A tricyclic antidepressant, similar to amitriptyline, used in the treatment of psychogenic dermatoses in dogs and cats.
| Systematic (IUPAC) name | |
|---|---|
| 2-chloro-11-(piperazin-1-yl)dibenzo[b,f][1,4]oxazepine | |
| Clinical data | |
| Trade names | Asendin |
| AHFS/Drugs.com | monograph |
| MedlinePlus | a682202 |
| Pregnancy cat. | C (US) |
| Legal status | ℞-only (US) |
| Routes | Oral |
| Pharmacokinetic data | |
| Bioavailability | ? |
| Protein binding | 90%[1] |
| Metabolism | Hepatic (cytochrome P450 system) |
| Half-life | 8-10 hours (30 hours for major metabolites)[1] |
| Excretion | Renal |
| Identifiers | |
| CAS number | 14028-44-5 |
| ATC code | N06AA17 |
| PubChem | CID 2170 |
| IUPHAR ligand | 201 |
| DrugBank | DB00543 |
| ChemSpider | 2085 |
| UNII | R63VQ857OT |
| KEGG | D00228 |
| ChEBI | CHEBI:2675 |
| ChEMBL | CHEMBL1113 |
| Chemical data | |
| Formula | C17H16ClN3O |
| Mol. mass | 313.781 g/mol |
| SMILES | eMolecules & PubChem |
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Amoxapine (Amokisan, Asendin, Asendis, Defanyl, Demolox, Moxadil) is a tetracyclic antidepressant of the dibenzoxazepine family, though it is often classified as a secondary amine tricyclic antidepressant. It is the N-demethylated metabolite of Loxapine.
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Amoxapine is used in the treatment of depression, anxiety disorders, panic disorder, and bipolar disorder. It also has properties similar to those of atypical antipsychotic,[2][3] and may be used in the treatment of schizophrenic psychosis off-label.
Amoxapine possesses a wide array of pharmacological effects. It is a moderate and strong reuptake inhibitor of serotonin and norepinephrine, respectively,[4] and binds to the 5-HT2A,[5] 5-HT2B,[6] 5-HT2C,[5] 5-HT3,[7] 5-HT6,[8] 5-HT7,[8] D2,[9] α1-adrenergic,[9] D3[10], D4,[10] and H1 receptors[9] with varying but significant affinity, where it acts as an antagonist (or inverse agonist depending on the receptor in question) at all sites. It has weak but negligible affinity for the dopamine transporter and the 5-HT1A,[7] 5-HT1B,[7] D1,[11] α2-adrenergic,[9] H4,[12] mACh,[9] and GABAA receptors,[11] and no affinity for the β-adrenergic receptors or the allosteric benzodiazepine site on the GABAA receptor.[11]
7-Hydroxyamoxapine, a major active metabolite of amoxapine, is a more potent dopamine receptor antagonist and contributes to its neuroleptic efficacy,[2] whereas 8-hydroxyamoxapine is a norepinephrine reuptake inhibitor but a stronger serotonin reuptake inhibitor and helps to balance amoxapine's ratio of serotonin to norepinephrine transporter blockade.[13]
Common side effects of amoxapine include hypotension, drowsiness, dry mouth, constipation, blurred vision, fatigue, and vertigo.[1] Additionally, due to the drug's and its metabolite 7-hyroxyamoxapine's potent blockade of dopamine receptors, it can cause neuroleptic malignant syndrome as well as acute extrapyramidal symptoms and tardive dyskinesia. Cardiovascular and anticholinergic side effects are much reduced compared to other tri- and tetracyclic antidepressants.
The drug is contraindicated in children because it lowers the seizure threshold to the extent that fits may be precipitated.[citation needed]
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