Attention-deficit/hyperactivity disorder tricyclic antidepressants

ADHD, attention-deficit hyperactivity disorder MAOI, monoamine oxidase inhibitor TCA, tricyclic antidepressants. Cluster B symptoms, reexperiencing, intrusive recollections, traumatic nightmares, flashbacks cluster C symptoms, avoidant behavior, numbing, dissociation cluster D symptoms, hyperarousal, insomnia, irritability, hypervigilance, hyperstartle. 

Wilens TE, Biederman J, Mick E, et al. A systematic assessment of tricyclic antidepressants in the treatment of adult attention deficit hyperactivity disorder. J Nerv Ment Dis 1995 183 48-50. 

OTHER THERAPEUTIC USES OE THESE DRUGS The various antidepressant agents have found broad utility in other disorders that may not be related psychobiologicaUy to the mood disorders. Current applications include rapid but temporary suppression of enuresis with low (e.g., 25 mg) pre-bedtime doses of tricyclic antidepressants, including imipramine and nortriptyline, by uncertain mechanisms in children and in geriatric patients, as well as a beneficial effect of duloxetine on urinary stress incontinence. Antidepressants have a growing role in attention-deficit/hyperactivity disorder in children and adults, for which imipramine, desipramine, and nortriptyline appear to be effective, even in patients responding poorly to or who are intolerant of the stimulants (e.g., methylphenidate). Newer NE selective reuptake inhibitors also may be useful in this disorder atomoxetine is approved for this application. Utility of SSRIs in this syndrome is not established, and bupropion, despite its similarity to stimulants, appears to have limited efficacy. 

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