Withdrawal from TCAs

Tricyclic antidepressants also have a documented syndrome associated with withdrawal from medications (Petti and Law, 1981). This syndrome can mimic appendicitis or the flu, and can include such symptoms as nausea and vomiting, headache, lethargy, and abdominal pain. If a child on TCAs presents with withdrawal symptoms, questions of compliance must be addressed. 

The light-side-effects burden of the SSRls, particularly when compared with the older TCAs, has important consequences for improving treatment. Several meta-analyses of published studies have reported a significant advantage in terms of tolerability and safety for the SSRls. Significantly lower rates of withdrawal from treatment due to side effects are consistently found with... 

The glycolytic intermediate pyruvate and the TCA cycle intermediate oxaloac-etate are direct precursors of the aspartate-derived amino acids. Thus, to improve L-lysine production, their supply has to be increased in a balanced manner. Withdrawal of oxaloacetate from the TCA cycle requires replenishment of the... 

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