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perphenazine and amitriptyline (Etrafon): Drug Side Effects

What is amitriptyline w/ perphenazine-oral, and how does it work (mechanism of action)?

Perphenazine/amitriptyline is a combination of an
antipsychotic and an antidepressant. Perphenazine is an antipsychotic that works
in the brain and nervous system. Its exact mechanism of action is unknown.
Amitriptyline is a tricyclic antidepressant. It is believed that in some
patients with depression, abnormal levels of neurotransmitters (chemicals that
nerves use to communicate with each other) may be related to their depression.
Amitriptyline elevates mood by raising the level of neurotransmitters in nerves
in the brain. The FDA approved perphenazine/amitriptyline in September 1969.

What brand names are available for amitriptyline w/ perphenazine-oral?

Etrafon (no longer available in the US)

Is amitriptyline w/ perphenazine-oral available as a generic drug?


Do I need a prescription for amitriptyline w/ perphenazine-oral?


What are the side effects of amitriptyline w/ perphenazine-oral?

Side effects of Perphenazine/amitriptyline are abnormal muscle
contractions, difficulty breathing and swallowing, neck spasms, and movement
abnormalities on face, arms, and legs. This medication also causes dizziness,
drowsiness, sedation, irregular heart rate and rhythm, increase or decrease in
blood pressure, and blurred vision.

Antidepressants increased the risk of suicidal thinking and behavior in
short-term studies in children and adolescents with depression and other
psychiatric disorders. Anyone considering the use of antidepressants in a child
or adolescent must balance this risk of suicide with the
clinical need. Patients who are started on therapy should be closely observed
for clinical worsening, suicidal thoughts, or unusual changes in behavior.

Elderly patients with
dementia related
psychosis treated with antipsychotics are at an increased risk of death.

What is the dosage for amitriptyline w/ perphenazine-oral?

  • Anxiety or agitation with depression: Initial dose is one tablet of 2/25 mg
    or 4/25 mg by mouth three to four times a day OR take one tablet of 4/50 mg by
    mouth twice a day.
  • Depression with

    schizophrenia: Initial dose is two tablets of 4/25 mg by
    mouth twice or three times a day, a fourth dose may be given at bedtime.

  • Maintenance dose for all patients: Take one tablet of 2/25 mg or 4/25 mg by
    mouth two to four times a day OR take one tablet of 4/50 mg by mouth twice a
    day. 2/10 mg and 4/10 mg doses can be used to increase flexibility in adjusting
    maintenance dosage to the lowest amount consistent with relief of symptoms.

The maximum dose is 16/200 mg per day.

Which drugs or supplements interact with amitriptyline w/ perphenazine-oral?

: Perphenazine/amitriptyline should be used with caution
with medications like paroxetine (Paxil), fluoxetine (Prozac), and sertraline
(Zoloft) because these medications also increase the concentration of
neurotransmitters in the body leading to severe and deadly reactions.

Perphenazine/amitriptyline should be avoided with medications like quinidine,
disopyramide (Norpace), procainamide (Pronestyl), propafenone (Rhythmol), and
flecainide (Tambocor) because they may also affect heart rhythm and increase the
risk of an irregular heart rate and rhythm.

Perphenazine/amitriptyline should be used with caution with medications like
epinephrine due to increased risk of irregular heart rates and rhythms.


Panic attacks are repeated attacks of fear that can last for several minutes.
See Answer

Is amitriptyline w/ perphenazine-oral safe to take if I’m pregnant or breastfeeding?

Perphenazine/amitriptyline enters breast milk and is not
recommended during

What else should I know about amitriptyline w/ perphenazine-oral?

What preparations of amitriptyline w/ perphenazine-oral are available?

Tablets: 2/10, 2/25, 4/10, 4/25, and 4/50 mg

How should I keep amitriptyline w/ perphenazine-oral stored?

Store Perphenazine/amitriptyline tablets at room temperature between
20 C to 25 C (68 F to 77 F). Protect the drug from light.


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