Indications
The indications for use in the instructions for the drug Ladisan include a variety of depression. These include:
- psychogenic depression, including exhaustion depression, reactive and neurotic;
- somatogenic depression, including organic and symptomatic;
- depression during menopause;
- endogenous depressions, including cyclical, involutional, periodic;
- masked types of depression.
Ladisan is also prescribed for other depressive disorders, which are accompanied by syndromes such as:
- feeling of fear,
- irritability,
- apathy.
Ladisan has a beneficial effect on psychosomatic as well as somatic disorders that may appear against a background of melancholy and fear.
Ladisan
Found (56 posts)
psychiatrist May 20, 2021 / Luda
... examination did not find any other reasons for subfibrillation. A diagnosis of VSD with impaired thermoregulation was made. Antidepressants were prescribed ( Ladisan
, stimaton), while taking the drugs, anxiety, insomnia, and tachycardia appeared. After a month, the drug was … open
psychiatrist November 13, 2015 / Inna / Minsk, Belarus
... dizziness, stuffy ears, like on an airplane, fainting. Vascular therapy was prescribed to improve cerebral circulation and Ladisan
, then the dose of Ladisan was reduced and Cipralex was added. After 4 months it became easier, and for almost a year I was on the half… open
psychiatrist April 27, 2014 / Olga / Belarus
… , How do you think? Ladisan effective?
in my case?
Thanks for the answer. ... become SSRIs. However, Ladisan
reduces anxiety, Betamax has vegetostabilizing properties and... I went to another doctor, he stopped
Ladisan
and prescribed Rexetine 1 tablet. + Eglonil … open
November 13, 2015 / Maria
....that I have this in my head, Our psychotherapist prescribed me Rexetine, after taking it for three weeks I became even worse, They changed the antidepressant to Ladisan
25 in the morning, 50 at night and clonozepam during attacks. Sonata at night. I’ve been taking all this for more than a month, the pressure is especially high now...
psychiatrist January 15, 2014 / Olga / Belarus
… I’ve been receiving the following treatment for a week now: drip emoxypine 10.0 + vitamins B1.6; I drink Ladisan
25 mg in the morning and 25 mg in the evening, Betamax 50 mg in the morning, ... .
Maybe I need a different antidepressant, what do you think? Ladisan
effective in my case? Thanks for the answer. open
August 21, 2014 / Anonymous
... pressure, legs trembling, hands too... it seems that she is dying, she gets to the ambulance... When the doctor prescribed Ladisan
, (25 mg in the morning and evening) the internal anxiety went away, but she became afraid of closed spaces, she walks to the ninth floor, ...
psychotherapist June 5, 2014 / Elena
Hello. Help me please. I gave birth 5 months ago. Now I understand that I am in postpartum depression. I live in Germany, there are no relatives here. All worries... open
June 19, 2014 / Elena
... the neuropathologist, a very good woman, listened to me and prescribed me to take Ladisan
.
A week of half a tablet 3 times a day and 3 weeks... which I cannot resolve. After I take Ladisan
, I have to come back for an appointment with a neuropathologist. Is it enough …
psychiatrist May 21, 2014 / Maria / St. Petersburg
...Good afternoon...After a difficult birth, I began to notice that something was happening to me...severe depression...everything seems to be fine...the baby is healthy...I love him very much...against the background of depression... open
June 19, 2014 / Elena
… their. There was a general fear of being left alone with the little one. Now I am visiting my parents in Belarus. The fear has passed a little. Ladisan now
. But as soon as I think that I have to return home, it’s as if I’m getting an electric shock. I still don’t know what this is. ...
psychotherapist April 24, 2014 / Alexander... / Minsk
... woke up like a drunk. And this tightness of the head prevents me from feeling emotions and mood. I don’t know what to do anymore. I’m drinking Ladisan
1 tablet 3 times a day and Grandaxin 1 tablet 3 times a day. It's already been 8 days and there is no improvement. Tell me if it looks like... open
January 15, 2014 / Shenderov Kirill Valerievich
..., panic, avoidant behavior (essentially phobias), SSRIs become the drugs of choice. However, Ladisan
reduces anxiety, Betamax has vegetostabilizing and anti-panic, antidepressant properties. It’s easier for you - and treatment should...
Form, composition
In what form is the medicine “Ladisan” produced? The instructions for use indicate that this product can be purchased in the following dosage forms:
Round tablets, coated and containing 50 or 25 mg of the active ingredient - maprotiline hydrochloride.
The drug in question also includes such additional substances as lactose, corn starch, talc, calcium phosphate, dyes, gelatin, colloidal silicon dioxide, polysorbate-80 and hypromellose. This medicine goes on sale in blisters, which are packed in cardboard boxes.
Solution for infusion "Ladisan". The instructions say that it is completely transparent and also has no color and is intended for intravenous infusions.
1 ml of medicinal solution contains maprotiline methanesulfonate in an amount of 5 mg. The medication also contains auxiliary components in the form of water for injection, mannitol and methanesulfonic acid. The drug goes on sale in 5 ml ampoules made of colorless glass.
Pharmacology of a medical product
What is the medicine "Ladisan"? Instructions and reviews indicate that this is a drug that belongs to the group of norepinephrine and serotonin reuptake inhibitors. In other words, this medication is an antidepressant with a tetracyclic structure.
The pharmacological action of the active component of this drug is to inhibit the reuptake of (neuronal) norepinephrine and the neurotransmitters serotonin by the presynaptic membranes of brain neurons.
The medication in question is distinguished by the correct combination of all the basic properties of drugs for depression. The use of this medicine raises the patient's mood, eliminates habitual feelings of fear, helps eliminate an excited state, and also relieves various somatic disorders and psychomotor retardation, which are characteristic of masked depression.
How quickly does Ladisan take effect? The instructions for use state that this drug exhibits its properties quite quickly. The therapeutic effect after using the product can be observed within a few days.
It should also be noted that the antidepressant in question is quite well tolerated by the human body. That is why it has become widespread in outpatient treatment.
Use of the drug LADISAN during breastfeeding and pregnancy
Contraindicated in the first trimester.
In pregnancy, the use of Ladisan should also be avoided in case of urgent need and the absence of a reliable, more alternative drug. Experience in the use of Ladisana during pregnancy is insufficient. Individual cases indicate a possible relationship between the use of the drug and side effects in the fetus. The active substance penetrates Ladisana into breast milk. After a repeated dose of 150 mg/day after five days, the concentration in breast milk is higher than during administration.
Dosage regimen
Doses should be individually selected depending on the patient's condition. For example, the evening dose can be increased by reducing the day dose or, alternatively, the daily dose can be given once, preferably in the evening. If a significant improvement is achieved, you can try to reduce the dose, but if the symptoms of depression re-intensify, you must return to the previous regimen.
dosage
Depression (mainly in outpatient treatment) 25 mg 1-3 times a day or 25-75 mg once (preferably depending) in the evening, depending on the severity of symptoms and therapeutic effectiveness.
severe For depression (mainly during hospitalization), 25 mg 3 times a day or 75 mg once (preferably in the evening).
necessary If the daily dose can be increased by 150 mg, when administered in several doses once or depending on the therapeutic effect.
IV
In newly diagnosed severe cases of depression or in the treatment of patients with insufficient response to oral therapy, Ladisan can be administered intravenously. For intravenous drip infusion, a daily dose of 25-100 mg is recommended. The contents of 1-2 ampoules (25-50 mg) are diluted with 250 ml of isotonic solution of sodium glucose chloride or and administered slowly over 1.5-2 hours. If a higher dose is required for the patient, 75-150 mg is infused over 2-3 hours ( 3-6 ampoules of the drug are diluted in the above 500 ml of solutions).
After infusion therapy, i.e. After achieving a clear therapeutic effect, usually during the first two weeks of the patient, treatment is transferred to oral treatment with the drug.
intravenous injections The daily dose is 25-50 mg.
The contents are diluted in ampoules with 10 ml of isotonic sodium chloride solution twice or with distilled water and administered slowly over a period of less than 3 minutes. Ladisan is used intravenously only in hospital settings.
Dosage forms
The pharmaceutical industry produces Ladisan in two dosage forms. The drug can be purchased in the form of tablets, round in shape and coated with a special coating. Tablets contain 25 or 50 mg of the active substance - maprotiline hydrochloride. The blister contains ten tablets.
The second dosage form of Ladisan is a solution intended for infusions and intravenous injections. 1 ml of solution contains 5 mg of active substance. Excipients in the solution are water for injection, methanesulfonic acid and mannitol.
Overdose
Symptoms
Overdoses develop after approximately 4 hours, reach a maximum after 24 hours of taking the drug and can persist in Overdose 4-6, the course may be manifested by
depression or central excitation of the nervous system
(drowsiness, anxiety, convulsions, ataxia, stupor, coma, increased reflexes, muscle rigidity , choreoathetosis);
disorders of the cardiovascular system
(tachycardia, arrhythmia, arterial hypotension, conduction disorders, cardiac shock, heart failure);
in rare cases
- respiratory depression, cyanosis, vomiting, mydriasis, fever, increased sweating, oliguria, anuria.
There is no specific antidote. Treatment
symptomatic. Peritoneal hemodialysis or dialysis are not effective.
Side effects of Ladisan
Reviews of Ladisan confirm that the use of the drug causes a variety of side effects. Patients may experience dizziness, dry mouth, fatigue, constipation, and impaired accommodation. Sometimes tachycardia and low blood pressure appear. The use of Ladisan may also cause allergic reactions such as skin rashes or hives.
According to the instructions, Ladisan is taken with caution in acute and chronic diseases, including renal and liver failure, and urinary disorders. If the patient takes Ladisan for a very long time, it is necessary to periodically conduct an ECG and monitor the cardiovascular system
This is especially true for elderly patients, as well as patients with diseases of the cardiovascular system.
Special Recommendations
When should the antidepressant Ladisan not be prescribed? The instructions for use indicate that this medicine is recommended with extreme caution to patients with impaired kidney or liver function, as well as with increased pressure (intraocular) and urinary disorders (including prostate diseases).
If this medication is used for a long time, patients should regularly undergo an ECG and monitor their heart function. This is especially true for those who suffer from cardiovascular diseases, including elderly patients.
Patients who are prone to orthostatic hypotension should regularly check their blood pressure while taking the drug.
It must be taken into account that, like other psychotropic drugs, this antidepressant significantly reduces a person’s tolerance to alcohol.
What else do you need to know before using Ladisan? Reviews from patients say that the drug in tablet form negatively affects their psychophysical reactions, especially if it was taken simultaneously with ethanol or medications that have a depressive effect on the central nervous system.
It should also be noted that when using the Ladisan infusion solution, attention and reactions are very often impaired in patients. Therefore, during therapy with this drug, patients are prohibited from driving vehicles and operating dangerous machinery.
Overdose
Psychogenic depression – neurotic, reactive, exhaustion depression; endogenous depressions – cyclical, periodic, involutional; somatogenic depression – symptomatic and organic; masked forms of depression; menopausal.
High sensitivity to the components of the drug; history of epilepsy and similar conditions; cardiac arrhythmias; pregnancy; myocardial infarction in the acute period.
Take with caution if you have liver and kidney diseases, urination disorders, or increased intraocular pressure. The dosage of the drug is selected individually depending on the severity of the disease
It is possible to increase or decrease the evening dosage by decreasing or increasing the daily dose. The daily dose can be taken in one dose, preferably in the evening. After achieving a positive effect, it is possible to reduce the dose, but if repeated signs of depression appear, you should return to the previous dose
The dosage of the drug is selected individually depending on the severity of the disease. It is possible to increase or decrease the evening dosage by decreasing or increasing the daily dose. The daily dose can be taken in one dose, preferably in the evening. After achieving a positive effect, it is possible to reduce the dose, but if repeated signs of depression appear, you should return to the previous dose.
Pills
Ladisan tablets are taken orally.
For severe depression (mainly in hospital treatment): 25 mg 3 times a day or 75 mg once (preferably in the evening). If necessary, the daily dosage can be increased to 150 mg.
Solution
Ladisan solution is administered intravenously. Before using the drug, the contents of 2 ampoules should be dissolved in 250 ml of sodium chloride or glucose solution. Introduce the prepared solution slowly over 2 hours.
When administering a higher dose, it is necessary to increase the infusion time to 3 hours. Course of treatment: no more than 2 weeks. Next, the patient is transferred to the oral form of the drug.
If recommended dosages are exceeded, in rare cases, overdose symptoms may develop: excitement or depression of the central nervous system (drowsiness, muscle rigidity, mydriasis, anxiety, convulsions, coma), dysfunction of the cardiovascular system (tachycardia, arterial hypotension, arrhythmia). Less commonly – vomiting, fever, cyanosis, anuria.
Symptoms begin to appear 4 to 24 hours after taking high doses of the drug.
https://www.youtube.com/watch?v=ytcopyrightru
Medicines with a similar mechanism of action (matching level 4 ATC code): Doxepin, Melipramine, Ludiomil.
Do not decide to change the drug on your own; consult your doctor.
Ladisan tablet p/o 25 mg in blister pack. in pack №10x3
Name
Ladisan tablet p/o 25 mg in blister pack. in pack №10x3
Description
25 mg tablets: film-coated tablets, orange-brown in color, round in shape, marked “PLIVA” on one side.
Main active ingredient
Maprotiline
Release form
30 tablets of 25 mg in a PVC/Al blister.
Dosage
25mg
pharmachologic effect
Ladisan contains maprotiline as an active substance, which is a tetracyclic antidepressant. It has a pronounced and selective inhibitory effect on the reuptake of norepinephrine by presynaptic neurons of the cerebral cortex, but has almost no inhibitory effect on the reuptake of serotonin. Maprotiline has a weak or moderate affinity for central β-adrenergic receptors; has a moderate anticholinergic effect and an inhibitory effect on histamine H1 receptors. It is believed that changes in the functional state of the neuroendocrine system (growth hormone, melatonin, endorphinergic system) and/or the neurotransmitter system (norepinephrine, serotonin, GABA) are also important in the mechanism of action of the drug during its long-term use.
Pharmacokinetics
Absorption After a single dose of the film-coated tablet, maprotiline hydrochloride is slowly but completely absorbed. The average absolute bioavailability is 66-70%. After a single oral administration of the drug at a dose of 50 mg, Cmax in the blood is 48-150 nmol/l (13-47 ng/ml) and is achieved within 8 hours. When Ladisan is administered orally at a dose of 150 mg/day, the equilibrium concentration of maprotiline in the blood is achieved in the second week of treatment and is 320-1270 nmol/l (100-400 ng/ml), regardless of whether the entire daily dose is administered once or in 3 doses. The values of the equilibrium concentration are linearly dependent on the dose of the drug, although they vary significantly in individual patients. Distribution The distribution coefficient of maprotiline between whole blood and plasma is 1.7. The average volume of distribution is 23-27 l/kg. The binding of maprotiline to plasma proteins is 88-90%, regardless of the patient’s age and the nature of the disease. The concentration of maprotiline in the cerebrospinal fluid is 2-13% of the concentration in the blood serum. Metabolism Maprotiline hydrochloride is largely metabolized, only 2-4% of the dose taken is excreted unchanged in the urine. The main metabolite is the pharmacologically active desmethyl derivative. Several hydroxylated and/or methoxylated metabolites are of minor importance; they are excreted in the urine in the form of conjugates. Elimination The half-life of maprotiline averages 43-45 hours. The total clearance varies from 510 to 570 ml/min. After taking a single dose of the drug, its elimination occurs within 21 days: 2/3 of the dose is in the urine (unchanged or in the form of conjugates) and about 1/3 is in the feces. Pharmacokinetics in special clinical cases When using the drug at the same dose in elderly patients (over 60 years), the equilibrium concentration of the active substance in the blood is higher than in young patients; the half-life is longer; The daily dose of Ladisan should therefore be halved. If renal function is impaired (creatinine clearance values 24-37 ml/min), the half-life of maprotiline changes slightly, provided that liver function is normal. Excretion of metabolites by the kidneys decreases, but this is compensated by increased excretion in bile. Preclinical safety data Animal studies have not revealed any adverse effects of maprotiline on the fetus. No carcinogenic effect of the drug was detected when high doses of the drug were used for a year. There was also no evidence of mutagenicity in mouse offspring at doses up to 60 times the recommended dose for humans.
Indications for use
Ladisan is used for depression and depressive conditions of various types.
Directions for use and doses
The recommended dose is between 75 mg and 150 mg per day. Depending on the severity of symptoms, tolerability and effect of treatment, a daily dose of 25 mg (one to three times daily) or 75 mg (once daily) may be started and then the dose may be gradually increased to an effective dose. It is not recommended to exceed the maximum daily dose of 150 mg. Doses should be selected individually depending on the patient's condition. For example, the evening dose can be increased by reducing the daily dose or, alternatively, the daily dose can be given in one dose, preferably in the evening. If a significant improvement is achieved, you can try to reduce the dose, but if the signs of depression re-intensify, you must return to the previous dosage regimen. If possible, you should strive to achieve a therapeutic effect with the lowest effective dose, and only if ineffective, gradually increase it. Ladisan film-coated tablets should be swallowed whole with a sufficient amount of liquid. Use in elderly people (over 60 years of age) In general, the use of lower doses of Ladisan is recommended. The initial dose is 10 mg 3 times/day or 25 mg 1 time/day. If necessary, the daily dose of the drug can be gradually, each time by a small amount, increased to 75 mg (25 mg 3 times / day or 75 mg 1 time / day) depending on tolerability and the effect of treatment. Use in children and adolescents (up to 18 years of age) No data have been obtained on the safety and effectiveness of maprotiline in children and adolescents. Therefore, taking Ladisan in this age group is not recommended. Discontinuation of treatment: Abrupt discontinuation of the drug or rapid dose reduction should be avoided.
Use during pregnancy and lactation
Animal experiments have shown that maprotiline does not have a teratogenic or mutagenic effect; does not cause fertility problems or damage to the fetus. However, the safety of the drug in humans during pregnancy has not yet been established. There are isolated reports of a possible relationship between adverse effects on the human fetus and the use of maprotiline. Ladisan should not be prescribed during pregnancy unless the expected therapeutic effect on the mother clearly outweighs the risk to the fetus. In order to prevent the development of symptoms in the newborn such as shortness of breath, lethargy, irritability, tachycardia, arterial hypotension, convulsions, nervous agitation and hypothermia, Ladisan should be discontinued at least 7 weeks before the expected day of birth (provided that the patient’s condition allows this ). Maprotiline passes into breast milk. After taking Ladisan at a daily dose of 150 mg for 5 days, the concentration of maprotiline in breast milk exceeds the concentration in plasma by 1.3-1.5 times. Although published reports indicate that maprotiline does not cause adverse effects in neonates, either the drug or breastfeeding should be discontinued during lactation. Interaction with other medicinal products and other modes of interaction Concomitant use of CYP2D6 inhibitors may lead to increased concentrations of maprotiline.
Precautionary measures
Suicide/suicidal thoughts or clinical deterioration In severe depression, there is always an increased risk of suicidal behavior, which may persist until remission occurs. Because symptoms may not improve during the first few weeks or more of treatment, patients should be closely monitored during this period. It is known that the risk of suicidal thoughts or suicide attempts increases in patients who have a history of suicidal actions or suicidal thoughts before treatment, so careful monitoring of such patients is necessary while taking the drug. In a meta-analysis of placebo-controlled clinical trials conducted in adult patients with psychiatric disorders, there is an increased risk of suicidal behavior in patients under 25 years of age taking antidepressants compared with patients receiving placebo. Careful observation is necessary during treatment and especially at the beginning of treatment and after dose changes. Patients (as well as their observers) should be warned to monitor for symptoms of clinical worsening, suicidal behavior or thoughts of suicide, or unusual changes in behavior. If these symptoms occur, you should seek immediate medical attention. Convulsions There are some rare reports of the development of convulsions when using maprotiline in therapeutic doses in patients who had no indication of a history of convulsions. Sometimes in these cases there were factors (for example, the simultaneous use of drugs that lower the seizure threshold), the effect of which could lead to the development of seizures. The risk of developing seizures may be increased by concomitant use of phenothiazine derivatives, by sudden discontinuation of concomitantly used benzodiazepines, or by a rapid increase in the dose of maprotiline above the usually recommended dose. Although a clear causal relationship has not been identified, it is nevertheless clear that the risk of seizures can be reduced by following the following recommendations: start treatment with Ladisan with a small dose; keep the initial dose unchanged for 2 weeks and then increase the dose slowly, in small “steps”; for long-term maintenance treatment, use the minimum effective dose; Avoid concomitant use of drugs that lower the seizure threshold (for example, phenothiazines) or, if such drugs are used, change their dosage with great caution; Avoid rapid withdrawal of concomitantly used benzodiazepines. Cardiac and vascular disorders There are reports that tricyclic and tetracyclic antidepressants can cause arrhythmias, sinus tachycardia and slowing of intracardiac conduction. In this regard, caution is required when prescribing these drugs to elderly patients and patients with cardiovascular diseases, incl. with a history of myocardial infarction, arrhythmias and/or ischemic heart disease. In these patients, especially with long-term treatment with antidepressants, regular monitoring of cardiac function, including an ECG, is indicated. Patients susceptible to orthostatic hypotension should have their blood pressure measured regularly. Other psychiatric effects Exacerbations of psychotic symptoms have sometimes been observed in patients with schizophrenia taking tricyclic antidepressants; the risk of developing such a complication should be taken into account when prescribing Ladisan. In patients with cyclic affective disorders who received tricyclic antidepressants during the depressive phase of the disease, hypomanic or manic episodes occurred. In such cases, it may be necessary to reduce the dose of Ladisan, up to its discontinuation, and prescribe an antipsychotic drug. Co-administration with antipsychotic drugs (for example, phenothiazines, risperidone) may lead to increased plasma concentrations of maprotiline, a decrease in the seizure threshold and seizures. Combination with the CYP2D6 inhibitor thioridazine may result in serious cardiac arrhythmias. Tricyclic antidepressants in predisposed patients and in elderly patients can provoke the development of drug-induced (delirious) psychoses, especially at night; these phenomena usually resolve on their own within a few days after discontinuation of the drug. Hypoglycemia The possibility of hypoglycemia should be considered in patients receiving maprotiline concomitantly with a sulfonylurea or insulin. When starting or stopping treatment with maprotiline, blood glucose levels should be carefully checked in patients with diabetes mellitus. White blood cell count Although there are only isolated reports of changes in the number of white blood cells in the peripheral blood during treatment with maprotiline, periodic monitoring of this indicator and increased attention to symptoms such as fever and sore throat are nevertheless necessary. Following these recommendations is especially important in the first months of treatment and during long-term therapy with Ladisan. Anesthesia Before performing general or local anesthesia, the anesthesiologist should be warned that the patient is taking Ladisan. Continuation of treatment with Ladisan seems safer compared to those disorders that may arise as a result of sudden discontinuation of the drug before surgery. Special groups of patients and long-term use During long-term therapy with Ladisan, it is recommended to regularly monitor liver and kidney function indicators. Ladisan should be used with caution in patients with a history of increased intraocular pressure or urinary retention, especially with prostatic hypertrophy. Tricyclic antidepressants may contribute to the development of paralytic ileus, mainly in elderly patients or in hospitalized patients. Therefore, if the patient experiences constipation, appropriate measures must be taken. Ladisan should be used with caution in patients with hyperthyroidism, as well as in those taking thyroid hormone medications (there may be an increase in the incidence of cardiac side effects). An increase in dental caries has been reported with long-term treatment with antidepressants. In this regard, during long-term therapy, regular examination of the patient by a dentist is recommended. Due to the anticholinergic effect of tricyclic antidepressants, there may be a decrease in tear production and a relative increase in the amount of mucus in the tear fluid, which can lead to damage to the corneal epithelium in patients using contact lenses. Discontinuation of treatment Sudden withdrawal or sharp reduction in the dose of Ladisan should be avoided, because this may lead to side effects. If a decision is made to discontinue Ladisan, the dose should be reduced, keeping in mind that sudden cessation may be associated with certain symptoms. Ladisan film-coated tablets contain lactose. Patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not take this drug.
Interaction with other drugs
It is not recommended to prescribe Ladisan for at least 14 days after discontinuation of MAO inhibitors (risk of severe drug interactions leading to the development of hyperpyrexia, tremor, generalized clonic seizures, delirium; possible death). The same rule is followed if MAO inhibitors are prescribed after previous therapy with Ladisan. Antiarrhythmic drugs Ladisan should not be prescribed in combination with antiarrhythmic drugs such as CYP2D6 inhibitors such as quinidine. The anticholinergic effect of quinidine may be synergistic with the effect of maprotiline, and its severity depends on the doses of these drugs. Antidiabetic agents The combined use of Ladisan with sulfonylurea derivatives or insulin may potentiate their hypoglycemic effect. In patients with diabetes mellitus, regular monitoring of blood glucose levels is necessary both at the beginning of Ladisan therapy and at its end. Antipsychotics Concomitant use of antipsychotic drugs (eg, phenothiazines, risperidone) may lead to increased plasma concentrations of maprotiline, a decrease in the seizure threshold and the development of seizures. Combination with the CYP2D6 inhibitor thioridazine may lead to the development of severe arrhythmias. Thus, it is necessary to adjust the dose. Anticoagulants Ladisan may enhance the anticoagulant effect of coumarin derivatives due to inhibition of their metabolism in the liver. In such cases, the prothrombin time should be carefully monitored and, if necessary, the dose of the anticoagulant should be reduced. Anticholinergic drugs Ladisan can potentiate the effect of drugs with anticholinergic properties (for example, phenothiazines, antiparkinsonian drugs, atropine, biperiden, antihistamines) on the pupil of the eye, the central nervous system, intestines and bladder. Antihypertensives Concomitant use of beta-blockers that are CYP2D6 inhibitors, such as propranolol, may lead to increased plasma concentrations of maprotiline. In such cases, it is recommended to monitor the concentration of the drug in plasma and dose adjustment. Ladisan can reduce (or even completely block) the antihypertensive effect of drugs that affect the transmission of adrenergic excitation, such as guanethidine, betanidine, reserpine, clonidine and alphamethyldopa. It should be borne in mind that sudden withdrawal of Ladisan can lead to severe arterial hypotension. Sympathomimetics Ladisan may potentiate the cardiovascular effects of sympathomimetic agents such as adrenaline (epinephrine), norepinephrine (norepinephrine), isoprenaline, ephedrine and phenylephrine, incl. and in cases where they are part of nasal drops or local anesthetics (for example, used in dentistry). In such situations, careful monitoring of the patient (monitoring blood pressure, heart rate) and careful selection of the dose of drugs are required. IIHC depressants Patients taking Ladisan should be warned that their reaction to alcohol, barbiturates and other drugs that have a depressant effect on the central nervous system may be more pronounced. Benzodiazepines The simultaneous use of Ladisan and benzodiazepines may lead to increased sedation. Methylphenidate Methylphenidate may increase plasma concentrations of tricyclic antidepressants and thereby enhance their effect. Dosage adjustments may be necessary if used together. Selective serotonin reuptake inhibitors (SSRIs) Selective serotonin reuptake inhibitors that are CYP2D6 inhibitors, such as fluoxetine, fluvoxamine (also an inhibitor of CYP3A4, CYP2C19, CYP2C9 and CYP1A2), paroxetine, sertraline or citalopram, may lead to increased plasma concentrations of maprotiline with associated side effects. Due to the long half-life of fluoxetine and fluvoxamine, this effect may be prolonged. Thus, there may be a need to adjust the dose of Ladisan. (H2) receptor antagonists Co-administration of histamine (H2) receptor antagonists, cimetidine (an inhibitor of several P450s, CYP2D6 including CYP3A4) suppresses the metabolism of several tricyclic antidepressants, which leads to an increase in the plasma concentration of the latter and increases the frequency of side effects (dryness in the mouth, blurred vision). Therefore, it may be necessary to reduce the dose of maprotiline when used concomitantly with cimetidine. Effect of tititochrome P450 inducers on the metabolism of Maprotiline Maprotiline is primarily metabolized through CYP2D6 and, to a lesser extent, through CYP1A2. It has not been established that CYP2D6 can induce, but concomitant use of substances known to induce CYP1A2 may increase the formation of desmethylmaprotiline. A decrease in the overall pharmacodynamic effect is not expected since it is an active metabolite. However, induction of an enzyme that is not yet known to be involved in the metabolism of maprotiline and desmethyl maprotiline (eg cytochrome P450 phase II enzyme) may accelerate the metabolism of the drug and reduce its effectiveness. Concomitant use of substances that induce cytochrome P450, it may be necessary to adjust the dose of maprotiline, especially when taking drugs that are commonly involved in the metabolism of tricyclic antidepressants, such as CYP3A4, CYP2C19 and/or CYP1A2 (for example, rifampicin, carbamazepine, phenobarbital and phenytoin ).
Contraindications
Hypersensitivity to maprotiline or any component of the drug. Hypersensitivity to tricyclic antidepressants. Epilepsy, convulsions and similar conditions in history, acute myocardial infarction, intracardiac conduction disorders, glaucoma, urinary outflow retention, severe liver and kidney dysfunction. Concomitant use or use within 14 days after discontinuation of monoamine oxidase inhibitors. Acute poisoning with alcohol, sleeping pills or psychotropic drugs.
Compound
1 tablet of 25 mg contains: 25 mg of maprotiline hydrochloride.
Overdose
An overdose of Ladisan may develop the same symptoms as in the case of an overdose of tricyclic antidepressants. The main complications are cardiac disorders and neurological disorders. In children, accidental ingestion of the drug should be regarded as a very serious and fatal incident, regardless of the size of the dose taken. Complaints usually appear within 4 hours after taking maprotiline and reach maximum severity after 24 hours. Due to slow absorption (anticholinergic effect of the drug), long half-life and hepatoenteric recirculation of maprotiline, the risk to the patient's life continues for 4-6 days. The following symptoms may occur. From the side of the central nervous system: drowsiness, stupor, coma, ataxia, anxiety, agitation, increased reflexes, muscle rigidity, choreoathetoid movements, convulsions. From the cardiovascular system: arterial hypotension, tachycardia, arrhythmias, intracardiac conduction disorders, shock, heart failure; in very rare cases - cardiac arrest. In addition, respiratory depression, cyanosis, vomiting, fever, mydriasis, sweating, oliguria or anuria are possible. Treatment: There is no specific antidote, treatment is mainly symptomatic and supportive. Patients who show signs of maprotiline overdose, especially children, should be hospitalized and under close medical supervision for at least 72 hours. Gastric lavage should be performed as quickly as possible or, if the patient is conscious, induce vomiting. If the patient is unconscious, tracheal intubation should be performed before starting gastric lavage; In this case, vomiting cannot be induced. These measures are recommended if up to 12 hours or even more have passed since the onset of the overdose, because the anticholinergic effect of the drug may slow down its absorption. To slow down the absorption of maprotiline, the use of activated carbon is useful. Treatment is based on the use of modern intensive care methods with constant monitoring of heart functions, gas composition and blood electrolytes. If necessary, anticonvulsant therapy, mechanical ventilation and other resuscitation methods are used. Since there have been reports that physostigmine can cause severe bradycardia, asystole and seizures, its use in cases of Ladisan overdose is not recommended. Hemodialysis and peritoneal dialysis are not effective because... plasma concentrations of maprotiline are low.
Side effect
Side effects are usually minor and temporary, usually disappearing with continued therapy or after dose reduction. There is not always a correlation between side effects and plasma drug levels or dose. Often, certain side effects are difficult to distinguish from symptoms of depression, such as fatigue, sleep disturbances, agitation, anxiety, constipation, or dry mouth. In case of serious side effects, such as neurological or psychiatric in nature, you must stop taking maprotiline. Elderly patients are particularly susceptible to anticholinergic, neurological, psychiatric or cardiovascular effects. Metabolism and elimination of the drug in elderly patients may be slower and lead to increased plasma concentrations. Below are the side effects that can develop both when using Ladisan and tricyclic antidepressants in general. Side effects are classified according to frequency as: Very common > 1/10 (> 10%); often > 1/100 and 1% and 1/1000 and 0.1% and 1/10000 and 0.01% and
Storage conditions
Store at a temperature of 15 - 25°C. 3 years (indicated on the packaging).
Ladisan
Found (56 posts)
neurologist November 15, 2009 / Anton / 0
Hello doctor! I am 22 years old and I have the following problem: on November 4, while walking, I felt suffocated. I thought it would go away on its own, but it didn’t. After some time, suffocation... open (2674 more messages)Last 5:
November 17, 2010 / Ivan-34
... not drinking provokes panic states the next day. In the fall, I usually feel all these delights more keenly. For example, now I take Noofen and Ladisan
. I saw a psychiatrist. I know my problem. I’m not so afraid of attacks anymore, I’m used to it and realized that the devil is not so scary. ...
psychotherapist August 20, 2010 / Larisa / Krasnoarmeysk
Hello! I want to ask for help. Two months ago, my eldest son drowned, the boy was 23 years old. I barely survived the funeral, they gave me fenezepam, then switched to... open (9 more messages)Last 5:
September 2, 2010 / @anonymous
...place. And what? I turned to help everywhere - to church, to grandmothers, and finally to a psychotherapist. Prescribed Stimuloton, Ladisan
, depakine, in emergency cases clonazepam. Such a cocktail. I was also afraid of becoming a drug addict, etc. AD only started to work...
psychotherapist April 28, 2010 / Tatyana / Gomel region
... I was in the neurosis department several times. I took fevarin for more than 1.5 years. The doctor, taking into account the lack of positive dynamics, changed fevarin to Ladisan
, but it made it even worse. I haven’t been taking any antidepressants for over a month now, but occasionally, when... open
(6 more messages)Last 5:
cardiologist February 3, 2010 / Tatyana
..., and while taking it, there were even daytime ones. and low blood pressure - 100/60, so I was afraid to increase the dose of Concor. 3. I drink Ladisan
prescribed by doctor. can it be combined with beta blockers? and isn't it harmful to the heart? Thank you. sorry for some confusion in ... open
psychotherapist January 30, 2010 / Tatyana / 0
... and several times a night, the heart accelerated to crazy numbers, the pressure crawled up (140-160). then I started taking Ladisan
(for three weeks already), I was treated in a day hospital by a psychotherapist.
the night attacks “smoothed out” - there were, but the heart did not beat... open (2 more messages) Last 5:
psychiatrist November 14, 2009 / Elena / 0
My husband has deep depression. He is 51 years old. I have been taking Ladisan
Lamolep Ketilept was prescribed beforehand. I don't see the effect. We see a psychiatrist regularly. Maybe stop taking the medications? open
psychotherapist October 15, 2009 / @anonymous
Hello! Tell me, what kind of disease could this be and how to treat it? My mother is 61 years old. All her life she was a hard worker and never screamed. My father, on the contrary, has a character... open
October 16, 2009 / @anonymous
...stage of Alzheimer's. At the hospital, the doctor ruled out Alts-ra and diagnosed depression. Now they want to show her to an assistant professor so that he can make his diagnosis, because no one knows how to treat her (they cannot make a diagnosis). The doctor told me to take Ladisan
.
psychotherapist May 25, 2009 / Alexey
... and there was nothing that left me worried. There was practice of using medications but it did not bring anything. drank Ladisan
150 mg per day for almost a month... no effect. District psychotherapists are not confident in themselves) What do you say about ... open
psychotherapist May 15, 2009 / Oksana
Hello! I have this problem. I am 45 years old. Until I was 30, everything was fine, then, due to problems in the family, fears began, fear of traveling, fear of death, fear for loved ones, fear... open (9 more messages)Last 5:
May 19, 2009 / Oksana
... I can’t remove it, plus I’m constantly cold. Naturally, my mood deteriorates, I don’t want anything, I just feel safe at home. Is it advisable to take mezapam now? I was also once prescribed Ladisan
, what can you say about him?
neurologist November 19, 2008 / Elena
... - fears, anxiety, hallucinations, memory loss (not often), colitis (about a year at the beginning). We drink Sindopa 1 t once a day, Ladisan
— 1t 3 times a day. We have been drinking for about a year, before we only drank 2 tons of syndopa. per day, then increased the dose. Seizures began to appear. ... open
Drug interactions
When using the drug Ladisan simultaneously with other drugs, the following are observed:
- weakening or complete cessation of the antihypertensive effect of inhibitors of adrenergic neurons directly (guanethidine, for example); in such cases, antihypertensive drugs of a different mechanism of action are indicated;
- potentiation of the effect of norepinephrine or adrenaline on the cardiovascular system, the activity of anticholinergic drugs and with a blocking effect on the central nervous system;
- simultaneous use with MAO inhibitors is contraindicated; Ladisan (like other antidepressant drugs) can be prescribed after completion of MAO inhibitors, observing a certain period of time (usually after 14 days).
Adverse reactions
According to reviews from most consumers, in the first days of using Ladisan, it can cause fatigue, as well as anticholinergic effects such as dry mouth, constipation, impaired accommodation and dizziness.
In very rare cases, while using the medication in question, the patient experiences a decrease in blood pressure and tachycardia. Skin reactions are also possible, which are associated with the patient's hypersensitivity to maprotilene. In this case, you need to stop taking the medicine.
Indications for use of Ladisan
According to the instructions, it is advisable to use Ladisan for various depressions:
- somatogenic (symptomatic, organic);
- endogenous (involutional, cyclical, periodic);
- depression of menopause;
- psychogenic (neurotic, reactive, exhaustion depression);
- masked forms of depression.
Ladisan is also prescribed for other depressive disorders accompanied by the following symptoms:
- apathy;
- irritability or dysphoria;
- feeling of fear.
According to reviews, Ladisan has a beneficial effect on somatic and psychosomatic disorders that arise against the background of feelings of fear or melancholy.
Pharmacological action of Ladisan
According to the instructions, Ladisan is a drug belonging to the group of serotonin and norepinephrine reuptake inhibitors. The pharmacological effect of maprotiline (an antidepressant with a tetracyclic structure) is to stop the reverse neuronal uptake of the neurotransmitters serotonin and norepinephrine by the presynaptic membranes of cerebral cortex neurons.
This medicine has an optimal combination of all the main properties of antidepressants. The use of Ladisan improves mood, promotes the disappearance of an excited state and feelings of fear, relieves psychomotor retardation and various somatic disorders characteristic of masked depression.
Ladisan acts quite quickly, and the therapeutic effect can be observed just a few days after the start of treatment. In addition, according to reviews, Ladisan is very well tolerated by the body, so it is widely used in outpatient practice.
Pharmacokinetics
After oral administration, Ladisan is completely absorbed. In therapeutic doses, it binds to serum proteins by 88%. The half-life of the active substance in unchanged form averages 43 hours. With daily or oral intravenous administration in a daily dose of 150 mg, the second week of treatment, an equilibrium of its concentrations in the blood plasma is established ( 320-1270 Equilibrium/l).
nmol concentrations of the drug in the blood plasma of elderly people (over 60 years of age) are higher than those at the same doses than in younger people. Approx. 57% of the administered dose of the drug is excreted in urine and 30% in feces. Over 90% of the active amount of the substance excreted by the kidneys is excreted in the form of metabolites (75% in the form of glucuronides).
glucuronides to the use of the drug LADISAN
Depression
— endogenous depressions: periodic, cyclical, involutional;
- psychogenic reactive: depression, neurotic, exhaustion depression;
— somatogenic organic: depression, symptomatic;
— larvated (masked) forms of menopause;
- depression depression.
Other depressive states accompanied by feelings of fear, dysphoria or irritability, especially (apathy in old age), then in cases of somatic and psychosomatic disorders against a background of feelings of melancholy and/fear or.
Ladisan should be used with caution in patients with impaired liver or kidney function, urination disorders (for example, with prostate disease), and a history of intraocular pressure. When using long-term high doses of the drug, it is necessary to monitor cardiac function and ECG. This applies especially to patients suffering from heart disease and elderly patients
In persons with a tendency to orthostatic hypotension, it is necessary to regularly monitor blood pressure. others and As psychotropic drugs, Ladisan reduces alcohol tolerance
This applies especially to patients suffering from heart disease and elderly patients. In persons with a tendency to orthostatic hypotension, it is necessary to regularly monitor blood pressure. others and As psychotropic drugs, Ladisan reduces alcohol tolerance.
Ladisan in the form of tablets can have an adverse effect on psychophysical reactions, especially when used simultaneously with alcoholic beverages or with a depressant effect on the central nervous system, the patient should be warned about this. When administered intravenously, Ladisan has a strong effect on psychophysical reactions. During treatment with the drug, it is not allowed to perform driving or work requiring fast psychomotor control.
Cautions
The drug is prescribed with caution to patients with impaired liver or kidney function, with increased intraocular pressure, and with urinary disorders (for example, with prostate diseases).
With long-term use of Ladisan, patients should regularly perform an ECG and monitor heart function. This is especially true for patients who suffer from cardiovascular diseases and elderly patients. Patients prone to orthostatic hypotension should have their blood pressure checked regularly while taking the medication.
It should be borne in mind that, like other psychotropic drugs, the use of Ladisan reduces tolerance to alcohol.
According to reviews, Ladisan in tablet form can negatively affect psychophysical reactions, especially if the medicine is combined with alcohol or drugs that have a depressive effect on the central nervous system.
When using Ladisan solution, a strong negative effect on psychophysical reactions is possible, therefore, during the treatment period, patients are prohibited from driving a car or operating potentially dangerous mechanisms.
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Ladisan
Found (56 posts)
psychiatrist February 23, 2012 / Sveta / Belarus
I have depression and PA. I have been taking amitriptyline and Xanox for 8 years. Now the doctor has added Ladisan
,PLEASE TELL HOW I CAN COMBINE THEM AND IS IT POSSIBLE. I won’t abruptly cancel what I was taking. THANK YOU! open
February 24, 2012 / Shenderov Kirill Valerievich
The country is correctly called Belarus (RB). Ladisan
- this is more familiar to us - lyudiomil (tetracyclic antidepressant).
For panic attacks, neither amitriptyline nor Ladisan
are the drugs of choice. Simultaneous administration of amitriptyline and...
psychotherapist December 26, 2011 / Artur
... sometimes I feel depressed, all sorts of bad thoughts creep in and my throat somehow tightens. I lay down in the hospital, checked my health, everything is fine, they prescribed me Ladisan
and Grandaxin during the day everything is fine, one can say, but in the evening it hits me, when I go to bed I’m afraid of suffocating... open
gastroenterologist November 16, 2011 / Olga / Belarus
...sour taste. Duodenal ulcer in remission. Currently in a state of depression (which recurs every six months), she is taking Ladisan
. Is it possible to take a course of omez? Is it compatible with Ladisan? Thank you. open
gastroenterologist November 15, 2011 / Olga / Brest
...sour taste. Duodenal ulcer in remission. Currently in a state of depression (which recurs every six months), she is taking Ladisan
. Is it possible to take a course of omez? Is it compatible with Ladisan? Thank you. open
psychiatrist July 30, 2011 / Vitaly / Minsk
Hello, please tell me - I stopped taking Fluxen (MAO inhibitor) 12 days ago, now I want to start taking Ladisan
(and this is a tricyclic drug). Can I already take it and what could happen if MAO and tricyclic drugs... open
July 30, 2011 / Anonymous
Fluxen, or fluoxetine, is an SSRI drug, Ladisan
- or maprotiline is a four-cyclic antidepressant.
None of them... just finished taking Fluxen and started taking Ladisan
. If you are interested in knowing the answer to your question…
psychotherapist July 22, 2011 / coon / Belarus
Hello, I have the following question. Is it possible to live normally with depersonalization? I went to the doctors and they prescribed Ladisan
, stimuloton, from which the condition worsened. I stopped taking them, I live with depers. 6 years old, everything seems fine. Please tell me it’s worth... opening
psychiatrist February 28, 2011 / Dima / Minsk
... these sensations. It seems to me that
Such feelings of mine have not yet been diagnosed by anyone, and therefore there are no such medicines. I take the following medications: Amitriptyline, Ladisan
, Clozapine, cycladol and, finally, they inject me
Senorm decanoate and Maditen depot. Thank you in advance. open
neurologist February 2, 2011 / Natalya / Minsk
... ) somatoformer. autonomic dysfunction with rare migraine-like paroxysms(?), asthenia…. (?) Treatment: sermion (1 month 3 times a day), Ladisan
for anxiety (3 times a day for 1 month), syncaptone (before attacks) I am afraid to take antidepressants. In... open
Antidepressant "Ladisan": instructions for use
The dosage of the drug in question is selected individually for each patient. Typically, this depends on the severity of the disease.
Experts say that decreasing or increasing the evening dosage of this drug is allowed only if the daily dose is increased or decreased. Also, the daily amount of the drug can be taken at a time, preferably in the evening.
After achieving a positive effect, doctors recommend reducing the dose of the medication. However, if symptoms of depression recur, it is necessary to immediately return to the previous treatment regimen.
So how should you take Ladisan tablets? The instructions for use indicate that this form of the drug is intended for oral administration.
As a rule, for outpatient treatment of depression, the medicine in question is prescribed in an amount of 25 mg three times a day or 50-75 mg once in the evening.
If depression is very severe, then its treatment should be carried out in a hospital setting. With this diagnosis, the daily dosage of the drug can be increased to 150 mg.
As for the infusion solution, it is usually recommended to administer it for newly diagnosed severe depression or if treatment with the oral form of the drug has not brought the desired effect.
The daily dose of the drug by drip intravenous infusion is about 25-100 mg. To prepare a medicinal solution, the contents of two ampoules should be dissolved in 250 ml of sodium chloride or glucose solution. Next, the finished drug must be injected slowly into a vein (over 2 hours).
If the patient needs a high dose of medication, then the infusion time is increased to 3 hours.
Usually, after the first 2 weeks of treatment with an antidepressant using an infusion solution, the patient is transferred to the oral method of treatment.
Ladisan - instructions for use, reviews, indications
Ladisan is an antidepressant indicated for depressive conditions of various etiologies.
Composition, release form and packaging
The drug Ladisan is produced in several pharmaceutical forms:
- In the form of tablets, coated on top, round.
Active ingredients: 1 tablet – 25 mg, 50 mg maprotiline hydrochloride.
Auxiliary components: gelatin, lactose, colloidal silicon dioxide, calcium phosphate, dyes, corn starch, polysorbate-80, hypromellose, talc.
In a cardboard package - 1 blister with 10 tablets.
- In the form of a solution for intravenous injection and infusion, transparent, colorless.
Active ingredients: in 1 ml of solution – 5 mg of maprotiline methanesulfonate.
Auxiliary components: mannitol, methanesulfonic acid, water for injection.
In a cardboard package - 1 ampoule with a volume of 5 ml made of colorless glass.
pharmachologic effect
Ladisan belongs to the group of SSRIs and norepinephrine.
The therapeutic effect occurs quite quickly. For disorders accompanied by a feeling of fear and sleep problems, the effectiveness of the use of Ladisan is recorded within a few days from the start of use.
The mechanism of action of the drug is the suspension of the reverse neuronal uptake of the neurotransmitters norepinephrine and serotonin by the presynaptic membranes of the neurons of the GM cortex.
Ladisan is characterized by an optimal balance of the main properties of antidepressants. Reduces feelings of excitement and fear, improves mood, eliminates somatic disorders inherent in masked depression.
Ladisan is well tolerated by the body, which has influenced the widespread use of the drug in outpatient practice.
Indications
Main indications of the drug Ladisan:
Therapy for depression and depressive conditions:
- masked forms of depression;
- somatogenic depression – organic and symptomatic;
- menopausal depression;
- endogenous depressions – involutional, periodic, cyclical;
- psychogenic depression - reactive, neurotic, exhaustion depression.
Ladisan is also indicated for:
- depressive states in which apathy, irritability, fear, dysphoria, as well as psychosomatic and somatic disorders against a background of fear or feelings of melancholy are recorded.
Directions for use and dosage
The treatment regimen, duration and dosage of Ladisan are determined by the doctor, purely individually, depending on the severity of the disease.
Ladisan tablets are usually prescribed for outpatient treatment.
Recommended dosages per day:
- 1–3 times 25 mg or once (preferably in the evening) 25–75 mg – standard dosage;
- 3 times 25 mg or once 75 mg - for severe depressive conditions, in the evening, usually a similar dosage regimen is used for inpatient treatment; if necessary, it is possible to increase the dose to 150 mg (single or in several doses).
IV administration is used when oral treatment is ineffective or in cases of severe depression.
Recommended dosages per day:
- from 25 to 100 mg – standard dose for intravenous drip infusion;
- immediately before administration, 1-2 ampoules (corresponding to 25-50 mg) are diluted in 250 ml of NaCl or glucose solution, the solution is administered over 1.5–2 hours;
- at higher doses, administration is carried out over 2-3 hours (3-6 ampoules per 500 ml solution).
IV administration of Ladisan is carried out exclusively in hospital settings. After injection or infusion therapy is carried out and effectiveness is achieved, the patient is transferred to oral therapy. A noticeable therapeutic effect from the start of infusions or injections is recorded within two weeks.
At high doses, long-term use of the drug requires monitoring of heart function and regular ECG, especially in elderly patients and with cardiovascular diseases. Blood pressure should be monitored if there is a tendency to orthostatic hypotension.
Overdose
In case of an overdose of Ladisan, the following symptoms are recorded, developing, as a rule, 4 hours after administration and reaching a maximum a day later:
- cardiovascular disorders (hypertension, heart failure, tachycardia, arrhythmia);
- excitement or depression of the central nervous system (muscle rigidity, drowsiness, convulsions, anxiety, stupor, coma).
In rare cases:
- cyanosis;
- fever;
- vomit;
- oliguria;
- mydriasis;
- increased sweating;
- anuria.
Symptomatic therapy is indicated as treatment.
Analogues of the drug
The drug Ladisan currently has no analogues, with the exception of drugs that contain maprotiline. These include the drug Maprotiline, which bears the trade name Ludiomil (antidepressant).
Storage conditions
The drug Ladisan is kept at room temperature, in a place inaccessible to children, sufficiently dark and dry.
The shelf life, subject to the storage requirements specified in the instructions, is 5 years.
In the pharmacy chain, Ladisan is sold upon presentation of a doctor's prescription.
Ladisan
Latin name: Ladisan
ATX code: N06AA21
Active ingredient: Maprotiline (Maprotiline)
Manufacturer: Pliva (Croatia); Teva Pharmaceutical Industries (Israel)
Description current as of: 12.12.17
Ladisan is a drug from the antidepressant group, used to treat depressive conditions of various etiologies.
Instructions for use Ladisan (method and dosage)
The dosage of the drug is selected individually depending on the severity of the disease. It is possible to increase or decrease the evening dosage by decreasing or increasing the daily dose.
The daily dose can be taken in one dose, preferably in the evening.
After achieving a positive effect, it is possible to reduce the dose, but if repeated signs of depression appear, you should return to the previous dose.
Pills
Ladisan tablets are taken orally.
For the treatment of depression: 25 mg 1 - 3 times a day or 25 - 75 mg once (preferably in the evening) depending on the severity of symptoms and therapeutic effectiveness.
For severe depression (mainly in hospital treatment): 25 mg 3 times a day or 75 mg once (preferably in the evening). If necessary, the daily dosage can be increased to 150 mg.
Solution
Ladisan solution is administered intravenously. Before using the drug, the contents of 2 ampoules should be dissolved in 250 ml of sodium chloride or glucose solution. Introduce the prepared solution slowly over 2 hours.
When administering a higher dose, it is necessary to increase the infusion time to 3 hours. Course of treatment: no more than 2 weeks. Next, the patient is transferred to the oral form of the drug.
Side effects
The following side effects are possible during Ladisan therapy: in the first days of therapy, fatigue, dizziness, constipation, dry mouth and accommodation disturbances may occur. In rare cases, tachycardia and low blood pressure are possible. In some cases, the medicine causes allergic skin reactions. If such symptoms appear, discontinuation of the drug is required.
Source: https://davlenie-vnorme.ru/antibiotiki/ladisan-instrukcziya-po-primeneniyu-otzyvy-pokazaniya
Composition and release form of Ladisan
Ladisan is produced in two dosage forms:
- Round, film-coated tablets containing 25 or 50 mg of the active substance - maprotiline hydrochloride. Additional components of the tablets are: corn starch, lactose, calcium phosphate, talc, gelatin, colloidal silicon dioxide, dyes, hypromellose, polysorbate-80. Blisters contain 10 tablets.
- Colorless transparent solution for infusion and intravenous injection. 1 ml of solution contains 5 mg of maprotiline methanesulfonate. Auxiliary components of the solution are: water for injection, methanesulfonic acid and mannitol. In colorless glass ampoules of 5 ml.
Pharmacological action of Ladisan
According to the instructions, Ladisan is a drug belonging to the group of serotonin and norepinephrine reuptake inhibitors.
The pharmacological effect of maprotiline (an antidepressant with a tetracyclic structure) is to stop the reverse neuronal uptake of the neurotransmitters serotonin and norepinephrine by the presynaptic membranes of cerebral cortex neurons.
This medicine has an optimal combination of all the main properties of antidepressants. The use of Ladisan improves mood, promotes the disappearance of an excited state and feelings of fear, relieves psychomotor retardation and various somatic disorders characteristic of masked depression.
Ladisan acts quite quickly, and the therapeutic effect can be observed just a few days after the start of treatment. In addition, according to reviews, Ladisan is very well tolerated by the body, so it is widely used in outpatient practice.
Indications for use of Ladisan
According to the instructions, it is advisable to use Ladisan for various depressions:
- somatogenic (symptomatic, organic);
- endogenous (involutional, cyclical, periodic);
- depression of menopause;
- psychogenic (neurotic, reactive, exhaustion depression);
- masked forms of depression.
Ladisan is also prescribed for other depressive disorders accompanied by the following symptoms:
- apathy;
- irritability or dysphoria;
- feeling of fear.
According to reviews, Ladisan has a beneficial effect on somatic and psychosomatic disorders that arise against the background of feelings of fear or melancholy.
Cautions
The drug is prescribed with caution to patients with impaired liver or kidney function, with increased intraocular pressure, and with urinary disorders (for example, with prostate diseases).
With long-term use of Ladisan, patients should regularly perform an ECG and monitor heart function. This is especially true for patients who suffer from cardiovascular diseases and elderly patients. Patients prone to orthostatic hypotension should have their blood pressure checked regularly while taking the medication.
It should be borne in mind that, like other psychotropic drugs, the use of Ladisan reduces tolerance to alcohol.
According to reviews, Ladisan in tablet form can negatively affect psychophysical reactions, especially if the medicine is combined with alcohol or drugs that have a depressive effect on the central nervous system.
When using Ladisan solution, a strong negative effect on psychophysical reactions is possible, therefore, during the treatment period, patients are prohibited from driving a car or operating potentially dangerous mechanisms.
Method of application and dosage regimen of Ladisan
The dosage of the medicine is selected individually for each patient depending on the severity of the disease. It is possible to increase or decrease the evening dosage by decreasing or increasing the daily dose.
It is also possible to take the daily dose in one dose, preferably in the evening.
Once a positive effect is achieved, you can try to reduce the dosage of the medication, but if repeated signs of depression appear, it is recommended to return to the previous dose.
Ladisan tablets are taken orally. They are mainly used for outpatient treatment of depression, 25 mg up to three times a day or 25-75 mg once in the evening. If depression is severe and is treated in a hospital setting, then the daily dose may be increased to 150 mg.
The solution is mainly prescribed for newly diagnosed cases of severe depression or if treatment with Ladisan tablets has not brought the desired result. The daily dosage for intravenous drip infusion is 25-100 mg.
To prepare the solution, the contents of 1-2 ampoules must be dissolved in 250 ml of glucose or sodium chloride solution and administered slowly over two hours.
If the patient needs to administer a higher dose of medication, the infusion time is increased to three hours.
As a rule, after the first two weeks of treatment with Ladisan using infusion therapy, the patient is transferred to oral treatment.
Use of Ladisan during pregnancy and breastfeeding
In the first trimester of pregnancy, the use of the medicine is strictly prohibited. In general, taking Ladisan during pregnancy is not recommended, except for exceptional indications or in the absence of an alternative.
Since the active component of the drug passes into breast milk, breastfeeding should be stopped while using the drug.
Storage conditions for Ladisan
Ladisan in the form of solution and tablets should be stored at room temperature in a dry place out of the reach of children. The shelf life is 5 years.
Source: https://www.pigulka.ru/ladisan.php
Methods of using Ladisan and dosage
The dosage and duration of use of the drug is selected individually by the attending physician, depending on the severity and form of the disease. Usually Ladisan is taken two to three times a day, but the daily dose can be taken at a time. You can also reduce or increase the evening dose at the expense of the day dose, depending on the patient’s condition. If improvement occurs, it is recommended to reduce the dose. However, if signs of depression return again, you should return to the previous dose.
Ladisan tablets are taken orally. Most often, tablets are used for outpatient treatment. They are taken three times a day at 25 mg, or once in the evening at a dose of up to 75 mg. In severe stages of the disease, the dose can be increased to 150 mg.
If treatment with tablets does not have a good result, then intravenous drip infusion of Ladisan is prescribed. The dose per day can range from 25 mg to 100 mg of the drug. To prepare a solution for infusion, you need to dissolve one or two ampoules of Ladisan in 250 ml of glucose or sodium chloride solution. The solution is administered very slowly over two hours. With an increased dose of the drug, the infusion time increases to three hours.
Ladisan - instructions for use, reviews
This drug belongs to the class of antidepressants. Ladisan is often prescribed to effectively treat depression in various forms.
Release form of the drug Ladisan and composition
Today the drug is available in two forms:
- Injection solution, solution for infusion. It is a clear liquid. Per milliliter of solution there are: five mg of maprotiline methanesulfonate. The solution also contains auxiliary components: metasulfanic acid, water, mannitol. The solution is produced in ampoules made of colorless glass, five milliliters each.
- Round tablets of 25 or 50 mg. Covered with a special shell. The tablets contain maprotiline hydrochloride. The tablet contains the following excipients: lactose and corn starch, colloidal dioxide and gelatin, calcium phosphate and gelatin, polysorbate dyes. The tablets are produced in blisters of ten pieces.
About contraindications
The instructions indicate the following situations when the use of Ladisan is contraindicated:
- pregnancy in the first trimester,
- hypersensitivity to maprotiline,
- convulsions,
- acute heart attack,
- cardiac arrhythmias.
Carefully! Doctors prescribe the drug Ladisan with great caution to people suffering from kidney and liver diseases, as well as problems with urination and high intraocular pressure.
If the patient uses Ladisan for a long time, he is indicated for an ECG, as well as monitoring the work of the heart muscle. This is especially important if the patient is elderly and has problems with the cardiovascular system.
It is on the cardiovascular system that Ladisan can have a great effect.
Ladisan may reduce tolerance to alcoholic beverages. Ladisan can negatively affect psychomotor reactions when combined with other drugs or alcohol. During the period of taking the drug, it is prohibited to work with dangerous mechanisms and drive a car. Alcohol is strictly prohibited.
Taking Ladisan during pregnancy
In the first three months of pregnancy, taking Ladisan is strictly prohibited. The drug is not recommended for use throughout pregnancy. It is prescribed only in exceptional cases, for example, in the absence of an alternative.
You should also not take Ladisan during lactation. The drug can be absorbed into the milk of a nursing woman.
Side effects when taking Ladisan
In the first days of taking Ladisan, it can cause the following reactions in the body:
- dry mouth,
- fatigue,
- constipation,
- violation of accommodation.
In rare cases, a decrease in blood pressure and tachycardia may occur. If the patient has an increased reaction to maprotilene, skin reactions may occur. In this case, you need to stop taking the drug.
Overdose of the drug Ladisan
According to the instructions, an overdose may occur when taking Ladisan. As a rule, all symptoms of an overdose may appear approximately 4 hours after administration. They develop most strongly after 24 hours. Several of the most pronounced symptoms of an overdose of Ladisan have been identified:
- depression or, conversely, stimulation of the central nervous system, which is expressed in convulsions, drowsiness, muscle rigidity, anxiety, stupor and coma;
- disruption of the cardiovascular system, which is expressed in arrhythmia and tachycardia, heart failure.
Much less frequently, cyanosis, vomiting, increased sweating, oliguria, mydriasis, fever, and anuria may occur due to an overdose.
In case of overdose, symptomatic treatment is required.
How to use Ladisan
The course of treatment with Ladisan is determined individually, it all depends on the general condition of the body. The dosage is varied only by the attending physician and depends on the severity of the disease.
Review
I took the drug for three months. I was severely depressed after giving birth, and then I stopped breastfeeding. The doctor prescribed Ladisan for me. At first I didn’t expect it to help, but the drug pleasantly surprised me. They often write that in the first days of taking it, vomiting and fatigue may occur, but I did not experience this.
There was only constipation, but it went away after a couple of days. Otherwise, there were no side effects, on the contrary, only benefit. Three months later, I forgot about depression and that just wouldn’t let me go. I took Ladisan tablets, they say that the drug is prescribed by injection in severe cases during hospital treatment.
A very good product and the price is quite reasonable.
Price and supply from pharmacies
The drug is sold only with a doctor's prescription. The shelf life of the drug is five years from the date of manufacture.
The price in different pharmacies ranges from 75 to 100 rubles.
