Maprotiline ( sold as Deprilept, Ludiomil, Psymion ) is a tetracyclic antidepressant ( TeCA ).

Although Maprotiline behaves in most regards as a ' first generation antidepressant ' it is commonly referred to as ' second generation antidepressant '.

Maprotiline is used in the treatment of depression, such as depression associated with agitation or anxiety and has similar efficacy to the antidepressant drug moclobemide.

Maprotiline causes a strong initial sedation ( first 2 to 3 weeks of therapy ) and is therefore indicated to treat agitated patients or those with suicidal risks.

It is not known if Maprotiline shares this risk, so cautionary measures are recommended.

Withdrawal symptoms frequently seen when treatment with maprotiline is stopped abruptly ( agitation, anxiety, insomnia, sometimes activation of mania or rebound depression ) are not indicative of addiction and can be avoided by reducing the daily dose of Maprotiline gradually by approximately 25 % each week.

* Hypersensitivity to Maprotiline or to other tri -/ tetracyclic antidepressants

Due to milder anticholinergic and cardiotoxic effects of Maprotiline the acute lethal dose may be higher compared with other classical antidepressants ( e. g. Amitriptyline, Doxepin ).

Some are typical for tri -/ tetracyclic antidepressants, others are caused by specific metabolic effects ( e. g. high plasma-protein-binding ) of Maprotiline:

* Drugs, which induce certain enzymes in the liver, e. g. Barbiturates, Phenytoin, Carbamazepine and oral anticonceptive drugs, enhance the elimination of Maprotiline and decrease its antidepressant effects.

* Maprotiline can increase the actions of oral antidiabetic drugs ( sulfonylureas ) and Insulin.

** Tetracyclic Antidepressants ( TeCAs ): Amoxapine, Maprotiline.

The pharmacologic profile of Maprotiline explains its antidepressant, sedative, anxiolytic, and sympathomimetic activities.

Maprotiline does not improve mood in nondepressed persons.

Maprotiline was developed and has been marketed by the Swiss manufacturer Geigy ( now Novartis ) since the early 1980s under the brand name Ludiomil.

Maprotiline should be used during pregnancy only if needed.

Maprotiline should not be given to nursing mothers.

Patients with suicidal thoughts, or those with previous suicidal attempts, should be monitored closely under treatment with Maprotiline.

Maprotiline has no known potential for abuse and psychological dependence.

Maprotiline may worsen psychotic conditions like schizophrenia and should be given with caution.

Maprotiline has a wide range of possible interactions.

* The concomitant use of Maprotiline and neuroleptics can lead to increased Maprotiline blood-levels and to seizures.

Combining Maprotiline and Thioridazine could induce severe arrhythmias.

* Additionally, increased blood-levels of Maprotiline are possible, if certain beta-blocking agents ( e. g. Propranolol ) are given concomitantly.

The sambur buck, the jungle stag that is even more noble than the Scottish elk.

And if he is so scornful of the rights of states, why not advocate a different sort of constitution that he could more sincerely support??

Since the Supreme Court's decision of that year this is more doubtful ; ;

The long-settled areas of states like Virginia and South Carolina developed the ante-bellum culture to its richest flowering, and there the memory is more precious, and the consciousness of loss the greater.

And there is no section of the nation more ardent than the South in the cold war against Communism.

Whether a concept analogous to the principle of internal responsibility operates in a nation's external relations is less obvious and more difficult to establish.

But it is more than that.

While the pattern is uneven, some having gained more than others, nationalism has in fact served the Western peoples well.

But it is more than irony: one of the main reasons why nationalism is no longer a tenable concept is because it has spread throughout the planet.

Only one rule prevailed in my conversations with these men: The more highly placed they are -- that is, the more they know -- the more concerned they have become.

Only recently new `` holes '' were discovered in our safety measures, and a search is now on for more.

Isfahan became more of a legend than a place, and now it is for many people simply a name to which they attach their notions of old Persia and sometimes of the East.

On Fridays, the day when many Persians relax with poetry, talk, and a samovar, people do not, it is true, stream into Chehel Sotun -- a pavilion and garden built by Shah Abbas 2, in the seventeenth century -- but they do retire into hundreds of pavilions throughout the city and up the river valley, which are smaller, more humble copies of the former.

But more important, and the thing which the casual traveler and the blind sojourner often do not see, is that these places and activities are often the settings in which Persians exercise their extraordinary aesthetic sensibilities.

Poetry in Persian life is far more than a common ground on which -- in a society deeply fissured by antagonisms -- all may stand.

Nostalgic Yankee readers of Erskine Caldwell are today informed by proud Georgians that Tobacco Road is buried beneath a four-lane super highway, over which travel each day suburbanite businessmen more concerned with the Dow-Jones average than with the cotton crop.

Truman Capote is still reveling in Southern Gothicism, exaggerating the old Southern legends into something beautiful and grotesque, but as unreal as -- or even more unreal than -- yesterday.

The resulting picture might appear a maze of restless confusions and contradictions, but it is more true to life than a portrait of an artificially contrived order.

So great a man could not but understand, too, that the thing that moves men to sacrifice their lives is not the error of their thought, which their opponents see and attack, but the truth which the latter do not see -- any more than they see the error which mars the truth they themselves defend.

Even in domains where detailed and predictive understanding is still lacking, but where some explanations are possible, as with lightning and weather and earthquakes, the appropriate kind of human action has been more adequately indicated.

`` What is more true than anything else??