Tricyclic Antidepressants (TCA): Pharmacology Made Easy & Clinically Relevant
TCA antidepressants have historically been used for depression, but due to their safety profile, their use today extends to other indications. Their unique mechanism & safety profile make them essential for all clinicians to know. Learn to understand, so that you will know the why & remember it.
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In this episode of This Is Why, Dr. Busti will dig into tricyclic antidepressants (TCA) — not just as legacy antidepressants, but as practical tools for neuropathic pain, migraine prophylaxis, fibromyalgia, IBS-related pain, and insomnia. We’ll connect structure (tertiary vs. secondary amines) to mechanism, side effects, and real-world choices, then tackle the big safety issue: sodium-channel blockade → QRS widening/QT prolongation, seizures, and what to do in an overdose (including why hypertonic sodium works). The goal is to make pharmacology easy and make pharmacology relevant.
Chapters
00:00 Introduction to TCAs: Tricyclic Antidepressants
01:45 TCA Modern Indications: Neuropathic Pain, Fibromyalgia, Insomnia & MDD
02:36 TCA Drug Lineup: Tertiary vs Secondary Amines
04:06 Mechanism of Action: Serotonin vs Norepinephrine Reuptake & Structure Differences
05:31 TCA Clinical Uses & Pain Syndromes: IBS, Neuralgia, Migraine Prophylaxis
12:40 Side Effects: Anticholinergic Burden, Sedation, Orthostasis & CNS Toxicity
16:11 Receptor Targets: Histamine, Alpha-1, Muscarinic & Sodium Channel Effects
18:47 Warnings & contraindications (suicidality, MAOIs, cardiac risk)
20:10 Pharmacokinetics & Metabolism: CYP Pathways, Active Metabolites & Drug Interactions
21:06 Drug Interactions (QT Prolongers, serotonergic meds, stimulants)
#TCAPharmacology #TricyclicAntidepressants #PsychiatryPharmacology #medicaleducation #pharmacologymadeeasy
Disclaimer:
This content is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard in this content.
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