TREATMENT:
TRICYCLIC ANTIDEPRESSANTS (TCA)
Tricyclic
antidepressants are an older class of antidepressants, but
which work quite well. They are named after their chemical
structure (having three rings - the chemical structure of
amitriptyline is shown below). The most common tricyclic
antidepressants used today are imipramine and amitriptyline,
as well as nortriptyline, doxepin and desipramine. This
class of antidepressants work very well for the treatment
of depression. Concern about these medications, however,
is a result of their extensive list of side effects and
drug interactions, and also because of the ability of these
medications to kill when taken in excess (i.e., a depressed
and suicidal patient has a fairly good chance of dying if
he or she takes an overdose of a tricyclic antidepressant).
Fairly
common side effects include dry mouth, blurred vision, drowsiness,
dizziness, and tremors (to name a few). Rare side effects
include liver inflammation, heart attack, stroke, and seizures.
Much like the action of other
classes of antidepressants, the tricyclic antidepressants
work by preventing the uptake of norepinephrine and serotonin.
Therefore the concentration of these neurotransmitters build
up and improve communication between certain neurons. Like
all antidepressants, the tricyclics should be tapered off
only under physician care.
For
all of the antidepressants, you should discuss all other
medications you are taking with your physician to ensure
there are no dangerous interactions.
Click
here for more information about specific drugs and side
effects.
