Tricyclic Antidepressants:

Tricyclic anti depressants 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 big profile of side effects.

TCAs include 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 year 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
*    Urinary retention
*    Blurred vision
*    Tachycardia
*    Arrhythmias
*    Nausea
*    Drowsiness.
*    Weight gain

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