Seizures associated with high maprotiline serum concentrations.

Maprotiline is a tetracyclic antidepressant which appears to have accounted for a relatively large proportion of the seizures associated with antidepressant use. The literature proposes two mechanisms of seizure induction: interaction with other medications and concomitant medical conditions lowering the seizure threshold. Observations during a study of maprotiline blood levels suggest that elevated serum concentrations achieved with therapeutic doses may also be linked to the seizure-induction mechanism. Monitoring of maprotiline blood levels may help to identify patients at risk.