PDR Health


What is Vivactil?

Vivactil (protriptyline) is a tricyclic antidepressant. It affects chemicals in the brain that may be unbalanced.

Vivactil is used to treat depression.

Vivactil may also be used for purposes not listed in this medication guide.


Health Benefits

Vivactil is used to treat depression. Depression is a serious medical condition that can lead to death. Vivactil may improve your mood, sleep, appetite and energy level and help you restore your interest in daily living.

Vivactil may also be used for purposes not listed in this medication guide.

Side Effects

Common side effects of Vivactil include:


dry mouth,

blurred vision,

tremors or shaking,


excitement or anxiety,


weight gain or loss,

changes in sex drive or ability.

rare side effects of Vivactil include:

seizures (convulsions),

fast/pounding/irregular heartbeat,

mental/mood changes (such as confusion, hallucinations, unusual thoughts or behavior),

easy bruising/bleeding, yellowing eyes/skin. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

seizures (convulsions);

a light-headed feeling, like you might pass out; fast/pounding/irregular heartbeat;

mental/mood changes (such as confusion, hallucinations, unusual thoughts or behavior);

easy bruising/bleeding (nosebleeds, bleeding gums); or yellowing eyes or skin. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.


The usual adult dose for Vivactil is 10 mg 3-4 times daily. The maximum recommended dose is 40 mg/day. Doses may be increased by 5 mg/day at weekly intervals until a therapeutic response has been achieved.

For the elderly and debilitated, the starting dose is 5 mg 3 times daily and the dosage should be adjusted to the needs of the individual patient.

For children 6 years of age and older, the usual dose is 1-2 mg/kg/day in 2-3 divided doses. The maximum recommended dose should not exceed 4 mg/kg/day or 150 mg/day, whichever is less.

If you miss a dose of Vivactil, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.


Some products that may interact with this drug include:

anticholinergics (such as glycopyrrolate, hyoscyamine, scopolamine),

certain antipsychotics (such as chlorpromazine, thioridazine),

arsenic trioxide,


certain drugs for high blood pressure (MAOIs such as phenelzine, linezolid, isocarboxazid, tranylcypromine, selegiline), ciprofloxacin, clozapine, dasatinib. Taking Vivactil with other drugs that make you drowsy can worsen this effect.

How does it work?

Vivactil works by inhibiting the reuptake of norepinephrine and serotonin in the brain, which helps to elevate mood.


Vivactil is rapidly absorbed from the gastrointestinal tract and peak plasma levels are reached in 2-4 hours. The mean elimination half-life is 12 hours. Vivactil is metabolized in the liver by demethylation, deamination, and hydrolysis. Excretion of the metabolites occurs primarily in the urine.

Alternatives to Vivactil

Other drugs that have been shown to be effective in the treatment of depression include:

selective serotonin reuptake inhibitors (SSRIs),

serotonin and norepinephrine reuptake inhibitors (SNRIs),

tricyclic antidepressants (TCAs),

monoamine oxidase inhibitors (MAOIs). These drugs may be used alone or in combination with each other. Your doctor will determine the best treatment for you based on your individual needs.

If you are looking for an alternative to Vivactil, talk to your doctor about other options that may be suitable for you.