Amoxapine

A treatment for the symptoms of depression, Amoxapine has demonstrated effectiveness on the central nervous system in increasing levels of important

Overview

What is Amoxapine?

Amoxapine is a tricyclic antidepressant (TCA) that is prescribed by a medical doctor to treat the symptoms of depression, a common mental disorder that approximately over 300 million people worldwide suffer from. Taken in tablet form, Amoxapine is also sold under the brand name Asedin, among other names.

Primarily prescribed to treat major depressive disorder, Amoxapine is also prescribed for use in the treatment of a number of anxiety disorders, social phobias, obsessive-compulsive disorder, schizophrenia and various panic disorders. You may also be prescribed Amoxapine if you suffer from post-traumatic stress disorder, body dysmorphic disorder, anorexia nervosa, bulimia and certain personality disorders such as borderline personality disorder. Patients who experience the symptoms of ADD and ADHD, as well as Parkinson's disease, chronic pain, neuropathic pain, fibromyalgia or migraine headaches, may also benefit from a prescription of Amoxapine.

What is a TCA?

Amoxapine is of the drug classification called a tricyclic antidepressant or TCA. A tricyclic antidepressant gets its name from the chemical structure it is made up of, which consists of three rings of atoms.

How does Amoxapine work?

Amoxapine works by directly affecting the neurotransmitters found in the brain. Neurotransmitters are a naturally occurring chemical messenger that is involved in maintaining all bodily functions. Two neurotransmitters that specifically control the regulation of mood are noradrenaline and serotonin.

When a person experiences depression, there may be a low level of both noradrenaline and serotonin released from the nerve cells in the brain. As these two chemicals aren’t present in enough quantity to regulate the person’s mood, they just don’t have any effect and are reabsorbed into the nerve cells as if they never existed.

Amoxapine steps in to prevent the reabsorption of both noradrenaline and serotonin by the nerve cells and develop them to a normal, effective level, thus relieving the dark mood and symptoms of depression.

How long does it take for Amoxapine to have an effect?

Amoxapine and other TCA treatments may take a while to do their work of building up the presence of noradrenaline and serotonin chemicals in the body. Typically, patients experience an effect on their mood within 14 days of treatment. Occasionally, some patients may take up to four to eight weeks to fully experience the benefits of Amoxapine. Patients are encouraged to continue taking Amoxapine to give the drug a chance to build up their body’s level of noradrenaline and serotonin.

How long is the course of treatment with Amoxapine?

Even after the patient has been taking Amoxapine for weeks or months and their mood is better, with symptoms of depression fading into the background, it is recommended that they continue a course of maintenance dosage for a further six months to lessen the chances of recurrence of depression. People with known recurrent depression typically continue a course of treatment with Amoxapine for up to two years.

Is Amoxapine addictive?

While there is a possibility for a TCA drug such as Amoxapine to give a patient unpleasant withdrawal symptoms when the dosage is stopped, this is a temporary feeling and does not include a craving or need for the drug itself. The withdrawal symptoms can typically be avoided if the patient is weaned off the medication slowly rather than have the dosage stop suddenly. This is not an addiction but instead classified as something called discontinuation syndrome.

Discontinuation syndrome symptoms may include insomnia or increased, vivid dreaming as well as flu-like symptoms such as headaches, sweating, chills, nausea or body aches. These symptoms are more commonly associated with other TCAs such as Amitriptyline and Imipramine rather than Amoxapine, though these patients could suffer from discontinuation syndrome as well.

What is depression?

Depression is a fairly common mental disorder found mostly in adults that leads to feelings of guilt, low self-esteem, and depressed mood. Depression is far more than feeling down or sad; it does not go away with time or when a certain situation improves. The lingering effects of depression often lead to insomnia, low energy, poor concentration and poor appetite. Soon, physical health is affected as well as others who are close to the person suffering from depression.

At its worst, depression can ultimately result in a person ending their own life; in fact, suicide is the second leading cause of death in 15-29-year-old adults according to WHO statistics. Known, effective treatment regimes for depression that involve TCA drugs such as Amoxapine can literally save lives. Sadly, fewer than 10% of depression sufferers receive treatment due to a lack of resources (both personal and medical availability) or the social stigma attached to mental illness.

Depression can happen at any age and to anyone, no matter their status in life. In fact, there have been recent news headlines about celebrities and other successful people who have suffered from depression. Globally, the World Health Organization estimates that there are more than 300 million sufferers of depression that are represented among all socio-economic classes, races, sexes, and ages.

Conditions treated

  • Depression
  • Major depressive disorder
  • Schizophrenia
  • Parkinson’s disease psychosis
  • Other mental disorders

Type of medicine

  • Antidepressant

Side effects

Patients being treated with Amoxapine may experience effects of the drug that are unwanted. Not all of these side effects are experienced by all patients taking Amoxapine, but if they do occur, it is important to report them to your healthcare provider immediately in case they are the symptom of an underlying health issue as a reaction to Amoxapine. If any of the following side effects occur, check with your doctor:

  • Excitability in mood
  • Racing heartbeat
  • Fear
  • Nervousness
  • Mood or mental changes
  • Nightmares
  • Restlessness
  • Shaking or unsteadiness
  • Erratic walk
  • Insomnia
  • Swelling
  • Unsteadiness
  • Trembling or loss of muscle control

The following possible side effects could happen but are rarely reported. Again, if you experience any of these side effects and they are prolonged or severe, report them to your doctor immediately:

  • Abdominal pain
  • Out of control behavior or actions
  • Black, tarry or clay-colored stools
  • Bleeding gums
  • Stomach bloating
  • Bloody or dark urine or bloody stools
  • Blurry vision
  • Pins and needles or tingling in arms, hands, legs or feet
  • Chest pain or tightness
  • Chills
  • Confusion about identity, place or time
  • Ringing or buzzing in the ears
  • Constipation
  • Cough, hoarse throat
  • Frequent urination
  • Low volume urination
  • Difficulty breathing or speaking
  • Trouble concentrating
  • Dizziness, faintness or light-headedness when sitting or standing
  • Double vision
  • Drooling
  • High fever
  • Paranoia
  • Fatigue
  • Headache
  • Hearing loss
  • High or low blood pressure
  • Hives or welts
  • Partial paralysis of arms, legs or facial muscles
  • Indigestion
  • Irritability
  • Itching
  • Clumsiness or lack of coordination
  • Loss of appetite
  • Loss of bladder control
  • Muscle cramps, spasms, jerking or trembling
  • Numbness
  • Pale, clammy skin
  • Skin redness or rash
  • Slow speech
  • Limb stiffness
  • Loss of consciousness
  • Swollen glands
  • Dry mouth
  • Uncontrolled movements like chewing, body twisting, neck or back movements
  • Bad breath
  • Strange bleeding or bruising
  • Vomiting blood
  • Yellow eyes and skin
  • Heartburn
  • Rapid weight gain
  • Severe sunburn

Patients who experience mild symptoms typically do not need medical attention; your doctor will inform you of ways to reduce or eliminate side effects. Keep in mind that any side effects experienced may go away the longer you are being treated with Amoxapine. Side effects that are prolonged or severe, however, should be immediately reported to your healthcare provider.

As with any drug, not all side effects are experienced by all patients and some side effects are extremely mild. Your doctor has determined that use of Amoxapine and the benefits it will have on your health outweigh any possible side effects you may experience. There are many patients using Amoxapine successfully and only experiencing very mild to no side effects at all, which is encouraging for those about to start the treatment.

Informing your health care professional of any and all medications including herbal or holistic and other non-prescription medications not to mention pre-existing health conditions is critical to the success of Amoxapine and other treatments that may be used in the course of your medical treatment. Make sure you have informed your doctor of all medications and pre-existing health conditions prior to starting your Amoxapine treatment.

Occasionally the side effects experienced by certain patients are determined to be worse than the condition they are being treated for and therefore have no benefit to the patient. A full discussion with your healthcare professional on the benefits and side effects of any prescribed drug is recommended. If you experience symptoms that are severe or prolonged, report them to your physician immediately.

Dosage

It is of critical importance that patients follow the treatment regimen prescribed by their doctor with regard to the size of the dose of Amoxapine as well as the time and frequency taken. Amoxapine prescriptions should include a medication guide, which patients should read and discuss with their healthcare provider if they have any questions.

Patients should keep in mind that the dosage, frequency and time of their prescription of Amoxapine are specific to them and prescribed by their physician for optimum effectiveness. The following is a general description of dosage; keep in mind that your dose may be different:

Adults

Initial dosage of 50 milligrams two to three times per day is common. Your dose may be increased on advice from your doctor as warranted, however, the dose is typically not more than 300 milligrams per day unless you are hospitalized. If you are prescribed a once-daily dose of Amoxapine, you will typically be advised to take it at bedtime.

Older adults

This age group will typically be prescribed 25 milligrams of Amoxapine to be taken two or three times per day. Your dose may increase but will typically not exceed more than 300 milligrams per day unless you are hospitalized and need a higher dose. Again, it is best to take Amoxapine at bedtime, but your doctor will advise you when to take the drug for optimum effectiveness.

It should be noted that older adults are more likely to experience unwanted side effects with the use of Amoxapine in the form of movement disorders and sleep disorders as well as increased effects on kidney and liver function. Adjustment of dosage for older adults with these risks in mind will be made by your healthcare professional. Any symptoms related to these unwanted side effects should be reported to your doctor immediately.

Children

The use of Amoxapine in children is not recommended on a regular basis. If prescribed for children, the health care provider will most likely provide explicit instruction on dosage size, frequency and time. Most likely the child will be hospitalized and under observation during treatment with Amoxapine.

Interactions

When you are under treatment with Amoxapine, it is important to disclose to your healthcare professional all prescription and non-prescription drugs you are taking, including herbal and holistic remedies that could cause an adverse reaction when taken together or limit the effectiveness of Amoxapine.

No specific studies exist on the effectiveness or risk of Amoxapine in pregnant or breastfeeding women. Your doctor will weigh up the options and risks with you during a consultation if you are a candidate for treatment with Amoxapine as well as being pregnant or breastfeeding at the time.

Overall, the following drugs are known to interact significantly with Amoxapine and should be avoided:

  • Bromopride
  • Clorgyline
  • Grepafloxacin
  • Isocarboxazid
  • Levomethadyl
  • Linezolid
  • Methylene Blue
  • Metoclopramide
  • Moclobemide
  • Phenelzine
  • Ranolazine
  • Safinamide
  • Selegiline
  • Tranylcypromine

In the case of the following medications, use in conjunction with Amoxapine is not recommended but may be required. Your physician may adjust the dosage of either or the frequency of one or both medications:

  • Acecainide
  • Aceclofenac
  • Acemetacin
  • Albuterol
  • Alfuzosin
  • Almotriptan
  • Amitriptyline
  • Amtolmetin Guacil
  • Apomorphine
  • Aprindine
  • Arsenic Trioxide
  • Asenapine
  • Aspirin
  • Astemizole
  • Azimilide
  • Azithromycin
  • Bretylium
  • Bromfenac
  • Bromocriptine
  • Brompheniramine
  • Bufexamac
  • Buprenorphine
  • Bupropion
  • Buspirone
  • Celecoxib
  • Chloral Hydrate
  • Chloroquine
  • Chlorpheniramine
  • Chlorpromazine
  • Choline Salicylate
  • Ciprofloxacin
  • Citalopram
  • Clomipramine
  • Clonidine
  • Clonixin
  • Clozapine
  • Cyclobenzaprine
  • Darunavir
  • Dasatinib
  • Desipramine
  • Desvenlafaxine
  • Dexibuprofen
  • Dexketoprofen
  • Dextromethorphan
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxepin
  • Droperidol
  • Droxicam
  • Eletriptan
  • Enflurane
  • Epinephrine
  • Erythromycin
  • Escitalopram
  • Etilefrine
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fentanyl
  • Fepradinol
  • Feprazone
  • Fingolimod
  • Flecainide
  • Floctafenine
  • Fluconazole
  • Flufenamic Acid
  • Fluoxetine
  • Flurbiprofen
  • Fluvoxamine
  • Foscarnet
  • Frovatriptan
  • Gatifloxacin
  • Gemifloxacin
  • Granisetron
  • Halofantrine
  • Halothane
  • Hydroxytryptophan
  • Ibuprofen
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Indomethacin
  • Iobenguane I 123
  • Iproniazid
  • Isoflurane
  • Isradipine
  • Ketoprofen
  • Ketorolac
  • Lapatinib
  • Levalbuterol
  • Levomilnacipran
  • Levothyroxine
  • Lidoflazine
  • Lithium
  • Lopinavir
  • Lorcainide
  • Lorcaserin
  • Lornoxicam
  • Loxoprofen
  • Lumefantrine
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Mefloquine
  • Meloxicam
  • Meperidine
  • Methadone
  • Methoxamine
  • Midodrine
  • Milnacipran
  • Mirtazapine
  • Moricizine
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Naratriptan
  • Nefazodone
  • Nefopam
  • Nepafenac
  • Niflumic Acid
  • Nilotinib
  • Nimesulide
  • Nimesulide Beta-Cyclodextrin
  • Norepinephrine
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Oxaprozin
  • Oxilofrine
  • Oxycodone
  • Oxymetazoline
  • Oxymorphone
  • Oxyphenbutazone
  • Paliperidone
  • Palonosetron
  • Parecoxib
  • Pargyline
  • Pazopanib
  • Pentamidine
  • Perflutren Lipid Microsphere
  • Phenylbutazone
  • Phenylephrine
  • Piketoprofen
  • Piroxicam
  • Pranoprofen
  • Procainamide
  • Procarbazine
  • Prochlorperazine
  • Proglumetacin
  • Promethazine
  • Propafenone
  • Propyphenazone
  • Proquazone
  • Protriptyline
  • Quinidine
  • Quinine
  • Rasagiline
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sematilide
  • Sertraline
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Sodium Salicylate
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Spiramycin
  • Sulfamethoxazole
  • Sulindac
  • Sumatriptan
  • Sunitinib
  • Tapentadol
  • Tedisamil
  • Telavancin
  • Telithromycin
  • Tenoxicam
  • Tetrabenazine
  • Tiaprofenic Acid
  • Tiotropium
  • Tolfenamic Acid
  • Tolmetin
  • Toremifene
  • Tramadol
  • Trazodone
  • Trifluoperazine
  • Trimethoprim
  • Trimipramine
  • Tryptophan
  • Valdecoxib
  • Vardenafil
  • Vasopressin
  • Venlafaxine
  • Vilanterol
  • Vilazodone
  • Voriconazole
  • Vortioxetine
  • Ziprasidone
  • Zolmitriptan

The following medications, while not typically prescribed with Amoxapine, may be used in conjunction with an adjustment to dosage and frequency made by your prescribing physician:

  • Acenocoumarol
  • Arbutamine
  • Atomoxetine
  • Cannabis
  • Carbamazepine
  • Dicumarol
  • Paroxetine
  • Phenprocoumon
  • S-Adenosylmethionine

Taking Amoxapine with food should be discussed with your doctor as should the use of alcohol, tobacco or other drugs. Interactions may occur that could harm the effectiveness of Amoxapine as well as create adverse health side effects if combined. Full disclosure of any current or past medications to your health care professional will increase the chance of effective treatment with Amoxapine.

Patients diagnosed with the following medical conditions could possibly experience unwanted side effects by taking Amoxapine. Inform your health care provider of any pre-existing health conditions that may interact with Amoxapine by decreasing the effectiveness of the drug or causing harmful health issues.

The following conditions are known to affect the use of Amoxapine:

  • Bipolar disorder
  • Heart attack
  • Glaucoma
  • Heart disease
  • Schizophrenia
  • Seizures
  • Urinary retention

Inform your healthcare provider if you have any of these conditions as use of Amoxapine could potentially be life-threatening in some cases.

Warnings

Amoxapine could cause agitated, irritable moods or other abnormal behaviors in certain patients. Some patients also experience an increase in suicidal thoughts and tendencies while taking Amoxapine. If any signs of deepening depression or other mood or behavioral disorders are observed in someone taking Amoxapine, inform your health care provider immediately.

Patients taking monoamine oxidase inhibitors (MAO) shouldn't take Amoxapine within two weeks of use of those drugs. Patients who have taken both drugs may develop confused mental states or agitation and restlessness along with stomach or intestinal symptoms, extremely high blood pressure or severe convulsions.

Amoxapine may cause certain patients to develop tardive dyskinesia, which is a movement disorder. If you exhibit any of the following symptoms, contact your healthcare provider right away:

  • Lip smacking
  • Lip puckering
  • Cheek puffing
  • Rapid or worm-like tongue movements
  • Uncontrolled chewing
  • Uncontrolled arm or leg movements

Your doctor should be informed immediately if you are having convulsions, seizures, difficulty breathing, rapid heartbeat, high fever or blood pressure disorders. Increased sweating and loss of bladder control as well as severe muscle stiffness, pale skin or fatigue could all be symptoms of an underlying serious condition known as neuroleptic malignant syndrome or NMS.

Do not stop taking this medication unless you have consulted with your health care provider, who will most likely recommend a gradual reduction in the drug rather than a complete stop of the medication. This will avoid any withdrawal symptoms and reduce the possible worsening of your condition.

Amoxapine is clinically shown to interact with the use of alcohol and other depressants and may increase drowsiness in those taking antihistamines or allergy medicines. Those taking tranquilizers or sleep aid medications or prescription pain relievers may increase the effects by taking Amoxapine in conjunction with these drugs. Check with your healthcare provider before combining any drug with a course of treatment of Amoxapine.

Some patients being treated with Amoxapine may experience excessive drowsiness and/or lowered alertness. Before you drive or operate heavy machinery, make sure you are aware of how Amoxapine affects you.

Storage

Amoxapine is available through prescription only and should be taken only as directed by your physician. Keep this and other medicines out of sight and reach of children as a precaution. Amoxapine should be kept in its original, labeled container at room temperature and not exposed to heat, moisture or direct light. Do not allow Amoxapine to freeze. Outdated or unused Amoxapine should be disposed of, with proper safety practices at the advice of your healthcare professional.

Summary

Amoxapine is an antidepressant drug available only on prescription by a medical doctor. Also known under the brand name Asedin, Amoxapine is considered a tricyclic antidepressant medication or TCA. Amoxapine works by suppressing the absorption of two neurotransmitters by the body in order to increase their levels to a normal state in patients suffering from depression. Depression sufferers typically exhibit symptoms as a result of the low levels of these two neurotransmitters, known as noradrenaline and serotonin. By blocking the body’s absorption of these two chemicals, a balanced mood can be achieved.

Depression is a common mental illness experienced by all races, sexes, and ages, with the World Health Organization estimating that over 300 million people worldwide suffer from it. Depression is more than mere sadness or discouraged feelings; at its worst, it can lead to suicide. A course of treatment with antidepressant drugs such as Amoxapine is known to be an effective treatment for depression symptoms. Typically recurrent sufferers of depression will be prescribed a course of treatment that lasts six months or longer.

Dosage varies depending on each patient’s unique situation, but typical doses for adults are at the level of 50 milligrams two or three times per day. Dosage for older adults is lower, as this age group is at higher risk for unwanted health side effects that could be chronic or life-threatening. Children are typically not prescribed Amoxapine unless their circumstances are extreme.

As with any drug, informing your health care provider of any pre-existing medical conditions - both present and past history, as well as family history, is imperative to effective, safe treatment. The same can be said about informing your doctor of any prescription, non-prescription, vitamin, herbal or holistic drugs or remedies you are taking now or have taken in the past. Avoiding dangerous health side effects and ensuring maximum effectiveness of the course of treatment is greatly assisted by your doctor’s knowledge of your full health history.

This drug, along with others, is best stored out of sight and reach of children in a dry, dark place, retaining the original packaging and information for reference. Disposal of unused or expired Amoxapine is best under safety advice of your healthcare provider.

Side effects of this drug that are prolonged in nature or severe should be reported to your healthcare provider. Two specific health conditions are a high risk for patients on a treatment regimen of Amoxapine. For this reason, any patients who exhibit signs of tardive dyskinesia, such as facial spasms or tics, as well as symptoms of neuroleptic malignant syndrome, including blood pressure and convulsiveness, must report these symptoms to their healthcare provider immediately.

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Last Reviewed:
December 10, 2017
Last Updated:
February 09, 2018