Antidepressants tricyclic drags

Blackwell, B. (1981) Adverse effects of antidepressant drugs. Part 1 monoamine oxidase inhibitors and tricyclics. Drags 21 201-219. 

Noradrenaline transporters (NAT) are localized in the presynaptic plasma membrane of adrenergic nerve terminals. They belong to a family of proteins with 12 putative transmembrane proteins which are responsible for recycling of released neurotransmitters (noradrena-line/adrenaline, dopamine, serotonin, amino acid transmitters) back into the presynaptic nerve ending. Noradrenaline transporters can be blocked by a number of different antidepressant drags, including tricyclic antidepressants (e.g. desipramine) and selective noradrenaline reuptake inhibitors (e.g. reboxetine). 

Imipramine is the primary representative of typical tricyclic antidepressants. It acts by blocking the mechanism of renptake of biogenic amines. It does not inhibit MAO activity. Imipramine lessens sadness, lethargy, improves mood, and improves the mental and overall tone of the body. It is nsed in depression of varions etiology accompanied by motor cinmsiness and ennresis in children and Parkinson s disease. Primary synonyms of this drag are tofranil, snrplix, imizin, melipramin, and others. 

In trials of hospitalized patients tricyclic antidepressants have generally been more efficacious than selective serotonin reuptake inhibitors (SSRIs). Otherwise there are no overall differences between the drugs in terms of tolerability or efficacy in primary care settings. After reviewing 15 trials it was concluded that drags are effective in the treatment of dysthymia with no differences between and within class of drugs. Tricyclic antidepressants are more likely to cause adverse events and dropouts. As dysthymia is a chronic condition, there remains little information on quality of life and medium or longterm outcome. 

Obsessive-compulsive disorder may be linked to abnormalities of the neurotransmitters serotonin and dopamine. The neuroanatomical basis of OCD may be related to dysfunction in the basal ganglia. The hallmark of treatment for OCD is use of SSRIs plus the tricyclic antidepressant clomipramine. Panic disorder is characterized by unexpected panic attacks, possibly linked to abnormalities in the neurotransmitters norepinephrine and GABA, in the sensitivity of benzodiazepine receptors, or even in the regulation of respiration. Drag treatments include SSRIs, several of the newer antidepressants, high-potency benzodiazepines, many tricyclic antidepressants, and MAO inhibitors. 

Petty F, Sacquitne JL, Sherman AD (1982) Tricyclic antidepressant drag action correlates with its tissue levels in anterior neocortex. Neuropharmacology 21 475 77. 

Drags that prolong QT interval (e.g., erythromycin, haloperidol, tricyclic antidepressants, sotalol, bepridil)... 

---