Maprotiline is a tetracyclic antidepressant (TeCA). However, Maprotiline's fourth ring is spurious, as formed by a bridge across the central tricyclic ring. It is a strong norepinephrine reuptake inhibitor with only weak effects on serotonin and dopamine reuptake. It exerts strong blocking effect at H1 receptors, moderate at 5-HT2 and alpha1 and weak blocking effect at D2 and mACh postsynaptic receptors. The pharmacologic profile of Maprotiline explains its antidepressant, sedative, anxiolytic, and sympathomimetic activities. In accordance to the pharmacological characteristics it is used in the treatment of depression, such as depression associated with agitation or anxiety. Additionally, it shows a strong antagonism against Reserpine-induced effects in animal studies, as do the other 'classical' antidepressants. Maprotiline may worsen psychotic conditions like schizophrenia and should be given with caution.
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