Drug Levels and Effects:

Summary of Use during Lactation:

If maprotiline is required by the mother, it is not a reason to discontinue breastfeeding. However, because there is little published experience with maprotiline during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.

Drug Levels:

Milk maprotiline levels after a single oral dose of 100 mg have been reported to have a peak milk level at about 8 hours after a dose at about 110 mcg/L. During a regimen of 50 mg orally three times daily, milk levels of 180 to 260 mcg/L were reported at unstated times after various doses. Details of the above manufacturer's studies were not reported.[1][2]

Infant Levels.

Relevant published information was not found as of the revision date.

Effects in Breastfed Infants:

Published information on maprotiline was not found as of the revision date. Although it is structurally a tetracyclic compound, maprotiline has pharmacologic actions similar to the tricyclic antidepressants.

Follow-up for 1 to 3 years in a group of 20 breastfed infants whose mothers were taking a tricyclic antidepressant found no adverse effects on growth and development.[3] Two small controlled studies indicate that other tricyclic antidepressants have no adverse effect on infant development.[4][5]

In another study, 25 infants whose mothers took a tricyclic antidepressant during pregnancy and lactation were tested formally between 15 to 71 months and found to have normal growth and development. One of the mothers was taking maprotiline.[6]

Possible Effects on Lactation:

Maprotiline has caused increased prolactin levels and galactorrhea in nonpregnant, nonnursing patients.[7][8] The clinical relevance of these findings in nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternate Drugs to Consider:



1. Lloyd AH. Practical considerations in the use of maprotiline (Ludiomil) in general practice. J Int Med Res. 1977;5 (Suppl 4):122-38. PMID:590609
2. Riess W. The relevance of blood level determinations during the evaluation of maprotiline in man. In: Murphy JE, ed. Research and clinical investigation in depression. Northampton: Cambridge Medical Publications Limited, 1975:19-38.
3. Misri S, Sivertz K. Tricyclic drugs in pregnancy and lactation: a preliminary report. Int J Psychiatry Med. 1991;21:157-71. PMID:1894455
4. Buist A, Janson H. Effect of exposure to dothiepin and northiaden in breast milk on child development. Br J Psychiatry. 1995;167:370-3. PMID:7496646
5. Yoshida K, Smith B, Craggs M et al. Investigation of pharmacokinetics and possible adverse effects in infants exposed to tricyclic antidepressants in breast-milk. J Affective Disord. 1997;43:225-37. PMID:9186793
6. Nulman I, Rovet J, Stewart DE et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry. 2002;159:1889-95. PMID:12411224
7. Perez OE, Henriquez N. Galactorrhea associated with maprotiline HCl. Am J Psychiatry. 1983;140:641. Letter. PMID:6682635
8. Baumgartner A, Graf KJ, Kurten I. Prolactin in patients with major depressive disorder and in healthy subjects. II. Longitudinal study of basal prolactin and post-TRH-stimulated prolactin levels. Biol Psychiatry. 1988;24:268-85. PMID:3135848

Substance Identification:

Substance Name:


CAS Registry Number:


Drug Class:

  • Antidepressants

  • Adrenergic Uptake Inhibitors

  • Administrative Information:

    LactMed Record Number:


    Last Revision Date:

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