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ANTIDEPRESSANTS: TCAs, MAOIs | ||
DRUG NAME | Tertiary TCAs: amitriptyline (Elavil), imipramine, clomipramine (Anafranil) Secondary TCAs: desipramine (Norpramin), nortriptyline (Pamelor) | isocarboxazid (Marplan) phenelzine (Nardil) tranylcypromine (Parnate) selegiline (Emsam, Zelapar) |
CLASS | Tricyclic antidepressants (TCAs) | Monoamine oxidase inhibitors (MAOIs) |
MECHANISM OF ACTION | Inhibition of serotonin and norepinephrine reuptake into nerve endings | Monoamine oxidase inhibition to prevent the breakdown of serotonin, norepinephrine, and dopamine |
INDICATIONS |
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ROUTE(S) OF ADMINISTRATION |
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SIDE EFFECTS |
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CONTRAINDICATIONS AND CAUTIONS |
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NURSING CONSIDERATIONS: ANTIDEPRESSANTS (TCAs, MAOIs) | ||
CLASS | TCAs | MAOIs |
ASSESSMENT AND MONITORING | All antidepressants
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TCA
| MAOI
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CLIENT EDUCATION | All antidepressants
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TCA
| MAOI
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Antidepressants are medications primarily used to treat major depressive disorder, which is a condition associated with a persistent feeling of sadness and loss of interest in everyday activities.
Even though the exact cause of major depressive disorder is still unknown, there's some evidence that suggests that it’s related to low levels of neurotransmitters called monoamines, which include serotonin, norepinephrine, and dopamine.
In this video, we’re going to cover two of the main classes of antidepressants: tricyclic antidepressants and monoamine oxidase inhibitors.
First, let’s focus on tricyclic antidepressants or TCAs for short, which can be further subdivided into tertiary or non-selective TCAs, like amitriptyline, imipramine, and clomipramine; and secondary or selective TCAs, such as desipramine and nortriptyline.
Now, tricyclic antidepressants are taken orally, and once absorbed into the bloodstream, they travel to the brain. Here, TCAs inhibit the reuptake of serotonin and norepinephrine.
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