Tetracyclic antidepressants

Tetracyclic antidepressants (TeCAs) are a class of antidepressants that were first introduced in the 1970s. They are named after their chemical structure, which contains four rings of atoms, and are closely related to the tricyclic antidepressants (TCAs).

History

The first TeCA, maprotiline, was introduced in the 1970s. It was followed by mianserin, amoxapine, and mirtazapine. These drugs were developed in an effort to create more effective and safer alternatives to the existing monoamine oxidase inhibitors (MAOIs) and TCAs.

Mechanism of action

TeCAs work by inhibiting the reuptake of certain neurotransmitters, such as norepinephrine and serotonin, thereby increasing their levels in the brain. Some TeCAs also have affinity for serotonin receptors, which may contribute to their antidepressant effects.

Uses

TeCAs are used primarily in the treatment of major depressive disorder. They may also be used off-label for other conditions, such as anxiety disorders, insomnia, and chronic pain.

Side effects

Common side effects of TeCAs include drowsiness, dry mouth, constipation, and weight gain. They can also cause more serious side effects, such as orthostatic hypotension, cardiac arrhythmias, and seizures.

See also

• List of antidepressants
• Pharmacology of antidepressants