Tricyclic Antidepressants (TCAs) (Nursing)

00:01 Hi, welcome to our video series on antidepressants.

00:03 In this one, we're gonna take a look at an old school drug, tricyclic antidepressants.

00:10 Now you'll probably see this shortened to be TCAs.

00:14 That's what they're talking about. Tricyclic antidepressants.

00:18 Now, tricyclic antidepressants block the neuronal reuptake of 2 monoamine transmitters.

00:25 Okay, we got a lot going on here, right? So monoamine transmitters, norepinephrine and serotonin.

00:33 Now, we've talked about with other drugs, the SSRIs, the NDRIs, those drugs, serotonin is a neurotransmitter.

00:40 It affects a lot of things.

00:42 Mood, social behavior, appetite, digestion, sleep, memory, sexual desire and function.

00:48 Okay, that's what we believe serotonin does.

00:51 But this blocks the reuptake of serotonin and norepinephrine.

00:57 Now, a norepinephrine is also a CNS neurotransmitter but it increases alertness, arousal, and speeds reaction time.

01:05 Man, all that sounds great during studying for finals, doesn't it? But we know that it plays a role in a person's mood and ability to concentrate.

01:14 Okay, so you put these two together, that sounds pretty good.

01:18 So I've got serotonin and all the things that it does and norepinephrine, that's gonna also impact my mood and my ability to concentrate.

01:27 That's the theory behind tricyclic antidepressants.

01:31 It's gonna block the reuptake of norepinephrine and serotonin.

01:36 I've got some examples of names here for you.

01:39 Because these drugs have been around a really long time, I have both the generic and the trade name there for you but I always wanna remind you any time I do this, remember, the names that are gonna be on the NCLEX are only the generic names, the ones on the left.

01:54 The ones in the parenthesis are the trade name and you won't see those on the NCLEX.

01:58 So there are examples there like, amitriptyline, imipramine.

02:02 You see the names that we have for you there.

02:04 There's a long list -- no, it's not that long.

02:06 It's only 5 names but just hang out here for a little bit.

02:10 Spend some time looking at these names so you're familiar and will recognize these names on an exam or the big exam, the NCLEX.

02:23 Now, we can use these as they're known, tricyclic antidepressants, depression seems like -- yes, that seems like it would be a pretty, well, expected treatment.

02:33 So tricyclic antidepressants can be used for depression.

02:38 But what else they can use for is kind of unusual about these.

02:41 We can use it for chronic pain.

02:43 So it's been effective in patients with fibromyalgia, right, you see that 'my' means muscle, 'algia' meaning pain, so chronic pain in fibromyalgia.

02:53 It's effective for some people with migraines and it can also be effective in pretty severe depression.

02:59 Okay, so these are 3 types of intense pain, 2 are in the body, one is gonna be a mood, a severe depression.

03:08 So tricyclic antidepressants, what's different for them is they do depression obviously but they can do a pretty severe depression and chronic pain.

03:18 Now, keep in mind it has more of a sedative hypnotic effect and each one of the TCAs are equally effective.

03:25 Now, we just -- before this, we talked about some names and you kinda hung out there trying to familiarize yourself with those names but they're actually all pretty equally effective.

03:34 You base the selection like, which TCA you're gonna use with the patient, the health care provider kind of base it on the side effects.

03:41 What's gonna be more problematic for the patient and what's not gonna be.

03:45 And remember, everybody is a different body and when it comes to pharmacokinetic processes and how it impacts the patient, every patient can have a little bit different experience.