effect throughout the day.

The drug is taken orally. Treatment requires caution in patients with cardiovascular diseases due to the risk of affecting myocardial conduction.

Wikipedia page
Melitracen

Indications

Melitracen is indicated for the treatment of various affective disorders in adults:

  • Depressive States: mild to moderate depression accompanied by apathy, lethargy, and loss of interest in life.
  • Asthenic Depression: conditions where fatigue and lack of energy are the primary features.
  • Masked Depression: somatic complaints without an organic cause occurring against a backdrop of low mood.
  • Psychosomatics: as part of combination therapy for the treatment of neurotic disorders related to chronic stress.

Dosage and administration

The dosing regimen for melitracen is determined by a physician, often based on the use of combined dosage forms.

  • Standard Dose: in monotherapy, it is usually 25–50 mg two or three times daily.
  • Combination Therapy: when combined with flupentixol, it is usually taken as 1 tablet (containing 10 mg of melitracen) in the morning and at noon.
  • Administration Method: tablets are taken orally with water, regardless of food intake.
  • Time Restrictions: due to its activating effect, the drug is not recommended for evening use (after 4:00 PM–5:00 PM) to avoid sleep disturbances.
  • Duration: the therapeutic effect usually appears within 7–10 days; however, a full course of therapy may last several months.

Melitracen is contraindicated in the following conditions, typical for most tricyclic antidepressants:

  • Hypersensitivity: known allergy to melitracen or other drug components.
  • Myocardial Infarction: acute phase and the recovery period following an infarction.
  • Rhythm Disturbances: heart blocks and other serious myocardial conduction disorders.
  • Glaucoma: closed-angle form due to anticholinergic effects.
  • Urinary Retention: severe prostatic hypertrophy.
  • MAO Inhibitors: concomitant use is contraindicated (a gap of at least 14 days is required between treatments).

Side effects of melitracen are related to its influence on receptors and the autonomic nervous system:

  • Anticholinergic Effects: dry mouth, blurred vision, and constipation.
  • Nervous System: insomnia (due to stimulating action), mild tremor, and dizziness.
  • Cardiovascular: tachycardia (rapid heartbeat) and orthostatic hypotension.
  • Digestion: nausea, changes in appetite, and sometimes heartburn.
  • General Reactions: increased sweating and general weakness during the initial stages of treatment.

Frequently Asked Questions

Melitracen is a bicyclic antidepressant. Its mechanism of action is similar to that of tricyclic antidepressants, as it increases the concentration of neurotransmitters (norepinephrine and serotonin) in the synapses of the central nervous system. This helps restore emotional balance and alleviate symptoms of depression.
The key feature of melitracen is its activating and energizing effect. Unlike sedative antidepressants, melitracen helps combat apathy, lethargy, and lack of initiative. It restores the patient's vitality and the capacity for active engagement.
The combination of melitracen and flupentixol is a classic regimen for treating psychosomatic disorders and asthenic depressions. Melitracen relieves despondency and provides energy, while flupentixol (in low doses) targets anxiety and restlessness. Together, they provide a balanced effect without causing excessive sedation.
Due to its pronounced stimulating effect, it is recommended to take melitracen during the first half of the day (morning and midday). Taking the medication in the evening may cause difficulty falling asleep, excessive alertness, or insomnia. The exact dosing schedule should always be determined by a physician.
Melitracen should not be taken during the acute recovery period following a myocardial infarction, in patients with cardiac arrhythmias, or those with closed-angle glaucoma. It is vital to avoid concurrent use with MAO inhibitors—a gap of at least 14 days is required between these medications to prevent the risk of severe adverse reactions.

List of medicines by active substance

-18%
Anxino 0.5 mg / 10 mg Everest
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Everest

Anxino

Flupentixol + Melitracen
0.5 mg / 10 mg 50 tablets
398₴ 486₴
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