Tricyclic antidepressants might cause the following side effects, but they might decrease after a few weeks as the body adjusts to them.

* Light-headedness.
* Mouth dryness.
* Tiredness.
* Weight gain.
* Constipation.
* Blurry vision.
* Trouble urinating.
* Night sweats.
* Heart rhythm problems.  


Side Effects of Tricyclic Antidepressants

Tricyclic (or heterocyclic) antidepressants inhibit the reuptake of serotonin and/or norepinephrine, and are thus called due to their three (or more)-ring chemical structure. Some examples include:

- Amitriptyline (Elavil) 
- Nortriptyline (Aventyl)
- Maprotiline hydrochloride (Ludiomil)
- Desipramine hydrochloride (Norpramin)
- Clomipramine (Anafranil)

A similar drug is Bupropion (Wellbutrin), which is an aminoketone that weakly blocks norepinephrine, serotonin, and dopamine reuptake.

Scripps College

Kalamazoo College

Antidepressants are psychotropic medications prescribed to alleviate symptoms of mood disorders like depression and anxiety. They work by addressing chemical imbalances of neurotransmitters in the brain. Different types of antidepressants target different neurotransmitters; for example, selective serotonin reuptake inhibitors (SSRIs) increase the availability of serotonin, while serotonin-norepinephrine reuptake inhibitors (SNRIs) elevate the levels of both serotonin and norepinephrine. Common SSRIs include Prozac and Zoloft, while tricyclics include Tofranil and Elavil.

Antidepressants

- Monoamine hypothesis
- Monoamine Oxidase (MAO)
- Reserpine
- Tricyclics
- Selective serotonin reuptake inhibitors (SSRIs)

Drug Treatments for Depressive Disorders

The study of the effects of drugs on the brain and behavior.

Psychopharmacology 

St. John's wort has shown promise as an affordable herbal treatment for depression, being compared to tricyclic antidepressants and SSRIs, particularly with less severe forms of the disorder. However, it is also known to interact with several other drugs.

St. John's Wort

S-adenosyl methionine has shown some promise in treating depression comparably to tricyclic antidepressants, especially in cases of unipolar depression or comorbid depression with other illnesses. It has been found to be well-tolerated and safe to use in conjunction with other drug treatments.

S-Adenosyl Methionine (SAMe)

National Center for Biotechnology Information (2021). PubChem Compound Summary for CID 2160, Amitriptyline. Retrieved October 21, 2021 from https://pubchem.ncbi.nlm.nih.gov/compound/Amitriptyline.

Amitriptyline (Elavil)

National Center for Biotechnology Information (2021). PubChem Compound Summary for CID 4543, Nortriptyline. Retrieved October 21, 2021 from https://pubchem.ncbi.nlm.nih.gov/compound/Nortriptyline.

Nortriptyline (Aventyl)

National Center for Biotechnology Information (2021). PubChem Compound Summary for CID 71478, Maprotiline hydrochloride. Retrieved October 21, 2021 from https://pubchem.ncbi.nlm.nih.gov/compound/Maprotiline-hydrochloride.

Maprotiline hydrochloride (Ludiomil)

National Center for Biotechnology Information (2021). PubChem Compound Summary for CID 65327, Desipramine hydrochloride. Retrieved October 21, 2021 from https://pubchem.ncbi.nlm.nih.gov/compound/Desipramine-hydrochloride.

Desipramine hydrochloride (Norpramin)

National Center for Biotechnology Information (2021). PubChem Compound Summary for CID 444, Bupropion. Retrieved October 21, 2021 from https://pubchem.ncbi.nlm.nih.gov/compound/Bupropion.

Bupropion (Wellbutrin)

National Center for Biotechnology Information (2021). PubChem Compound Summary for CID 2801, Clomipramine. Retrieved October 14, 2021 from https://pubchem.ncbi.nlm.nih.gov/compound/Clomipramine.

Clomipramine (Anafranil)

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs used to treat conditions like depression, which is often associated with low serotonin levels. Unlike agonists or antagonists that bind to receptors, SSRIs work by blocking the reuptake process. This action prevents unused serotonin from being reabsorbed by the presynaptic neuron, allowing it to remain in the synaptic cleft for a longer period. The extended presence of serotonin enhances its interaction with postsynaptic receptors, thereby strengthening its overall effect. Common examples of SSRIs include Prozac, Paxil, and Zoloft.

SSRIs and SNRIs

Tricyclic Antidepressants

MAOIs inhibit the breakdown of the enzyme that breaks down monoamine neurotransmitters. Some MAOIs have antidepressant effects, including:

- Phenelzine (Nardil)
- Isocarboxazid (Marplan)
- Tranylcypromine (Parnate)

Monoamine Oxidase Inhibitors (MAOIs)

Reference for Side Effects of Antidepressants

Side effects of SSRIs: 
* Headache
* Nausea
* Weight gain
* Drowsiness
* Reduced sex drive

Side effects of Tricyclics:
* Dry mouth
* Constipation
* Blurred vision
* Drowsiness
* Reduced sex drive
* Increased risk of suicide

Side Effects of Antidepressants

A clinician is considering two different types of medication for a patient. Medication A primarily works by increasing the amount of serotonin available between nerve cells. Medication B works by increasing the availability of both serotonin and norepinephrine. Which of the following statements accurately distinguishes between the mechanisms of these two medications?

References for Long-Term Use of Antidepressants

In past years, the overall use of antidepressants has increased. This could be from a mixture of increased "new" users or longer durations of use. Long-term is defined as 12 months or more of consistent medication use. Prevalence and incidence have increased SSRI use specifically. Treatments typically are as follows:

treatment of acute phase: 4-6 weeks
treatment for prevention of relapses: 4 to 12 months
treatment for prevention of recurrence: maintenance treatment (2-5 years)

Long-Term Use of Antidepressants

- A risk of taking SSRIs
- Many over-the-counter drugs may synergize with the drugs to push synaptic serotonin levels too high
- Symptoms include confusion, muscle spasms, and fever

Serotonin Syndrome

Psychedelics, in particular LSD and psilocybin, have been investigated as potential treatments for depressive symptoms. There is evidence for short-, medium-, and long-term usefulness in both micro-dosing and regular studies. In addition to the potential cognitive stimulation (LSD) or emotional well-being effects (psilocybin), these treatments are generally well-tolerated in clinical and general populations. In addition, MDMA has received breakthrough treatment status with the FDA for the treatment of PTSD.

Potential clinical uses for psychedelics

Ketamine, a rapid-acting anesthetic and NMDA receptor antagonist, has been investigated for use in treatment-resistant  depression. When infused in sub-anesthetic doses over a short period (e.g. 40 minutes), ketamine has been shown to have rapid antidepressant effects that can last for up to 4 weeks in some patients.

Using ketamine for treatment-resistant depression

Caffeine has been shown to increase the antidepressant effects of repeated transcranial magnetic stimulation in humans and the antidepressant-like effects of SSRIs, SNRIs, and atypical antipsychotics in mouse models. The proposed mechanism for this is that caffeine's adenosine receptor antagonism increases downstream production of serotonin, dopamine, and norepinephrine.

Caffeine and depression treatments

Psychopharmacology Library

Microdosing is the administration of a psychedelic drug/medication at one-tenth of the dose that would cause hallucinogenic effects.

Microdosing

A class of drugs that typically alleviate symptoms of schizophrenia. (Also called neuroleptics)

- The Dopamine Hypothesis

- Typical Antipsychotics

- Long-Term Effects of Antipsychotic Drugs

- Atypical Antipsychotics

- The Glutamate Hypothesis

Antipsychotic Drugs

Psychoplastogens class of compounds that take effect on neural plasticity in key circuits involved in brain health. Psychoplastogens include psychadelics, and produce a quantifiable change in plasticity within a short time frame (>72 h) post administration.

Psychoplastogens 

The study of the use of extracts and compounds obtained from mushrooms as medicines or health-promoting agents. Mycotherapy, also known as fungal or mushroom therapy, is a branch of natural medicine exploring the therapeutic properties and potential health benefits of various mushrooms. The practice of using mushrooms for medicinal purposes has been observed in different cultures throughout history, and it continues to gain recognition and scientific interest in modern times.

Mycotherapy

Medications that have Anticholinergic effects are associated with central and peripheral side effects. These include constipation, confusion, sedation, and dry mouth. Increased Anticholinergic exposure increases adverse risks.

Anticholinergic Medicines

Psychomotor stimulant drugs, such as amphetamines, are a primary treatment for narcolepsy. These medications function by increasing overall levels of neural activity to combat daytime sleepiness. Examples include modafinil, armodafinil, and various amphetamines.

Stimulants for Narcolepsy

Generally speaking, depression is an overall feeling of sadness. More specifically, those with depression tend to experience several things such as: an increase or decrease in weight, troubles with concentration, feelings of meaninglessness or worthlessness, thoughts of death or suicide, and so on. 

Depression

Selective Serotonin Reuptake Inhibitors (SSRIs) work by blocking the reabsorption of the neurotransmitter serotonin into neurons. This increases the levels of serotonin in the brain. 

SSRIs include:

- Citalopram

- Escitalopram

- Fluoxetine

- Paroxetine

- Sertraline

Learn Before

Related

Learn After