Tetracyclic antidepressants side effects

Mirtazapine was introduced in 1994 and, like bupropion, is one of the few antidepressants not commonly associated with sexual side effects. It has a tetracyclic chemical structure and belongs to the piperazino-azepine group of compounds. 

Although very strict dietary and concomitant drug restrictions must be observed to prevent hypertensive crises and serotonin syndrome, the most common side effects of MAOl and tricyclic/tetracyclic antidepressant combinations may be weight gain and orthostatic hypotension... 

Tricyclic/tetracyclic antidepressants are no longer generally considered a first-line treatment option for depression because of their side effect profile... 

Reboxetine. Most of the activity of rehoxetine resides in the 5.5 isomer (The marketed compound is RR and 55.) It is claimed to he superior to fluoxetine in severe depression. It is marketed in Europe. At least three tricyclic compounds, desipramine. nortriptyline, and the technically tetracyclic maprotiline are SNERIs. They, of course, have typical characteristic TCA side effects but lower anticholinergic and H -antihistaminic (sedative) effects than dimethyl compounds. SNERIs arc clinically effective antidepressants. 

Serotonin and norepinephrine reuptake inhibitors. The only member of this class which has received regulatory approval is venlafaxine (Effexor). Venlafaxine is a phenethylamine bicyclic derivative, chemically unrelated to tricyclic, tetracyclic or other available antidepressant agents. In a retrospective review of 35 consecutively treated overweight or obese outpatients with BED, venlafaxine 75-300 mg daily given for 1 to 43 weeks appeared to reduce the frequency of binge eating and to lower body weight (Malhotra et al. 2002). Reported side effects included dry mouth, sexual dysfunction, insomnia and nausea As there have thus far been no published randomised controlled trials, its place in the treatment of BED must remain uncertain. 

Rarely causes side-effect or data are not TeCA Tetracyclic antidepressant... 

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