Analytical epidemiological studies, using predominantly older drivers, have documented increased crash risks, with a relative risk of 2.3 Leveille, Buchner, Koepsell, Mc Closkey, Wolf, and Gagner (1994).Ramaekers (2003) summarized the major results of all studies published from 1983 to 2000 that investigated the effect of antidepressants on driving performance.Tricyclic Antidepressants (TCAs) were developed in the 1950s as a way to treat depression with chemical compounds.

sedating tricyclic-46

Back when TCAs were approved, they were considered a first-line treatment option for depression.

These days they are still used for depression, but are considered a second-line treatment to newer drugs like SSRIs/SNRIs and atypical antidepressants.

Tricyclic antidepressants help keep more serotonin and norepinephrine available to your brain.

These chemicals are made naturally by your body and are thought to affect your mood.

Physicians use tricyclic antidepressants in the treatment of panic disorder, PTSD, generalized anxiety and depression that occurs with anxiety. If uncomfortable side effects appear, one approach is to wait two to three weeks for them to diminish before increasing to the next higher dose. The sedating side effects can limit productivity and concentration during the day.

Of this family, imipramine has been the focus of most of the panic treatment research. Often effective in reducing panic attacks and elevating depressed mood. If the patient adjusts to the side effects, the physician increases the dosage every two or more days until the patient is taking the preferred dosage. One quarter to one half of imipramine patients relapse after tapering from the drug. Initial use of imipramine occasionally causes an increase in anxiety that usually diminishes in several weeks. Patients with certain abnormal electrocardiograms, with narrow-angle glaucoma, or with an enlarged prostate should not take this medication. Like imipramine, you may experience more general anxiety the first few days up to three weeks. Increase by 25 mg every three to four days to 100 mg per day, usually taken in one dose. Avoid during first three months of pregnancy and consult physician before using last six months and before breast-feeding.

Tricyclics were developed after researchers began exploring derivatives of the first typical antipsychotic medication Thorazine.

Experimentation with derivatives lead to the development of the first TCA drug called “Imipramine.” Initially the drug Imipramine was not intended to treat depressive symptoms, but it was found to induce mania.

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That’s why these drugs are not often used as a first treatment.