Tricyclic & tetracyclic antidepressants


Tricyclic & tetracyclic antidepressants


Act by blocking transporters of serotonin and NE

  • List of antidepressants are:
  1. Imipramine
  2. Desipramine
  3. Trimipramine
  4. Amitriptyline
  5. Nortriptyline
  6. Protriptyline
  7. Amoxapine
  8. Doxepin
  9. Maprotiline
  10. Clomipramine
  • Secondary Effects include [Responsible for S/E]:
  1. Blockage of muscarinic and histaminic [Ant cholinergic S/E]
  2. Blockage of α1 and α 2 [Postural Hypotension]
  3. Blockage of Cardiac Na channels [Cardiac arrhythmias, seizures]
  • Clomipramine [Serotonin selective] Desipramine [Most NE selective]
  • Amoxapine has D2 blocking action hence EPM side effects
  • Imipramine is used in T/T of nocturnal enuresis
  • Clomipramine is used as 1st line in OCD [However SSRIs Preferred]
  • Due to significant anticholinergic S/E avoided in Glaucoma and BPH
  • Anticholinergic S/E – constipation, urinary retention, blurred vision, dry mouth / decreased sweat

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