Educational only — not medical advice.If you’re in crisis or thinking about suicide: call or text 988 (U.S.) or your local emergency number. Support resources.Under construction and review—see the updates log.
Typical dose range: Label dosing is individualized. Outpatient adults: typically start 75 mg/day in divided doses, increasing to 150 mg/day; maximum outpatient dose is 200 mg/day. Hospitalized adults: start 100 mg/day, with a maximum of 250–300 mg/day. Adolescent and geriatric patients: start 50 mg/day with a maximum of 100 mg/day. Once at maintenance dose, the total daily amount can often be given as a single bedtime dose (label).
Therapeutic drug monitoring recommended; reference range 150–300 ng/mL.
Frequency: Label dosing is individualized. Outpatient adults: typically start 75 mg/day in divided doses, increasing to 150 mg/day; maximum outpatient dose is 200 mg/day. Hospitalized adults: start 100 mg/day, with a maximum of 250–300 mg/day. Adolescent and geriatric patients: start 50 mg/day with a maximum of 100 mg/day. Once at maintenance dose, the total daily amount can often be given as a single bedtime dose (label).
Typical range: Label dosing is individualized. Outpatient adults: typically start 75 mg/day in divided doses, increasing to 150 mg/day; maximum outpatient dose is 200 mg/day. Hospitalized adults: start 100 mg/day, with a maximum of 250–300 mg/day. Adolescent and geriatric patients: start 50 mg/day with a maximum of 100 mg/day. Once at maintenance dose, the total daily amount can often be given as a single bedtime dose (label).
Therapeutic range: 150–300 ng/mL
Mechanism (brief)
Tertiary-amine tricyclic antidepressant (TCA) with a sedating/anxiolytic clinical profile; mixed monoamine effects plus strong H1/α1/muscarinic antagonism.
Baseline and follow-up ECG planning in patients with cardiac history, older age, electrolyte disturbance risk, or multiple QT-active drugs (clinical).
TDM after steady state or after major interaction changes when response is partial or toxicity is suspected (Hiemke 2018/clinical).
Orthostatic vitals, falls risk, and anticholinergic burden (bowel and bladder symptoms, cognition), especially in older adults (clinical).
Suicidality and mood switching surveillance early in treatment and after dose changes, particularly in young adults and bipolar-spectrum illness (label/clinical).