CPR First Aid

How Tricyclic Antidepressants Work?

How Tricyclic Antidepressants Work

When it comes to antidepressant medications, tricyclic antidepressants (TCAs) are some of the oldest and most commonly prescribed drugs. Because of their wide range of side effects, tricyclics are mainly used as last-resort medications, especially in older people to treat severe depression and anxiety. But what are they, and how do they work? Let’s take a closer look at TCAs and discuss their uses, side effects, and other important information.

Overview of Tricyclic Antidepressants

A tricyclic antidepressant is a drug class that acts on the brain and nerves to treat conditions such as depression. TCAs are older medications that are not as commonly used as newer antidepressants, but they can be effective for some people. 

Tricyclics work by blocking the reuptake of certain neurotransmitters, in turn, increasing the levels of certain chemicals in the brain which helps in nerve signalling resulting in signaling improved mood. The downside to this is that TCAs can also cause significant changes to the number of other chemicals like histamine and acetylcholine that are responsible for several body processes, therefore disrupting function.

A tricyclic antidepressant is a drug class that acts on the brain and nerves to treat conditions such as depression. TCAs are older medications that are not as commonly used as newer antidepressants, but they can be effective for some people. 

Conditions Treated by TCAs

In Cheltenham, there are several conditions that tricyclic antidepressants are used to treat. In addition to depression, these are:

Major Depressive Disorder

Tricyclic antidepressants are a class of medication commonly used to treat a major depressive disorder, which is a severe form of depression. TCAs work by increasing the levels of serotonin and norepinephrine in the brain which helps to improve mood. They are typically taken once or twice daily and may take several weeks to become fully effective.

Dysthymia

Also known as persistent depressive disorder (PDD), is a long-term or chronic form of depression. Symptoms of dysthymia are similar to those of major depression, but they’re less severe and last longer. With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy 

The tricyclic antidepressant medication amitriptyline is often used as an adjunctive dysthymia treatment. Studies have shown that TCA’s can be effective in treating dysthymia, although they are not as commonly prescribed as SSRI’s or SNRI’s. The reason for this is that TCA’s tend to have more side effects than the other classes of antidepressants.

Anxiety Disorders

Tricyclics are popular anti-anxiety medications that are sometimes used in combination with other medications for anxiety. TCAs are also commonly used to treat other psychiatric conditions such as obsessive-compulsive disorder (OCD), or panic disorder. They are often used as first-line medications to treat anxiety in children, teens, and adults.

There is some evidence that TCA may be effective in treating anxiety disorders, particularly generalised anxiety disorder (GAD). A small study found that tricyclic antidepressants were more effective than placebo in treating GAD. However, larger and more well-designed studies are needed to confirm these findings.

What are Anxiety Disorders?

Anxiety disorders encompass a spectrum of mental health conditions characterized by overwhelming feelings of fear, worry, and apprehension. They can manifest in various forms, from specific phobias to panic attacks, each with its distinct triggers and physical symptoms of anxiety disorders. Panic attacks often bring an avalanche of physical symptoms like thyroid problems, shortness of breath, and chest pain, leaving individuals feeling utterly out of control.

Adolescents, especially, grapple with these challenges, often experiencing trouble sleeping, social phobia, and heightened stress due to academic pressures and social changes. Traumatic events and life events such as major transitions or a loss may also trigger the onset of the disorder. Risk factors such as genetics, trauma, or substance use can exacerbate these conditions.

Seeking support from a healthcare provider or mental health professional becomes crucial. They can offer guidance in stress management techniques and provide strategies to alleviate symptoms. It offers solace not only to the affected individuals but also to their concerned family members and loved ones.

What are the Types of Anxiety Disorders?

The American Psychiatric Association lists the following types of anxiety disorders on its website.

  • Generalized Anxiety Disorder – it comes with ongoing worry and tension with physical health issues and health problems such as restlessness, fatigue, muscle tension, or trouble sleeping
  • Social Anxiety Disorder (social phobia) – a person who has this has a significant anxiety and discomfort of being humiliated or being looked down on in social situations
  • Agoraphobia – fear or being in situations where it is hard to escape
  • Panic Disorder – its symptoms include recurring panic attacks, heart palpitations, chest pain, and others
  • Specific Phobiaintense fear of a specific object or situation that is harmless
  • Separation Anxiety Disorder – a feeling of fear and anxiousness when being separated from significant people
  • Selective Mutism – lack of speech in social situations outside the family

Additional information is found in the same resource’s book for the Diagnostic and Statistical Manual of Mental Disorders (DSM). 5th ed. Text Revision.

What Treatments Are Available for Anxiety Disorders?

The National Institute of Mental Health, which is part of the USA gov’s NIH, provides a fact sheet that mentions the following treatments.

  • Psychotherapy – it is a “talk therapy” with healthcare professionals that directs specific anxieties
  • Cognitive behavioural therapy (CBT) – teaches people how to react to situations that make them anxious
  • Acceptance and commitment therapy – uses strategies (such as mindfulness) to minimise discomfort and anxiety
  • Medication – antidepressants, anti-anxiety medications (such as benzodiazepines), and beta-blockers that help relieve symptoms
  • Support groupsself-help organisations that share problems in person or online
  • Stress management and relaxation techniques – exercise, mindfulness, and meditation may help relieve the symptoms and improve the effects of psychotherapy
  • Exposure therapy – the progressive exposure to situations that trigger anxiety

Psychiatry will play an important role in the application of these treatments according to a person’s needs.

Chronic Pain Syndromes

The effectiveness of tricyclic antidepressant treatments can vary depending on the individual and the specific chronic pain condition being treated. The mode of action of TCA treatment helps to increase pain tolerance and reduce pain perception. This can also help modulate the body’s inflammatory response, which can further reduce pain and swelling. Ultimately, TCA treatments can provide substantial relief for many chronic pain sufferers.

Insomnia

The increased levels of neurotransmitters in the brain improve sleep. Furthermore, TCA may have a sedative effect on the brain. It is generally considered to be a safe and effective treatment for insomnia.

Paroxysmal Extremes of Blood Pressure

The mechanism of action of tricyclics in the treatment of paroxysmal extreme hypertension is not fully understood. However, it reduces sympathetic nervous system activity. In addition, TCAs may also block the release of these neurotransmitters from nerve endings. This decreases blood pressure by reducing sympathetic outflow from the central nervous system.

Other Conditions

Tricyclic antidepressants are also sometimes used in the treatment of eating disorders, substance abuse disorders, and certain types of personality disorders. However, their use in these cases is generally considered to be off-label.

Side Effects of Tricyclic Antidepressants

TCA side effects are typically mild and generally go away with time. The most common side effects include:

  • dry mouth
  • constipation
  • weight gain
  • drowsiness and dizziness
  • blurred vision

More serious side effects of TCAs may include low blood pressure, fast heart rate, and seizures. These side effects are rare but can be potentially life-threatening. If a person experiences any of these side effects, it is important to seek medical help immediately.

Overall, tricyclic antidepressants are generally safe and effective medications for treating depression. However, as a caregiver or first aider in Cheltenham, it is important to be aware of the potential side effects as TCAs can also be dangerous if they are not used correctly. If you experience any serious side effects, it is important to seek medical help immediately.

TCA side effects are typically mild and generally go away with time.

What Happens in Depression?

What is depression? It is a mental health disorder that is characterised by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and home.

What is depression? It is a mental health disorder that is characterised by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and home.

Symptoms of Depression

Depression can be caused by a variety of factors, including genetic vulnerability, psychological stress, biochemical, environmental, and medical conditions. Symptoms can vary from mild to severe, but they must be present for at least two weeks to be classified as depression. Symptoms include:

  • Persistent sad, anxious, or “empty” mood
  • Loss of interest or pleasure in activities once enjoyed
  • Decreased energy, fatigue, being “slowed down”
  • Difficulty concentrating, remembering details, making decisions
  • Insomnia, early-morning awakening, or oversleeping; or restless, irritable sleep
  • Loss of appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; or suicide attempts
  • Feelings of hopelessness, helplessness, worthlessness
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

Who is At Risk for Depression?

Depression can occur at any age, but it usually begins in the teens or early twenties. Often runs in families, but it can also occur in people who have no family history of the condition. Women are more likely than men to experience this. Some people experience only one episode in a lifetime, but for others, depression is a recurring problem.

Depression in Australia

A serious problem in Australia. It is estimated that one in six people experience depression at some stage in their lives. Depression can lead to suicide, which is the leading cause of death in young Australians.

In emergencies, empathy is a useful skill as it enables the responder to comprehend that person’s viewpoint and frame events positively. CPR First Aid has first aid courses in Cheltenham and different locations that involve honing the different skills in effectively providing emergency care. Contact us for more information.

What are Some Tricyclic Antidepressants?

In Australia, there are several different tricyclics available in tablet or capsule dosage forms. Common TCAs are as follows:

Amitriptyline

Can be used to treat severe depression, post-traumatic stress disorder (PTSD), and neuropathic pain.

Desipramine

Depression, PTSD, and neuropathic pain

Doxepin

For severe depression and neuropathic pain

Imipramine

Can be used in severe depression, GAD, panic disorder,

Nortriptyline

For severe depression and neuropathic pain.

Who Should Not Take Tricyclics?

The conditions below are contraindicated for tricyclic antidepressants. Avoid TCAs if you have any of the following:

  • Cardiac conduction disorders
  • Glaucoma
  • Severe urinary retention
  • Pregnancy (due to the risk of neonatal toxicity)
  • Breastfeeding (due to the risk of infant exposure to the drug)
  • Hypersensitivity to the drug

In conclusion, tricyclic antidepressants are a safe and effective treatment for depression and other mental illnesses. There are some potential side effects that first aiders should be aware of. Call CPR First Aid to get first aid certified in Cheltenham for all medical emergencies.

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