Tricyclic Antidepressants (TCAs) (Nursing)

by Rhonda Lawes, PhD, RN

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    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.

    About the Lecture

    The lecture Tricyclic Antidepressants (TCAs) (Nursing) by Rhonda Lawes, PhD, RN is from the course Central Nervous System (CNS) Medications (Nursing).

    Included Quiz Questions

    1. Amitriptyline
    2. Imipramine
    3. Amoxapine
    4. Clomipramine
    1. Side effects of the drug
    2. Effectiveness of the drug
    3. Efficacy of the drug
    4. Duration of action of the drug

    Author of lecture Tricyclic Antidepressants (TCAs) (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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