Tricyclic antidepressants

Tricyclic antidepressants (TCA’s):
• eg amitriptyline, amoxapine, clomipramine, doxepin
• act by blocking serotonin and noradrenaline uptake  intensifies effects of these neurotransmitters (consistent with monoamine hypothesis)
• often first choice for most with depression  elevate mood, increase activity, increase alertness, improves appetite, improve sleep patterns
• takes 1-3 weeks for initial responses; up to 2 months for maximal response
• adverse reactions – sedation (due to blockade of histamine receptors in CNS), dry mouth, blurred vision, constipation, postural hypotension (due to blockage of alpha1-adrenoreceptors on blood vessels), increased risk for arrhythmia’s, weight gain

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