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Tricyclic antidepressants (TCAs) are a class of medications that are used primarily as antidepressants. TCAs were discovered in the early 1950s and were marketed later in the decade. [ 1 ] They are named after their chemical structure , which contains three rings of atoms .
TCA overdose may occur by accident or purposefully in an attempt to cause death. [2] The toxic dose depends on the specific TCA. [2] Most are non-toxic at less than 5 mg/kg except for desipramine, nortriptyline, and trimipramine, which are generally non-toxic at less than 2.5 mg/kg. [5] [2] In small children one or two pills can be fatal. [6]
A drug test (also often toxicology screen or tox screen) is a technical analysis of a biological specimen, for example urine, hair, blood, breath, sweat, or oral fluid/saliva—to determine the presence or absence of specified parent drugs or their metabolites.
Drugs that contain four rings not all fused together but are sometimes still classified as TeCAs include: Amoxapine (Asendin) – often classified as a TCA and grouped with the secondary amines Quetiapine (Seroquel) - an atypical antipsychotic sometimes used as an adjunct antidepressant
Desipramine, sold under the brand name Norpramin among others, is a tricyclic antidepressant (TCA) used in the treatment of depression. [8] It acts as a relatively selective norepinephrine reuptake inhibitor, though it does also have other activities such as weak serotonin reuptake inhibitory, α 1-blocking, antihistamine, and anticholinergic effects.
Imipramine, sold under the brand name Tofranil, among others, is a tricyclic antidepressant (TCA) mainly used in the treatment of depression.It is also effective in treating anxiety and panic disorder.
The therapeutic effects of protriptyline, like other antidepressants, appear slowly. Maximum benefit is often not evident for at least two weeks after starting the drug. [7] Protriptyline is a TCA. [5] It was thought that TCAs work by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin by neurons. [5]
Amoxapine, sold under the brand name Asendin among others, is a tricyclic antidepressant (TCA). It is the N-demethylated metabolite of loxapine.Amoxapine first received marketing approval in the United States in 1980, approximately 10 to 20 years after most of the other TCAs were introduced in the United States.