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Lofepramine (trademarked Gamanil, generic Lomont)
is a third generation tricyclic antidepressant used
in the treatment of depressive disorders. It has both
antidepressant and anxiolytic properties. Lofepramine
is metabolized in vivo into desipramine; hence its pharmacological
profile is extremely similar.
In the United Kingdom, lofepramine is licensed for the
treatment of depression. Description: An antidepressant
administered orally (as tablets). It has fewer sedative
properties than many of the products used to treat depressive
illnesses and is suited to patients whose symptoms tend
towards withdrawal and apathy, rather than restlessness
and agitation.
It is commonly prescribed for major depressive disorder,
anxiety, insomnia, neuropathic/chronic pain, and treatment
resistant depression.
Side effects
Drowsiness, dry mouth, heartbeat irregularities, sweating,
low blood pressure, constipation, blurred vision palpatations,
and urinary retention. Can cause confusion in elderly
patients or behavioural disturbance in the young. May
produce weight gain or cause changes in the levels of
blood sugar. Some patients report muscular discomfort,
particularly in the shoulders. However, lofepramine
is less sedating than, for instance, amitryptaline,
and is safer in overdose than older tricyclics.
To be used with caution for epileptic patients or those
with glaucoma or psychosis. Lofepramine should not be
given to people who have suffered liver failure or heart
disease. Not advisable for use in pregnant women.
Dosage
140-210mg daily in divided doses.
Before dispensing medication on a set course, the first
prescribed dosage to a patient must be 70mg (one tablet)
to be taken at NIGHT only. If no adverse side effects
have been reported then the next course would be 140mg
(2 tablets to be taken at NIGHT) for a period of 2-3
weeks.
Then again, if no adverse side effects have been reported,
the patient must undergo the full dosage of 210mg per
DAY for a period of 3 WEEKS.
If the patient is using the maximum daily dosage of
210mg, then the dosage must be divided into THREE SEPARATE
time slots, preferably one in the morning, one in the
afternoon and one at night; or alternatively one in
the morning and two at night (two 140mg tablets is safe
to take at the same time).
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