Aprotiline

Aprotiline is a tricyclic antidepressant (TCA) that was developed in the 1970s but has seen limited use compared to other antidepressants. It belongs to the dibenzoxepin class of compounds and acts primarily by inhibiting the reuptake of norepinephrine and, to a lesser extent, serotonin in the brain. This mechanism helps regulate mood and alleviate symptoms of depression.

The drug was introduced under the brand name **Levate** and was marketed primarily in Europe and some other regions. Aprotiline was designed to have a more selective effect on norepinephrine compared to other TCAs, which were often associated with significant side effects such as sedation, anticholinergic effects, and cardiovascular risks. However, clinical studies did not consistently demonstrate superior efficacy or tolerability compared to other antidepressants, leading to its reduced popularity.

Common side effects of aprotiline include dry mouth, dizziness, blurred vision, and gastrointestinal disturbances. Due to its potential to prolong the QT interval on the electrocardiogram, it carries a risk of cardiac arrhythmias, particularly in overdose situations. As a result, its use has been restricted or discontinued in many countries.

Aprotiline is generally not recommended as a first-line treatment for depression. Its role in modern psychiatry is minimal, and it is rarely prescribed today. Research on its long-term safety and efficacy remains limited, and it is often overshadowed by newer antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), which are generally better tolerated.

The drug is available in tablet form, typically prescribed in doses ranging from 100 to 300 milligrams per day, though dosing varies based on individual response and tolerability. As with all antidepressants, abrupt discontinuation should be avoided to prevent withdrawal symptoms.