How do tricyclic antidepressants work
What are Tricyclic Antidepressants?
Tricyclic anti-depressants are sometimes used to treat and manage depression. Tricyclics work by interfering with neurotransmitter pathways in the body, affecting neurotransmitters such as serotonin, dopamine, and adrenaline. Tricyclic antidepressant (TCA) medications have been used since the 1950s to treat depression and bipolar disorder, as well as other conditions like chronic pain, insomnia, and more. Although newer classes of antidepressants have much fewer side effects than TCAs, they still have a place in the treatment of depression and other conditions.
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10 Ways Tricyclic Antidepressants Can Help You
Tricyclic antidepressants are a class of medications that have been used for decades to treat depression and other conditions. Here are ten ways tricyclic antidepressants can help you:
1. Treat depression: Tricyclic antidepressants are effective in treating mild to severe depression.
2. Manage anxiety: These medications can help manage anxiety tricyclic antidepressants for anxiety disorders such as obsessive-compulsive disorder, social anxiety disorder, and panic disorder.
3. Help with chronic pain: Tricyclic antidepressants can provide relief for chronic pain conditions such as fibromyalgia and neuropathic pain.
4. Improve sleep: Some tricyclic antidepressants can help improve sleep quality and reduce the risk of insomnia.
5. Decrease migraine frequency: These medications can help reduce the frequency of migraines and ease their severity.
6. Treat ADHD: Tricyclic antidepressants can be used as an alternative treatment for ADHD when other medications are not effective.
7. Treat eating disorders: These medications can help treat symptoms of binge eating disorder and bulimia.
8. Treat PTSD: Tricyclic antidepressants can be used to treat PTSD symptoms such as nightmares and flashbacks.
9. Reduce symptoms of menopause: These medications can help reduce the symptoms of hot flashes and mood swings associated with menopause.
10. Promote smoking cessation: Tricyclic antidepressants may help reduce nicotine cravings and promote smoking cessation.
How Tricyclic Antidepressants Work
Neurotransmitters are chemicals that transmit messages in the brain. These messages are sent from one neuron to another and, depending on which neurotransmitter is involved, can affect how you feel and respond.
How Tricyclic Antidepressants Work
Tricyclic antidepressants stop the body from reabsorbing neurotransmitters called serotonin and norepinephrine. Our bodies need these neurotransmitters to function properly. Tricyclics can help balance these levels.
Since TCAs stop the body from routinely reabsorbing these neurotransmitters (reuptake), there will be more fluidity in the synapses between neurons in your brain. If you suffer from depression, tricyclic antidepressants for anxiety restoring the levels of serotonin and norepinephrine in your synapses may improve your symptoms.
Tricyclic antidepressants vs ssri, (Selective Serotonin Reuptake Inhibitors) are the most widely prescribed antidepressant medications. Although the individual effects of SSRIs vary, they are generally well tolerated and effective.
Unlike tricyclics, SSRIs do not cause as many side effects as other antidepressants. Tricyclics, on the other hand, are not as selective as SSRIs and affect more body systems.Tricyclic antidepressants vs ssri,They also have a higher risk of side effects and overdose, while SSRIs tend to have lower risks of toxicity and overdose. However, SSRIs can cause problems when taken in large doses or in combination with other drugs that affect serotonin levels.
The main use of tricyclic antidepressants is for mood disorders, but they can also be used for anxiety, personality, and neurodevelopmental disorders. Tricyclic antidepressants have more adverse reactions than more recent antidepressants, so they are used when other medications cannot provide adequate relief.
Mood disorders often treated with TCAs include:
Anxiety disorders sometimes treated with TCAs include:
- Body dysmorphic disorder (BDD), including eating disorders such as anorexia nervosa and bulimia nervosa
- Generalized anxiety disorder (GAD)
- tricyclic antidepressants for anxiety
- Panic disorder (PD)
- Post-traumatic stress disorder (PTSD)
Neurological disorders sometimes treated with tricyclic TCAs include:
- Attention-deficit hyperactivity disorder (ADHD)
- Chronic pain
- Parkinson’s disease
- Neuropathic pain
TCAs may also be used to treat insomnia, irritable bowel syndrome (IBS), interstitial cystitis, nocturnal enuresis (bedwetting), narcolepsy, and chronic hiccups.
When Are Tricyclics Prescribed?
Because newer-generation antidepressants have fewer side effects and a lower risk of overdose, tricyclics are prescribed less frequently than they were in the past. However, they are still utilized in some cases, particularly for people who have not found sufficient symptom relief from other antidepressants.
Tricyclics might be prescribed if:
- Other antidepressants have led to side effects
- The individual has a condition such as headaches, migraines, or neuropathic pain
- The individual is experiencing co-occurring depression and insomnia
- The individual has depression and another co-occurring condition such as PTSD, OCD, or panic disorder
Examples of Tricyclic Antidepressants | How do tricyclic antidepressants work
Tricyclic antidepressants examples, With tricyclic antidepressants, like other antidepressants, it will usually take between six to eight weeks before you feel any substantial improvement in your depression symptoms.3 Some of the more commonly prescribed TCAs include:
- Anafranil (clomipramine)
- Ascendin (amoxapine)
- Elavil (amitriptyline)
- Norpramin (desipramine)
- Pamelor (nortriptyline)
- Sinequan (doxepin)
- Surmontil (trimipramine)
- Tofranil (imipramine)
- Vivactil (protriptyline)
Common Side Effects | tricyclic antidepressants side effects
Tricyclic antidepressants side effects– While different TCAs have slightly different mechanisms of action, they share similar side effects. Many of these are associated with the effect the drugs have on the smooth muscles of the internal organs. Common side effects include:
- Blurred vision
- Increased appetite
- Muscle twitches
- Nausea and vomiting
- Rapid or irregular heart rate
- Sexual dysfunction
- Weight gain
These side effects may be reduced if treatment is started with lower dosages and then gradually increased. While not strictly addictive per se, the long-term use of TCAs may lead to drug dependence.
Tricyclic Overdose| How do tricyclic antidepressants work
TCAs are also a significant cause of fatal drug overdoses in the United States.4 Initial symptoms may include dry mouth, blurred vision, urinary retention, constipation, dizziness, vomiting, and hallucinations. If left untreated, an overdose may result in delirium, seizures, coma, cardiac arrest, and death.
Interactions and Precautions
Some of the side effects of tricyclic antidepressants may be intensified if taken with other drugs. In other cases, it can affect the bioavailability (concentration) of the drug in the bloodstream.
As such, you should always advise your doctor about any substances you may be taking, including over-the-counter medications, herbal remedies, and recreational drugs. Certain drugs are contraindicated for use with tricyclic antidepressants, including:5
- Alcohol blocks the action of TCAs and should be avoided.
- Anticholinergic drugs used to treat urinary incontinence and COPD can cause intestinal paralysis if co-administered with a TCA.
- Clonidine, used to treat hypertension, can trigger a dangerous rise in blood pressure if used with a TCA.
- Epinephrine used to treat severe allergic reactions can also trigger severe high blood pressure if used with a TCA.
- Monoamine oxidase (MAO) inhibitors, also used as antidepressants, can cause high fever, convulsions, and even death is coadministered with a TCA.
- Tagamet (cimetidine), used to reduce stomach acid, may increase the concentration of the TCA in your blood, further intensifying the drug side effects.
Some tricyclic antidepressants can harm your baby if you take them during pregnancy or while breastfeeding, so talk to your doctor if you are pregnant or may become pregnant.
Tricyclics may also increase the risk for anticholinergic effects, cardiac problems, and postural hypotension in older adults. Postural hypotension can lead to falls, increasing a person’s risk of experiencing fractures and other injuries.
Combining tricyclics with other medications that affect serotonin levels can also lead to a condition known as serotonin syndrome. This potentially dangerous condition occurs when serotonin levels in the body become too high, causing symptoms such as:
- Changes in blood pressure
- Rapid heart rate
Medications contributing to serotonin syndrome include other antidepressants such as SSRIs and herbal supplements such as St. John’s wort.
Stopping tricyclics or changing the dose can lead to symptoms of withdrawal. Common withdrawal symptoms include nausea, fever, chills, headache, dizziness, lethargy, and vomiting.
To minimize tricyclic withdrawal effects, your doctor may advise gradually lowering your dose over a period of several weeks.