Tricyclic antidepressant

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In medicine and pharmacology, tricyclic antidepressants are adrenergic uptake inhibitors that "contain a fused three-ring moiety and are used in the treatment of depression. These drugs block the uptake of norepinephrine and serotonin into axon terminals and may block some subtypes of serotonin, adrenergic, and histamine receptors. However the mechanism of their antidepressant effects is not clear because the therapeutic effects usually take weeks to develop and may reflect compensatory changes in the central nervous system."[1]

Contents

Classification

Tertiary amine tricyclics

Older tricyclics include amitriptyline, doxepin, and imipramine have a tertiary-amine side chain block both serotonin and norepinephrine and increase anticholinergic drug toxicity.[2]

Secondary amine tricyclics

Secondary amine tricyclics include desipramine, nortriptyline, and others have less anticholinergic drug toxicity.

Mechanism of action

Depression may be due to the monoamine-deficiency hypothesis, which is a "deficiency in serotonin or norepinephrine neurotransmission in the brain."[3]

By blocking the reuptake of norepinephrine and serotonin, tricyclics may overcome the mono-amine deficiency.[4]

Medical uses

Depression

For more information, see: Depression.


Irritable bowel

For more information, see: Irritable bowel syndrome.

Tricyclic antidepressants can reduce symptoms of irritable bowel syndrome, perhaps with greatest benefit for diarrhea-predominant irritable bowel syndrome.[5]

Chronic pain

For more information, see: Pain.


References

  1. ↑ Anonymous, (2009) Tricyclic antidepressant (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ (2006) “Antidepressant Agents”, Keith Parker; Laurence Brunton; Goodman, Louis Sanford; Lazo, John S.; Gilman, Alfred: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 11th. New York: McGraw-Hill. ISBN 0-07-142280-3. 
  3. ↑ Belmaker RH, Agam G (2008). Major depressive disorder. N. Engl. J. Med. 358 (1): 55–68. DOI:10.1056/NEJMra073096. PMID 18172175.
  4. ↑ Katzung, Bertram G. (2006). “Antidepressant Agents”, Basic and Clinical Pharmacology, 10th. New York: McGraw-Hill Medical Publishing Division. ISBN 0-07-145153-6. 
  5. ↑ (2008-12-18) An Evidence-Based Position Statement on the Management of Irritable Bowel Syndrome. Am J Gastroenterol 104 (S1): S1-S35. ISSN 0002-9270. Retrieved on 2008-12-20.
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