Tricyclic antidepressant
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]
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 and less sedation.[3]
Mechanism of action
Depression may be due to the monoamine-deficiency hypothesis, which is a "deficiency in serotonin or norepinephrine neurotransmission in the brain."[4]
By blocking the reuptake of norepinephrine and serotonin, tricyclics may overcome the mono-amine deficiency.[5]
Medical uses
Depression
Irritable bowel
Tricyclic antidepressants can reduce symptoms of irritable bowel syndrome, perhaps with greatest benefit for diarrhea-predominant irritable bowel syndrome.[6]
Chronic pain
References
- ↑ Anonymous (2024), Tricyclic antidepressant (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ (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.
- ↑ Baldessarini Ross J, "Chapter 17. Drug Therapy of Depression and Anxiety Disorders" (Chapter). Brunton LL, Lazo JS, Parker KL: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 11e
- ↑ Belmaker RH, Agam G (2008). "Major depressive disorder". N. Engl. J. Med. 358 (1): 55–68. DOI:10.1056/NEJMra073096. PMID 18172175. Research Blogging.
- ↑ Katzung, Bertram G. (2006). “Antidepressant Agents”, Basic and Clinical Pharmacology, 10th. New York: McGraw-Hill Medical Publishing Division. ISBN 0-07-145153-6.
- ↑ (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.