VI. TRICYCLIC ANTIDEPRESSANTS

The TCAs block norepinephrine and serotonin reuptake into the neuron. The TCAs include the tertiary amines imipramine (the prototype drug), amitriptyline clomipramine doxepin trimipramine. The TCAs also include the secondary amines desipramine and nortriptyline (the respective N demethylated metabolites of imipramine and amitriptyline) and protriptyline. Maprotiline and amoxapine are related “tetracyclic” antidepressant agents and are commonly included in the general class of TCAs.These drugs are a valuable alternative for patients who do not respond to SSRIs.