Tricyclic antidepressants TCAs are an older class of drug first discovered in the s. They were named after their chemical structure, which is composed of three interconnected rings of atoms. TCAs work similarly to reuptake inhibitors in that they block the absorption of serotonin and norepinephrine into nerve cells, as well as another neurotransmitter known as acetylcholine which helps regulate the movement of skeletal muscles.
Examples of TCAs include:. Ludiomil maprotiline belongs to the same class of the drug but is more appropriately described as a tetracyclic antidepressant TeCA due to its fourth atomic ring.
Common symptoms include constipation, dry mouth, blurry vision, drowsiness, dizziness, and weight gain. In some cases, irregular heartbeats, low blood pressure, and seizures can also occur. In addition to their use in depression, tricyclic antidepressants can help treat chronic pain. One of the first classes of antidepressants developed were monoamine oxidase inhibitors MAOIs. This antidepressant class, first discovered in the s, inhibits the action of an enzyme called monoamine oxidase, whose role it is to break down monoamines.
Examples of MAOIs include:. MAOIs are less commonly used due to potentially severe reactions with foods high in tyramine. To avoid this, MAOI treatment usually involves dietary restrictions. Other side effects include nausea, dizziness, drowsiness, restlessness, and insomnia. Despite the risks, MAOIs have proven useful in treating agoraphobia, social phobia, bulimia, PTSD, borderline personality disorder, and bipolar depression.
Even so, its use is usually reserved for when other antidepressant options have failed. There are also other fairly new antidepressants that do not fit into any of the above-listed categories. Broadly described as atypical antidepressants, they affect serotonin, norepinephrine, and dopamine levels in unique ways. Side effects can vary by drug type but may include dizziness, dry mouth, insomnia, nausea, vomiting, constipation, blurry vision, weight gain, and sexual dysfunction.
There are several factors that go into choosing the right antidepressant. Chief among them is tolerability.
Because many antidepressants are equally effective in treating depression, a greater emphasis is placed on prescribing the drugs with the fewest short- and long-term side effects. This is especially true with nausea and weight gain , both of which can affect a person's quality of life and lead to the premature discontinuation of treatment. Antidepressants should never be used on their own to treat major depression but rather in conjunction with psychotherapy , self-help strategies , social support, and the treatment of co-existing conditions such as chronic pain, anxiety, bipolar disorder, and personality disorders.
Antidepressants are sometimes used in combination with other drugs to treat a variety of conditions. In some cases, the combined use of drugs that both exert serotonergic action can lead to serotonin syndrome. This is the toxic accumulation of serotonin that can trigger a cascade of potentially dangerous physical and psychiatric symptoms.
To avoid this, always advise your doctor about any and all drugs you are taking, including prescription drugs, over-the-counter medication, nutritional supplements, or herbal remedies. Antidepressants should only be used as prescribed and may take up to eight weeks before the benefits are fully felt.
It is important never to stop, interrupt, decrease, or increases doses without first speaking with your doctor. Stopping abruptly can lead to disruptive and often debilitating withdrawal symptoms , including nausea, vomiting, tremors, nightmares, dizziness, depression, and electrical shocks sensations. This can be avoided by gradually tapering the dose , preferably under the direction of a doctor. Antidepressants should be used with extreme caution in children, teens, and younger adults.
In , the FDA issued a black box warning about the increased risk of suicidal thoughts and actions in people under 24 on antidepressants of any type. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at for support and assistance from a trained counselor.
If you or a loved one are in immediate danger, call For more mental health resources, see our National Helpline Database. Antidepressants should only be used in children, teens, and younger adults when absolutely needed and only after weighing the potential benefits of treatment against the potential risks. Everything feels more challenging when you're dealing with depression. Get our free guide when you sign up for our newsletter. Depression: How effective are antidepressants?
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Haloperidol also lowers BDNF levels, reducing neuroprotection in the brain to enable haloperidol's toxic effects. Atypical drugs have opposing effects. They increase levels of BDNF, improve cell survival and enhance neurogenesis.
Atypical drugs can also prevent or reverse the effects of haloperidol induced toxicity.
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