Tricyclic antidepressants - how do/did they work?

[pammi_i]

Hi, I know this is a forum about panic and axiety, but depression also seems to be very related to that. Tricyclic antidepressants may be old hat now, I don't know I used to get prescribed Lophepramine a few years ago, on the odd occasion that I needed something to get my back on equilibrium, but have more recently been prescribed Citalopram.

Now, Citalopram I know is an SSRI which stands for Specific Seratonin Reuptake Inhibitor. That tells me exactly what it does, it inhibits the reuptake of seratonin and is specific to seratonin which is one of the endorphines (a naturally produced pleasure inducing or pain-killing biochemical).

Lophepramine is a tricyclic antidepressant, but I haven't the first clue what that means. How do they actually work? By antidepressing the trycyclics perhaps? What are they then?

Does anyone know?

[jo61]

I was on a tricyclic years ago which didn't work for me. Try this link - it gives info on most drugs.

http://www.nmhct.nhs.uk/pharmacy/

Jo

[sandie]

Could try looking this up on a really good website I've used for some years now.

www.netdoctor.co.uk.

I'm going to have a look when I finish on NMP in a short while.

Sandie

[Nel]

I don't think there is a huge difference in HOW they work. The only difference I am aware of is that (allegedly) SSRI's have fewer side effects, and they are less potent in the event of an overdose.
I've tried both types, and both had unbearable side effects (well, for me they did).

Nel xxx

___________________________________________
"At the end of a storm, there's a golden sky..."

[paleblue]

Trycyclics work by affecting the re-uptake of both serotonin and noradrenaline to varying degrees, some biased to serotonin, some noradrenaline.
Lofepramine is biased towards noradrenaline with only a small effect on serotonin and would therefore be more suited to a depression characterised by apathy, anhedonia.
The nearest modern equivalent would be Duloxetine, an SNRI.

Hope that helps.

[pammi_i]

That was very good paleblue, thanks. It still doesn't explain why they are called tricyclic - bicyclic might seem more appropriate as the work on two endorphines.

Would you know what sort of depression that seratonin reuptake inhibitors are good for please?

Thanks,

pammi x

[paleblue]

First of all, I am not qualified in this area but have a strong interest and have done a lot of research online and in libraries.
The info is out there but you have to dig deep into medical journals, clinical trials etc.

Anyway, the name Trycyclic refers to the chemical structure rather than relating to the effect.

Serotonin reuptake seems to help more with the kind of depression characterised by sadness, insomnia and suicidal thoughts.

ANd, as I said noradrenaline(norepinephrine) seems more suited to Atypical Depression- oversleeping, anhedonia etc. Dopamine related drugs also look promising for Atypical also eg. Wellbutrin

It's still very hit and miss but a good Psychiatrist will prescribe right. GP's however just tend to stick to the usual drugs, Prozac et al.