Amoxapine

Amoxapine (Amokisan, Asendin, Asendis, Defanyl, Demolox, Moxadil) is a tetracyclic antidepressant (TeCA) of the dibenzoxazepine class, though some authorities classify it as a secondary amine tricyclic antidepressant.

Uses
Amoxapine is used in the treatment of depression, anxiety disorders, panic disorder, and bipolar disorder. Amoxapine is contra indicated in children because it lowers the seizure threshold to the extent that fits may be precipitated, especially in children. Cardiovascular effects and anti-cholinergic side effects are much reduced. It also has action similar to an atypical antipsychotic.

Pharmacology
Amoxapine is a strong norepinephrine reuptake inhibitor and weak serotonin reuptake inhibitor. It also possesses antiadrenergic, anticholinergic, antidopaminergic, antihistamine, and antiserotonergic actions.

Side effects
One of its major metabolites, 7-hydroxyamoxapine, has a dopamine receptor blocking effect, making this drug a common cause of neuroleptic malignant syndrome. Amoxapine is also associated with acute extrapyramidal symptoms and tardive dyskinesia.

Special precautions
Mania, hypomania, severe liver damage, diabetes, myocardial infarction, epilepsy.

Drug Interactions
potential sedative effects of alcohol, antiparkinson, agents, reduce effects of sympathomimetics.