Tricyclic Antidepressants (TCA’s)

Question 1

Name all of the TCA’s (6)

Answer 1

Amitriptyline (Endep)
Nortriptyline (Allegron)
Clomipramine (Placil)
Imipramine (Tofranil)
Dosulepin (Dothep)
Doxepin (Deptran)

Question 2

TCA MOA

Answer 2

Inhibits the reuptake of noradrenaline and serotonin into presynaptic terminals

They also block cholinergic, histaminergic, alpha 1 adrenergic and serotonergic receptors

Question 3

TCA Adverse Effects

Answer 3

Sedation
Dry mouth
Blurred vision
Constipation
Dry eyes
Orthostatic hypotension

Question 4

TCA Counselling

Answer 4

Dry mouth, blurred vision and drowsiness should lessen in 7 days

Get up gradually from sitting or standing

May increase the effects of alcohol

Take at night due to drowsy side effects

Question 5

Which TCA has the highest anticholinergic effects

Answer 5

1. Amitriptyline
2. Doxepin
3. Clomipramine, dosulepin, imipramine
4. Nortriptyline

Question 6

Which TCA has the highest sedation effects

Answer 6

1. Doxepin
2. Amitriptyline
3. Clomipramine, dosulepin, imipramine, Nortriptyline

Question 7

Which TCA has the highest orthostatic hypotension effects

Answer 7

1. Amitriptyline, Doxepin
2. Clomipramine, dosulepin, imipramine
3. Nortriptyline

Question 8

Which TCA has the highest serotonin activity

Answer 8

Clomipramine