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Examples: amitryptiline, clomipramine, dothiepin, imipramine, lofepramine
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The nerve cells normally recycle serotonin and norepinephrine by soaking it back up again. The majority of TCAs work by stopping (inhibiting) this re-uptake of serotonin and norepinephrine. As serotonin and norepinephrine is not soaked up again, more will be present to pass on messages to nerve cells nearby.
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Common side effects, as associated with the receptor profiles:
- Anticholinergic: dry mouth, blurred vision, urinary retention, constipation, drowsiness, confusion.
- Adrenergic antagonism: drowsiness, postural hypotension, tachycardia, sexual dysfunction.
- Antihistaminergic: drowsiness, weight gain.
- 5HT2 antagonism: anxiolytic, reduced sexual dysfunction, sedation.
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Advantages
- Well-established efficacy
- Possibly more effective in severe depression
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Disadvantages
- Toxicity in overdose
- Less well-tolerated than SSRIs
- Lower seizure threshold
- Slow cardiac conduction
Treatments > Biological > Medication > Tricyclic Antidepressants (TCAs)