Cotriptyline

Cotriptyline is a tricyclic antidepressant (TCA) that is used in the treatment of depression. It is a tertiary amine TCA, with its side chain-demethylated metabolite nortriptyline being a secondary amine. Other TCAs include amitriptyline, imipramine, and doxepin. Cotriptyline is less sedating than other TCAs and is similar in efficacy to SSRIs.

Pharmacology

Cotriptyline acts by inhibiting the reuptake of serotonin and norepinephrine, thereby increasing the concentration of these neurotransmitters in the synaptic cleft. This results in an elevation of mood and reduction in symptoms of depression. Cotriptyline also has anticholinergic properties, which can lead to side effects such as dry mouth, constipation, and blurred vision.

Clinical Use

Cotriptyline is used primarily in the treatment of depression, but can also be used off-label for conditions such as chronic pain, migraine prophylaxis, and insomnia. It is typically used when other treatments have failed or are not tolerated.

Side Effects

Common side effects of cotriptyline include dry mouth, constipation, blurred vision, and dizziness. More serious side effects can include cardiac arrhythmias, orthostatic hypotension, and suicidal ideation. It is contraindicated in individuals with a history of cardiac disease or those who have recently had a myocardial infarction.

See Also

• Tricyclic antidepressant
• Serotonin
• Norepinephrine
• Depression (mood)