What is the mechanism of action of tricyclic antidepressants? - They block the reuptake of both
norepinephrine and serotonin
What are the potential side effects of TCA's? - Anticholinergic effects (urinary retention, constipation,
tachycardia, dry mouth, and blurred vision), sedation, sexual dysfunction, orthostatic hypotension,
hyperpyrexia, and confusion and hallucinations in the elderly
What happens when a patient has overdosed on TCA's? - Arrhythmias with QRS prolongation,
cardiotoxicity, coma, and convulsions
What are some common TCA's? - amitriptyline (Elavil), desipramine (Norpramin), nortriptyline
(Pamelor), clomipramine, imipramine, and doxepin
What is serotonin syndrome? - It is a hypertensive crisis, with delirium, hyperpyrexia, convulsions. It
occurs when multiple drugs that affect serotonin levels are used at the same time: for example MAOI's
combined with SSRI's
What is the mechanism of action of amitriptyline? - It is a TCA, so it inhibits reuptake of norepinephrine
and serotonin
What are the side effects of SSRI's? - GI upset, head aches, insomnia, sweating, and sexual dysfunction
What are the indications for SSRI use? - Depression, panic disorders (DOC), obsessive compulsive
disorder (might need higher doses), social anxiety disorder, and PTSD
True or false: a patient who does not respond to one SSRI might respond to another - True.
What is the mechanism of action of desipramine? - It is a TCA, so it inhibits the reuptake of
norepinephrine and serotonin
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