Topic overview

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Classic TCAs include amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, and doxepin. They inhibit norepinephrine and serotonin reuptake, while also blocking muscarinic, alpha-1, histamine H1, and sodium-channel activity. These actions are associated with uses such as depression, neuropathic pain, migraine prevention, and selected condition-specific applications, as well as effects including anticholinergic symptoms, sedation, orthostatic hypotension, and cardiac conduction toxicity. The lesson also covers pharmacokinetics, important contraindications and interactions, and special considerations such as delayed therapeutic benefit and overdose danger. Nortriptyline and desipramine are noted for comparatively lower anticholinergic and sedative burden.