amitriptyline/perphenazine (Etrafon, Triavil)

Indications

• treatment of moderate to severe anxiety (rarely used)

Contraindications

• concurrent use of MAO inhibitors
• angle-closure glaucoma
• bone marrow depression Warnings:
• safety not established for patients < 12 years of age
• avoid use of alcoholic beverages

pregnancy-category D

safety in lactation -

Dosage

1 tab PO TID/QID

Tabs: 2/10, 2/25, 4/10, 4/25, 4/50 mg/mg perphenazine/amitriptyline.

Pharmacokinetics

elimination: liver > kidney

Adverse effects

see amitriptyline & perphanazine

• drug adverse effects of antidepressants
• drug adverse effects of psychotropic agents

Drug interactions

• increased effect & toxicity:
  • cimetidine, methyldopa, propranolol, methylphenidate, increased effect of CNS depressants (including tricyclic antidepressants), adrenergic agents, anticholinergic agents, warfarin, lithium, fluoxetine
• decreased effect:
  • antacids, carbamazepine, barbiturates, anticholinergic agents
• MAO inhibitors: contraindicated

• drug interaction(s) of antidepressant in combination with GLP1-agonist
• drug interaction(s) of benzodiazepines with antidepressants
• drug interaction(s) of antidepressants with benzodiazepines
• drug interaction(s) of NSAIDs with antidepressants
• drug interaction(s) of antidepressant with opiates

More general terms

• antidepressant combination

Components

• amitriptyline (Elavil, Endep)
• perphenazine (Trilafon)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=165659