Melitracen: Tricyclic Antidepressant for Depression
Melitracen is a tricyclic antidepressant belonging to the dibenzocycloheptadiene group, possessing antidepressant and anxiolytic properties. The drug inhibits the reuptake of norepinephrine and serotonin in the central nervous system, increasing their concentration in the synaptic cleft, thereby improving mood and reducing anxiety.
Melitracen is most widely used in a fixed-dose combination with flupentixol (known under the trade name Deanxit), which combines the antidepressant properties of melitracen with the anxiolytic and activating effects of low-dose flupentixol. On Unifarm, you can find generic versions of medications containing this active ingredient.
Indications
- Mild-to-Moderate Depressive Disorders: Treatment of depression, particularly when accompanied by anxiety, restlessness, and asthenia.
- Mixed Anxiety-Depressive States: Treatment of combined anxiety and depressive disorders.
- Psychosomatic Disorders: Treatment of somatic complaints caused by anxiety-depressive disturbances (abdominal pain, headaches, neurotic cardiac pain).
- Astheno-Depressive Syndrome: Conditions accompanied by apathy, reduced motivation, and chronic fatigue.
Dosage and administration
Melitracen is most commonly used in a fixed-dose combination with flupentixol. It is rarely used as a monotherapy agent.
Combination melitracen + flupentixol (Deanxit):
- Standard dose: 1 tablet (melitracen 10 mg + flupentixol 0.5 mg) 1–2 times daily, in the morning and at noon.
- Maximum dose: 2 tablets in the morning and 2 tablets at noon (total 4 tablets daily).
Melitracen as monotherapy (when available):
- Standard dose: 25–75 mg daily, divided into 1–3 doses.
- Maximum dose: 150 mg daily (in a hospital setting).
The drug should be taken in the morning and early afternoon. Evening administration is not recommended due to the potential activating effect and sleep disturbance. Discontinuation should be gradual.
- Hypersensitivity to melitracen or any component of the product.
- Acute myocardial infarction and recovery period.
- Cardiac conduction disorders (heart block, arrhythmias).
- Untreated narrow-angle glaucoma.
- Urinary retention, severe prostatic hyperplasia.
- Concomitant use with MAO inhibitors (at least 14-day washout required).
- Manic states or manic phase of bipolar disorder.
- Pregnancy and breastfeeding (use only when strictly necessary).
- Pediatric use (limited safety data).
Side effects of melitracen are typical of tricyclic antidepressants and are mainly related to anticholinergic activity. Common adverse reactions include:
- Anticholinergic effects: Dry mouth, constipation, urinary retention, blurred vision, increased intraocular pressure.
- Neurologic: Drowsiness or insomnia, dizziness, tremor, headache.
- Cardiovascular: Orthostatic hypotension, tachycardia, cardiac conduction disturbances, QT prolongation.
- Metabolic: Weight gain, increased appetite.
- Gastrointestinal: Nausea, dyspepsia.
- Endocrine: Libido changes, erectile dysfunction.
- Dermatologic: Sweating, skin rash, photosensitivity.
- Psychiatric: Agitation, anxiety (at treatment initiation), mood switching (to mania in predisposed patients).
- Withdrawal syndrome: Headache, nausea, irritability upon abrupt discontinuation.
