Side Effects of protriptyline: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Main Research Findings

Protriptyline, a tricyclic antidepressant, has been studied for its effects on sleep-related breathing disorders. Research suggests that protriptyline can improve sleep apnea by reducing REM sleep time. 11 , 21 , 20 , 19 Protriptyline may also improve oxygen levels during sleep and reduce daytime sleepiness. 19 However, protriptyline can cause a range of side effects, particularly anticholinergic effects. 10 , 8 , 12 Additionally, protriptyline can block the HERG potassium channel, which may contribute to an increased risk of arrhythmias. 3 These side effects may limit the use of protriptyline for regular treatment. 13

Reasons for Side Effects

Protriptyline, being a tricyclic antidepressant, has several mechanisms that can lead to side effects. Its anticholinergic action, which blocks the action of the neurotransmitter acetylcholine, can cause a variety of side effects such as dry mouth, constipation, blurred vision, and difficulty urinating. 10 , 8 , 12 , 16 , 24 , 22 Additionally, its inhibition of the HERG potassium channel can contribute to arrhythmias, such as prolonged QT interval, torsades de pointes, and even sudden death. 3

Common Side Effects

Anticholinergic Effects

Protriptyline can cause side effects like dry mouth, constipation, urinary retention, and blurred vision due to its anticholinergic action. 13 , 10 , 20 , 19 , 12 , 16 , 24 , 22

Cardiotoxicity

Protriptyline can potentially cause heart-related side effects like arrhythmias, prolonged QT interval, and ventricular fibrillation, as a result of its cardiotoxicity. 3

Psychomotor Agitation

Some patients may experience psychomotor agitation while taking protriptyline. 23

Other Side Effects

Other reported side effects of protriptyline include weight loss, headaches, and sexual dysfunction. 5 , 4 , 2

Countermeasures for Side Effects

Countermeasures for Anticholinergic Effects

To mitigate anticholinergic effects, staying hydrated and consuming a fiber-rich diet are recommended. If constipation becomes problematic, consult a doctor for appropriate medication.

Countermeasures for Cardiotoxicity

Individuals with pre-existing heart conditions should discuss the use of protriptyline with their doctor. Regular heart check-ups are essential during treatment.

Countermeasures for Psychomotor Agitation

Taking protriptyline before bedtime may help minimize psychomotor agitation. It's crucial to be aware of this potential side effect and discuss any concerns with your healthcare provider.

Comparison Between Studies

Commonalities Between Studies

Multiple studies highlight the effectiveness of protriptyline in improving sleep-related breathing disorders. 11 , 21 , 20 , 19 Several studies also point to the occurrence of anticholinergic side effects with protriptyline. 10 , 8 , 12

Differences Between Studies

The specific effects and side effects of protriptyline can vary considerably between individuals. Furthermore, differences in research methodology and study populations can lead to varying results.

Precautions for Application in Daily Life

Protriptyline may be prescribed by a doctor for the treatment of sleep-related breathing disorders, but it's essential to use it only under their supervision. Self-medication is strongly discouraged due to the potential for side effects. Individuals with heart conditions should especially consult with their doctor before taking protriptyline.

Limitations of Current Research

Research on protriptyline is still ongoing and more studies are needed, particularly regarding its long-term effects and side effects.

Directions for Future Research

Future research should focus on evaluating the long-term effects and side effects of protriptyline. Determining which patients are most likely to benefit from protriptyline treatment is also crucial.

Conclusion

While protriptyline shows promise in treating sleep-related breathing disorders, it can cause various side effects, including anticholinergic effects and potential heart complications. Always consult your doctor before taking protriptyline and adhere to their guidance for safe and effective treatment.

Keywords
Benefit Keywords
Improved drug stability
Increased water solubility
Reduced side effects
1
Reduced headaches
Weight loss
5
Reduced ADHD symptoms
6
Improved sleep quality
OSAS treatment
Reduced apnea index
7
Improves blood gas tensions
8
Improve sleep quality
Reduce snoring
9
Improved hypoxemia
Improved sleep quality
10
OSA treatment
11
Improved breathing
Increased function
Longer survival
12
Reduced REM sleep time
Reduced desaturation
Reduced hypoxemia
13
Affective illness treatment
Post-stroke depression treatment
14
Insomnia treatment
Narcolepsy treatment
Sleep disorder treatment
15
Improved oxygen saturation
Nocturnal hypoventilation treatment
16
Ventricular fibrillation response
17
Antiarrhythmic
Prevents VT
18
Improved oxygenation
Improved somnolence
19
Improved gas exchange
Improved sleep apnea
Reduced hypersomnolence
20
Improves sleep apnea
21
Fewer adverse reactions
Improved antidepressant response
22
Optimized antidepressant use
24
Maximal efficacy at specific levels
Treats depression
25
Risk Keywords
DNA damage
2
Arrhythmia
3
Painful ejaculation
4
Side effects
5
Adverse effects
Intolerable side effects
6
Anticholinergic side effects
8
Individual variability
Mild side effects
9
Side effects
10
Variable response
11
Side effects
12
Anticholinergic side effects
13
Anticholinergic effects
Lithium toxicity
Orthostatic hypotension
Tardive dyskinesia
14
Amnesia
Daytime sedation
Psychotic-like symptoms
15
Anticholinergic side effects
16
Hypotension
Low efficacy
17
Orthostatic hypotension
18
Anticholinergic side effects
19
Constipation
Dry mouth
Erectile dysfunction
Urinary hesitancy
20
Intolerable side effects
21
Antidepressant side effects
Neuroleptic side effects
Phospholipid changes
23
Drug interactions
Side effects
24
Side effects
25
Literature analysis of 25 papers
Positive Content
18
Neutral Content
2
Negative Content
5
Article Type
2
0
0
4
25
2.

In vitro studies of DNA damage caused by tricyclic antidepressants: a role of peroxidase in the side effects of the drugs.

Author: KorobkovaEkaterina A, NgWilliam, VenkatratnamAbhishek, WilliamsAlicia K, NizamovaMadina, AzarNikolay

DNA damage

Tricyclic antidepressants can cause DNA damage, possibly through reactive intermediates generated by peroxidases. This study shows that imipramine, in the presence of horseradish peroxidase and hydrogen peroxide, degrades DNA.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Painful ejaculation and urinary hesitancy in association with antidepressant therapy: relief with tamsulosin.

Author: DemyttenaereKoen, HuygensRemko

Painful ejaculation

Tamsulosin has been shown to be effective in resolving painful ejaculation associated with reboxetine, a type of antidepressant.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Protriptyline, chronic tension-type headaches, and weight loss in women.

Author: CohenG L

Reduced headaches
Weight loss
Side effects

Protriptyline effectively reduced the number of headaches in women with chronic tension-type headaches, with an average weight loss during the study period.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

A naturalistic assessment of protriptyline for attention-deficit hyperactivity disorder.

Author: WilensT E, BiedermanJ, AbrantesA M, SpencerT J

Reduced ADHD symptoms
Adverse effects
Intolerable side effects

Protriptyline did not show significant clinical utility in the routine management of complex cases of ADHD in children and adolescents. Only 45% of patients were considered positive responders, and 38% discontinued treatment due to intolerable side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

7.

[Treatment of obstructive sleep apnea syndrome with a mandibular positioning device and other nonsurgical modalities].

Author: SakakibaraH, UmemotoM, KuwaharaM, SuetsuguS

Improved sleep quality
OSAS treatment
Reduced apnea index

The study discusses the individualized approach to treating obstructive sleep apnea syndrome (OSAS), including non-surgical options like weight loss and positional therapy. The effectiveness of a mandibular positioning device was evaluated in 20 patients, demonstrating a significant reduction in apnea index and improvement in sleep quality in good responders.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Japanese

8.

Effect of protriptyline, 10 mg daily, on chronic hypoxaemia in chronic obstructive pulmonary disease.

Author: StrömK, BomanG, PehrssonK, AltonM, SingerJ, RydströmP O, UddenfeldtM, EricssonC H, OstholmB, MörlinC

Improves blood gas tensions
Anticholinergic side effects

A daily dose of 10 mg of protriptyline did not significantly improve daytime arterial oxygen tension in patients with stable mild or moderate hypoxemia caused by COPD. Anticholinergic side effects were experienced by most patients, leading to drug withdrawal in one case.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Effects of protriptyline on snoring characteristics.

Author: SérièsF, MarcI

Improve sleep quality
Reduce snoring
Individual variability
Mild side effects

Protriptyline can improve both snoring frequency and loudness in some nonapneic snorers, with the highest decrease occurring in slow-wave sleep.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Long-term effects of protriptyline in patients with chronic obstructive pulmonary disease.

Author: SérièsF, MarcI, CormierY, La ForgeJ

Improved hypoxemia
Improved sleep quality
Side effects

Protriptyline improved nocturnal and diurnal hypoxemia in patients with chronic obstructive pulmonary disease, but the benefits disappeared after stopping the drug.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Response of obstructive sleep apnea to fluoxetine and protriptyline.

Author: HanzelD A, ProiaN G, HudgelD W

OSA treatment
Variable response

Fluoxetine, a serotonin-uptake inhibitor, was beneficial to some, but not all, patients with obstructive sleep apnea (OSA). It decreased the proportion of REM sleep time and the number of apneas or hypopneas in NREM sleep, but did not significantly improve oxygenation or arousal.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

12.

The use of protriptyline for respiratory failure in patients with chronic airflow limitation.

Author: CarrollN, ParkerR A, BranthwaiteM A

Improved breathing
Increased function
Longer survival
Side effects

Protriptyline was effective in treating REM-related nocturnal hypoventilation in patients with chronic airflow limitation. This treatment improved daytime arterial blood gas tensions, increased functional ability, and may increase survival.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

Protriptyline treatment of sleep hypoxaemia in Duchenne muscular dystrophy.

Author: SmithP E, EdwardsR H, CalverleyP M

Reduced REM sleep time
Reduced desaturation
Reduced hypoxemia
Anticholinergic side effects

Protriptyline, an antidepressant, reduced REM sleep time in patients with Duchenne muscular dystrophy. While it also reduced sleep-related hypoxemia, its anticholinergic side effects limited its use for regular treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Treatment of affective illness in the elderly with drugs and electroconvulsive therapy.

Author: JenikeM A

Affective illness treatment
Post-stroke depression treatment
Anticholinergic effects
Lithium toxicity
Orthostatic hypotension
Tardive dyskinesia

Several medications and ECT are effective in treating affective illness in the elderly, with varying levels of effectiveness and side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Clinical neuropharmacology of sleep disorders.

Author: ManfrediR L, KalesA

Insomnia treatment
Narcolepsy treatment
Sleep disorder treatment
Amnesia
Daytime sedation
Psychotic-like symptoms

This review discusses medication use for sleep disorders. Flurazepam is effective for both sleep induction and maintenance, temazepam for maintenance, and triazolam for both but with rebound effects. Antidepressants are recommended for insomnia secondary to depression, while methylphenidate or amphetamines are used for narcolepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Bethanidine sulfate: efficacy in prevention of ventricular tachyarrhythmias during programmed stimulation. Report of a multicenter study of 56 patients.

Author: TeichmanS L, WaspeL E, MatosJ A, KimS G, FisherJ D

Ventricular fibrillation response
Hypotension
Low efficacy

Bethanidine sulfate was not effective in preventing ventricular tachyarrhythmias in 56 patients. Hypotension was a common side effect.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

18.

Antiarrhythmic and electrophysiologic actions of bethanidine sulfate in primary ventricular fibrillation or life-threatening ventricular tachycardia.

Author: BendittD G, BensonD W, DunniganA, KriettJ M, PritzkerM R, BacanerM B

Antiarrhythmic
Prevents VT
Orthostatic hypotension

Bethanidine sulfate, a bretylium tosylate analog, effectively prevented ventricular tachyarrhythmias in patients who survived out-of-hospital cardiac arrest. However, orthostatic hypotension was a common side effect that could be managed with protriptyline.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

19.

The role of protriptyline in obstructive sleep apnea.

Author: BrownellL G, Perez-PadillaR, WestP, KrygerM H

Improved oxygenation
Improved somnolence
Anticholinergic side effects

Protriptyline improved somnolence in 4 out of 5 obese patients with obstructive sleep apnea, and it also improved oxygenation by reducing REM sleep and severe REM apneas. The drug was effective in 3 patients after 6 months, but anticholinergic side effects occurred in 5 out of 9 patients who received long-term treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

The clinical application of tricyclic antidepressant pharmacokinetics and plasma levels.

Author: AmsterdamJ, BrunswickD, MendelsJ

Fewer adverse reactions
Improved antidepressant response

Tricyclic antidepressants are effective in treating depression. There is a suggested therapeutic range for some tricyclic antidepressants, however, more research is needed to determine the necessary plasma levels for others.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

[Metabolism and blood levels study of antidepressants: a rationale of their therapeutical use (author's transl)].

Author: VialaA, CanoJ P, DurandA

Optimized antidepressant use
Drug interactions
Side effects

Pharmacokinetics plays a crucial role in optimizing the therapeutic use of antidepressants. The relationship between clinical response and drug levels varies depending on the specific antidepressant.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : French

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