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Tricyclic antidepressants

thinking about buying tricyclic antidepressants and want to gather some more information on the topic before doing so. This website has both technical and non-technical information on the various different types of tricyclic antidepressants, branded products, and a little bit of history.
First a little history… Tricyclic antidepressants or more commonly abbreviated TCAs have been around for a long while; they were discovered in the early 1950s and were not originally intended on targeting depression but rather, psychosis.
The first TCA that was reported to be used in the treatment of depression was Imipramine, which seemed to have a tendency to cause manic effects on the patients.

There are a variety of TCAs in use today, some of which most popularly include Amitriptyline (Elavil), Dimetacrine (Istonil) and Melitracen (Melixeran). More information on what their generic drug names are and what they do can be found in the full TCAs list listed at the bottom of the page.

Tricyclic antidepressants are still in use today but are rapidly getting replaced by selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) which seem to have a few less side effects than the TCAs.

Enough of history…  What are TCAs used for?

There are many uses for TCAs some of which include anxiety disorder, bipolar disorder, dysthymia (which is basically a mood disorder consisting of chronic depression), panic disorder, obsessive compulsive disorder (which I’ve personally experienced ever since my youth but have learnt to manage as I got older… I remember washing my hands up to twenty times a day… how annoying!), social anxiety disorder (have a friend that used to fit into this one, luckily I was able to help him out), attention deficit hyperactivity disorder (more commonly known as ADHD, this is another one I fell victim to in my youth but eventually got over), post-traumatic stress disorder, and of course, major depressive disorder (MDD) which is probably one of the toughest to handle out of the ones I listed.

As I said above, TCAs are still used today but are being replaced by SSRIs and SNRIs. A recent review of the efficiency of SSRIs done by the Cochrane Collaboration (click link to Wikipedia for more info on this) said they weren’t too much more effective than placebo. This could have some truth to it but if they’re helping people out then I’m all for it.

Here’s a question you should be asking yourself before taking TCAs…

Are tricyclic antidepressants addictive?

TCAs are not considered to be addictive, by whom? Well by the companies that supply them of course. It is said the term “withdrawal symptoms” was removed from the dictionary when relating to pharmaceutical drugs because it made them relate too much to recreational drugs such as ecstasy and cocaine so they’ve renamed the term to “discontinuation syndrome”.

Basically what this means is if you’ve been taking TCAs for a long period of time and suddenly stop, you will suffer from symptoms such as insomnia, nausea, headaches and anxiety. The reason for this is most of these pharmaceutical drugs promote the release of serotonin, norepinephrine and/or dopamine neurotransmitters above normal, just like ecstasy (for serotonin) or cocaine (for dopamine) would, but on a much lower and safer level of course. This causes the little receptors in your brain to slowly start storing less of those chemicals every time you consume more and therefore making you more dependent on the drug to get a release of these wonderful neurotransmitters that are capable of making us feel like everything is okay even though sometimes things are not.

Can you overdose on tricyclic antidepressants?

The short answer is yes.  There aren’t many cases that have been documented but some people tend to want to abuse TCAs and use them for recreational purposes, which can cause a significant amount of drug poisoning due to the high toxicity in the cardiovascular and neurological system. If you feel you have ingested too much and notice your vision going blurred, have a dry mouth, dizziness or vomiting it’s recommended visit your local GP straight away.

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Paul Nasri

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