Prothiaden (dothiepin hydrochloride) is a tricyclic antidepressant (TCA) used primarily for the treatment of major depressive disorder and anxiety-related conditions. With a dual mechanism of action that enhances the availability of key neurotransmitters in the brain, Prothiaden helps restore emotional balance, improve mood, and alleviate associated somatic symptoms. Its well-established efficacy and tolerability profile make it a trusted option in clinical psychiatry for patients requiring sustained antidepressant therapy.

Features

• Active ingredient: Dothiepin hydrochloride
• Available in 25mg and 75mg tablets
• Dual action: inhibits reuptake of serotonin and norepinephrine
• Sedative properties beneficial for patients with sleep disturbances
• Long half-life allowing for once-daily dosing in maintenance therapy

Benefits

• Effectively alleviates symptoms of moderate to severe depression
• Reduces anxiety and somatic complaints such as chronic pain or gastrointestinal discomfort
• Improves sleep quality due to inherent sedative effects
• Supports functional recovery and enhances overall quality of life
• Suitable for long-term maintenance therapy in recurrent depression

Common use

Prothiaden is indicated for the management of major depressive episodes, particularly where anxiety and sleep disturbances are prominent. It is also used off-label in certain chronic pain syndromes, such as neuropathic pain, and for prophylaxis in recurrent depressive disorders. Its anxiolytic and sedative properties make it especially useful in patients with mixed depressive and anxiety symptoms.

Dosage and direction

The initial adult dosage is typically 75 mg daily, administered orally, usually in divided doses or as a single dose at bedtime. Depending on patient response and tolerability, the dose may be gradually increased to a maximum of 150 mg daily. Elderly patients or those with hepatic impairment should start at a lower dose, such as 25–50 mg daily. Dosage adjustments must be made under strict medical supervision. Tablets should be swallowed whole with water, with or without food.

Precautions

Patients should be monitored for worsening depression, suicidal ideation, or unusual changes in behavior, especially during the initial weeks of treatment. Caution is advised in individuals with cardiovascular disease, glaucoma, urinary retention, or a history of seizures. Prothiaden may impair cognitive or motor performance; patients should avoid driving or operating machinery until their response is known. Alcohol should be avoided due to enhanced sedative effects.

Contraindications

Prothiaden is contraindicated in patients with known hypersensitivity to dothiepin or other tricyclic antidepressants. It must not be used concomitantly with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy. Additional contraindications include recent myocardial infarction, severe liver disease, and narrow-angle glaucoma.

Possible side effects

Common side effects may include dry mouth, drowsiness, blurred vision, constipation, and weight gain. Less frequently, patients may experience orthostatic hypotension, tachycardia, sweating, or urinary retention. Serious adverse effects such as arrhythmias, seizures, or blood dyscrasias are rare but require immediate medical attention.

Drug interactions

Prothiaden may interact with MAOIs, leading to serotonin syndrome. Concomitant use with other CNS depressants (e.g., benzodiazepines, opioids) can enhance sedation. It may also potentiate the effects of anticholinergic drugs and increase the risk of arrhythmias with antiarrhythmics or antipsychotics. Caution is advised with SSRIs, SNRIs, and tramadol due to additive serotonergic effects.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose is not recommended.

Overdose

Overdose with Prothiaden can be life-threatening and may manifest as severe drowsiness, hypotension, convulsions, cardiac arrhythmias, or coma. Immediate medical attention is required. Treatment is supportive and may include gastric lavage, activated charcoal, and monitoring of cardiac and respiratory function.

Storage

Store at room temperature (15–30°C) in a dry place, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice. Always consult a healthcare provider for diagnosis, treatment decisions, and personalized dosage recommendations. Do not discontinue use abruptly without medical supervision.

Reviews

Clinical studies and patient reports indicate that Prothiaden is effective in reducing depressive and anxiety symptoms, with many users noting improved sleep and overall functioning. Some individuals report side effects such as drowsiness and dry mouth, though these often diminish over time. Overall, it is regarded as a valuable option within the TCA class for appropriate patient populations.