Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults with major depressive disorder and other psychiatric disorders. Maprotiline not FDA approved for use in children. Might worsen psychosis in some patients or precipitate shift to mania or hypomania in bipolar disorder. Maprotiline not FDA approved for treatment of bipolar depression. Might cause anticholinergic effects (blurred vision, constipation, urinary retention, xerostomia)(use with caution in decreased gastrointestinal motility, paralytic ileus, urinary retention, BPH, xerostomia, or visual problems). Might cause orthostatic hypotension (use with caution in cerebrovascular disease, cardiovascular disease, hypovolemia, or concurrent medication use which may predispose to hypotension/bradycardia). Might cause sedation. Use with caution in history of cardiovascular disease (including previous myocardial infarction, stroke, tachycardia, or conduction abnormalities). Use with caution in hepatic and renal impairment. Use with caution in risk of seizures, including patients with history of seizures, head trauma, brain damage, alcoholism, or concurrent therapy with medications which may lower seizure threshold. Use with caution in hyperthyroidism or patients receiving thyroid supplementation. Effects may be potentiated when used with other sedative drugs or ethanol. Use with caution in the elderly. Therapy should not be abruptly discontinued in patients receiving high doses for prolonged periods. Might increase risks associated with electroconvulsive therapy.