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Tricyclic Antidepressant Theory

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Depression is a mental illness in the brain, and is characterised by low moods, poor self-esteem. These feelings of self-worthlessness can often be accompanied by suicidal ideologies. [1] Depression is thought to be due to a deficit in the concentration of noradrenaline, serotonin and dopamine in the brain and spinal cord. This is called the Monoamine Theory of Depression. This theory is emphasised by the way antidepressants work, in that they increase levels of serotonin, dopamine and noradrenaline in the brain in order to combat depression. [2] One such group of antidepressants that work in this way, in that its target role is to increase the concentration of monoamines in the brain to cure depression, are the Tricyclic antidepressants. Tricyclic …show more content…
Usually serotonin, dopamine and noradrenaline are coupled to post-synaptic receptors after their release from a nerve terminal. In the presynaptic neuron, proteins that aid in reuptake of the various neurotransmitters are blocked and the levels of serotonin, dopamine and noradrenaline in the synaptic cleft escalate. The receptors that the TCAs block are histamine H1 receptors, alpha 1 adrenergic and muscarinic receptors which gives the severe side effects as the transport of histamine, acetylcholine and noradrenaline is prohibited. The main cause for the atropine like side effects are the blocking of the cholinergic receptors. This gives rise to the side effects mentioned prior. Histamine H1 block causes sedation and alpha 1 obstruction causes dizziness, stiffness and increased heart rate. [4] These side effects make it a very undesirable drug to take for depression and make the drugs such as selective serotonin reuptake inhibitors more desirable to take as the side effects are less harsh, the new side effects being nausea, insomnia and dizziness among others. …show more content…
Amitriptyline and Imipramine are both anticholinergic, albeit not as strong at preventing the transmission of acetylcholine as atropine. [7] From this experiment, although we cannot know which drug has a better mechanism of action or potency, the side effect of constipation for imipramine is slightly more prominent than in the drug amitriptyline. Between amitriptyline and imipramine, the drug I would recommend to give to a patient, based on the results of the experiment, is amitriptyline, as from this experiment, it is seen that it has a slightly smaller presence of constipation. This is known as there is a slightly larger response to carbachol with amitriptyline than with imipramine.
Atropine is a very strong anticholinergic antagonist. It works at muscarinic receptors and competitively binds to them, preventing them from having any activity. [8]. From this experiment, the side effect of constipation is a definite with this drug as it completely blocks the muscarinic receptors. This is seen from the 0mV response of the fundus with atropine in the presence of

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