Welcome back to the Real Life Pharmacology podcast.

I'm your host Eric Christensen pharmacist.

And today we're going to cover tricyclic antidepressants.

And the first three examples that come to mind of drugs that are maybe more commonly used in clinical practice are amatryptylene, brand name Elliville,

nortripylene, brand name Pamilar, and doxapin brand name Cinequin. So tricyclic

antidepressants are really older drugs. They've got a little bit more of a vast

side effect profile and we're certainly going to cover that

today. But first, I want to start mechanistically. So from a mechanism perspective, the primary

mode of action of these medications is they inhibit the re-uptake of serotonin, as well as may have some

activity on norepinephrine as well.

And these levels are changed in the brain, and these levels are increased, generally, in the brain.

And if you think of other drug classes like SSRIs or SNRI, serotonin-norepenephrine-uptake inhibitors,

they definitely cross over and have similar activities to those classes of medications.

However, there also are other mechanisms with the tricyclic antidepressants.

So some of them definitely have older generation antihistamine activity as well.

And we'll kind of cover some of the issues that may prop up because of that mechanism

and the drugs being older anticholinergic type meds.

So with that, let's get into the uses for the medications.

Tricyclics may see it used for depression.

These drugs are not first line due to the side effect profile.

May see them used for various pain syndrome.

So a couple of classic examples.

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