Amoxapine, sold under the brand name Asendin among others, is a tricyclic antidepressant (TCAs). It is the N-demethylated metabolite of loxapine. Amoxapine first received marketing approval in the United States in 1992 (approximately 30 to 40 years after most of the other TCAs were introduced in the United States). Medical uses
Amoxapine is used in the treatment of major depressive disorder. Compared to other antidepressants it is believed to have a faster onset of action, with therapeutic effects seen within four to seven days. In excess of 80% of patients that do respond to amoxapine are reported to respond within two weeks of the beginning of treatment. It also has properties similar to those of the atypical antipsychotics, and may behave as one and may be used in the treatment of schizophrenia off-label. Despite its apparent lack of extrapyramidal side effects in patients with schizophrenia it has been found to exacerbate motor symptoms in patients with Parkinsons disease and psychosis. Contraindications
As with all FDA-approved antidepressants it carries a black-box warning about the potential of an increase in suicidal thoughts or behaviour in children, adolescents and young adults under the age of 25. Its use is also advised against in individuals with known hypersensitivities to either amoxapine or other ingredients in its oral formulations.
Palatal myoclonus is a rare condition in which there are rhythmic jerky movements or a rapid spasm of the palatal (roof of the mouth) muscles. Chronic clonus is often due to lesions of the central tegmental tract (which connects the red nucleus to the ipsilateral inferior olivary nucleus).When associated with eye movements, it is known as oculopalatal myoclonus. Signs and symptoms
Signs and symptoms of Palatal Myoclonus include:
- A rhythmic clicking sound in the ear due to the opening and closing of the Eustachian tube.- Rhythmic, jerky movements in the face, eyeballs, tongue, jaw, vocal cord or extremities (mostly hands). Diagnosis
Classifications
physiologic, essential, epileptic, and symptomatic

Treatment
Drugs
Drugs used to treat palatal myoclonus include clonazepam, carbamazepine, baclofen, anticholinergics, tetrabenazine, valproic acid, phenytoin, lamotrigine, sumatriptan, and PIR. A rare case of palatal myoclonus that associated with orofacial buccal dystonia has been treated with Botulinum toxin A (Dysport) injection and counseling. Notes
http://www.tchain.com/otoneurology/disorders/central/opm.html
https://www.hindawi.com/journals/criot/2013/231505/
"NINDS Tremor Information Page". National Institute of Neurological Disorders and Stroke. July 20, 2007. Archived from the original on October 6, 2007. Retrieved 2007-10-08. References


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