2023-05-18 21:32:42
Several antidepressants are used for the treatment of depression. One of the best known on the market is the tricyclic antidepressant. It is highly valued for its effectiveness in restoring a person’s mood, which is why it is widely used. What are its particularities? What treatments is it intended for? Does it have side effects?
What are the particularities of the tricyclic antidepressant?
Tricyclic antidepressants, commonly known as TCAs or ATDs, are prescribed for the treatment of depressed mood. They are called tricyclics in tribute to their particular molecular structure.
Tricyclic antidepressants derive from the molecule « imipramine ». It is made up of three rings of atoms, unlike other antidepressants that play the same role, such as tetracyclic antidepressants. However, the latter are composed of four rings of atoms.
Appearing for the first time in 1950, ATC is classified with the (MAOI) mono-amine oxidase among the antidepressants of the first generation. It was long following that selective neurotransmitter inhibitors called second and third generation antidepressants appeared.
How do tricyclic antidepressants work?
To regulate mood, tricyclic antidepressants will act as an inhibitor. They go prevent brain cells from absorbing neurotransmitters such as serotonin, norepinephrine and reuptake. By blocking the pumps responsible for acting on the side of the synapses, they promote a good concentration of these neurotransmitters in the synaptic cleft and, in turn, good neurotransmission.
Serotonin, norepinephrine, and reuptake are neurotransmitters that regulate behaviors like mood, anxiety, decision-making, and motivation. However, people with endogenous depression show a very low early on of these neurotransmitters, hence their condition. Moreover, by promoting a high concentration of these neurotransmitters in the synapses thanks to inhibition, tricyclic antidepressants make it possible to bring the psychological state of depressive patients back to normal.
Tricyclic antidepressants: for which treatments?
Tricyclic antidepressants are used in the treatment of:
- The Depression : for the treatment of characterized depressive episodes, which are not due to external situations such as separation and bereavement;
- TOC: for the prevention of obsessive-compulsive disorders;
- The depressive states of parkinsonians;
- Prevention and treatment of panic disorders;
- Anxiety;
- Rebellious pains;
- Hyperactivity;
- The treatment of manic-depressive disorders ;
- Akinesia;
- The treatment of stubborn pain.
The tricyclic antidepressants allow on the whole an improvement of the depressive episodes and prevent the suicidal risks of the patient. However, when it comes to condition improvements, it usually takes several weeks of use. On average, it takes 4-6 weeks for a full depression treatment. Also, in the case of some more serious problems such as OCD, the treatment can last more than 8 weeks before the patient feels the first improvements.
Attention : Even following the improvement of the state of health, in no case should the treatment be stopped without the advice of the doctor.
How to take tricyclic antidepressants?
Tricyclic antidepressants work differently. Thus, their grip varies according to their type:
Anxiolytic or sedative molecules
They are intended for fight the feeling of fear patients during a crisis. These are tranquilizers prescribed in the case of suicidal risk or in the case of anxious depression. Mention may, for example, be made of amoxapine and maprotiline. These drugs should be used in the evening.
Intermediate or psychotonic molecules
Intermediate or psychotonic molecules are found in drugs such as imipramine and clomipramine. These are to be administered preferably in the morning, in the worst case before 5 p.m. They are also prescribed for promote inhibition of neurotransmitters.
Analgesic molecules
Medications like amitriptyline are intended for the treatment of bedwetting and aggravated depression. In adults, the dose is between 75 to 200 g per day. For children, the dose is between 10 to 20 mg per night for children aged 7 to 10 years and a dose of 25 to 50 mg for older children.
What are the side effects of tricyclic antidepressants?
Like all medications, the use of tricyclic antidepressants can have certain consequences on the body. Side effects vary, however, from person to person. The most listed side effects are: loss of appetite, constipation, dry mouth, nausea, visual accommodation disturbances. These disorders include headache, and itchy or watery eyes.
In addition, taking antidepressants can cause heart problems, of the delusional states such as paranoid delusions and hallucinatory psychosis or paraphrenia. The patient may also be prone to urinary retention, increased intraocular pressure and physical problems, such as sudden weight gain.
Tricyclic antidepressants also act through their action on acetylcholine, a neurotransmitter that carries nerve impulses between nerve and muscle in the brain. In doing so, they sometimes cause orthostatic hypotension in the patient.
Other more serious symptoms such as insomnia, nightmares, convulsions, disappearance of periods, tremors, excessive sweating and bulimia may appear during treatment. Sexual disorders such as low libido, impotence, inability to achieve orgasm or erectile dysfunction have also been reported. Finally, in elderly patients, it has been reported mental confusion.
Antidepressants: what are the contraindications?
Tricyclic antidepressants should not be combined with other antidepressants. Indeed, such an association might lead to risks of seizures, hypertension or serious hyperthermia. The treatment is also contraindicated in the case of benign prostatic hypertrophy and in all acute urinary retention problems. Similarly, in the event of heart failure or atrioventricular block, treatment with tricyclic antidepressants is strictly prohibited.
In addition, tricyclic antidepressants can cause, in some cases, suicidal thoughts. This is why it is not recommended to take this treatment in cases of hallucinatory delirium. Tricyclic antidepressants should also be avoided in the case of acute angle-closure glaucoma or when the patient has a myocardial infarction.
In addition, tricyclic antidepressants can cross the placental wall or breast tissue. They are therefore prohibited for pregnant women and breastfeeding women. For patients with epileptic seizures, treatment can be tolerated as long as it is safe. But as soon as the first seizures appear, antidepressants should be stopped immediately.
What are the risks of an overdose?
Because of their effect on the body, tricyclic antidepressants should be taken in accordance with the doctor’s prescriptions. A higher dose than prescribed is strongly discouraged. In the event of an overdose, the patient may observe an arrhythmia due to increased cardiac conduction time.
In addition, even in patients without seizure disorders, overdose may cause convulsions, and in some cases, death. After an overdose, one should immediately go to the hospital for treatment of potential adverse effects.
Are antidepressants addictive?
Treatment with tricyclic antidepressants does not induce any state of physical dependence in the patient. There is therefore no craving to fear following stopping the tablets. However, a sudden stop can unbalance the body and cause flu symptoms such as nausea, fever, chills for a few days.
1684469865
#tricyclic #antidepressant
