Tricycline Antidepressant Summary:

Tricycline antidepressants are considered to be the second line of defence for depression but are not uncommon in practice. Similar to the SNRI medications, they inhibit the reuptake of serotonin and norepinephrine in the synapses. The difference is that they also block adrenergic, muscarinic, and histamine receptors, which results in a wide range of other effects and adverse reactions in the body. 

Tricyclines are well absorbed in the gut and cross easily into the brain. They have a failry low therapeutic index howeveer. 


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Indications:

  • To elevate mood
  • Improve mental alertness
  • Increase physical activity
  • Migraines
  • Moderate to severe depression
  • Chronic pain syndromes like shingles and trigeminal neuralgia

Adverse Reactions:

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

Toxicity/Cautions

  • Overdose is fatal - cardiac failure
  • Doesnt go well with alcohol
  • Higher suicide rate
  • Can exacerbate manic depressive patients
  • Can exacerbate other conditions like epilepsy, angina, benign prostatic hyperplasia

Common interactions:


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Drugs:

Amitriptyline

INSERT

Generic Name: Amitriptyline Brand Name: Endep
Receptor: INSERT Source: INSERT
Main Action: INSERT
Common Dosage: xxx Suitable during pregnancy? INSERT

Clomipramine

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Generic Name: Clomipramine Brand Name: Anafranil
Receptor: INSERT Source: INSERT
Main Action: INSERT
Common Dosage: xxx Suitable during pregnancy? INSERT

Imipramine

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Generic Name: Imipramine Brand Name: Tofranil
Receptor: INSERT Source: INSERT
Main Action: INSERT
Common Dosage: xxx Suitable during pregnancy? INSERT

Nortriptyline

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Generic Name: Nortriptyline Brand Name: Allegron
Receptor: INSERT Source: INSERT
Main Action: INSERT
Common Dosage: xxx Suitable during pregnancy? INSERT