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Tricyclic Antidepressants - mechanism - indications - side/adverse effects- anti depressant drugs



Tricyclic Antidepressants:

Tricyclic antidepressants inhibit the retake of both serotonin and nor epinephrine. TCAs also block alpha adrenergic receptors, serotonergic, histaminic, muscarinic receptors. And blockage of these receptors is the cause of a big profile of side effects.

TCAs include the following drugs:

1)    Tertiary amines:
Ø     Imipramine
Ø     Amitriptyline
Ø     Clomipramine
Ø     Doxepin
Ø     Trimipramine

2)    Secondary amines:
Ø     Desipramine
Ø     Nortriptyline

3)    Tetra cyclic antidepressants:
Ø     Maprotiline
Ø     Amoxapine



Indications:

ü     Moderate to Severe Depression
ü     Panic disorder
ü     Imipramine is used to control bed-wetting in children of more than 6 years of age
ü     Amitriptyline has been used to treat migraine headache and chronic pain syndromes (e.g. naturopathic pains) and when the cause of pain is not clear.

Adverse Effects:

Adverse effects are because of unwanted effects of TCAs on alpha-adrenergic and cholinergic histaminic receptors. TCAs block these receptors.

Following are the common adverse effects of TCAs:

*    Dry mouth
*    Constipation
*    Urinary retention
*    Blurred vision
*    Tachycardia
*    Arrhythmias
*    Nausea
*    Drowsiness.
*    Weight gain

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