Tricyclic Antidepressants

Overview

• Presenter: Cathy with Level Up RN
• Topics: Tricyclic Antidepressants (TCAs)
• Medications: Amitriptyline, Imipramine
• Uses:
  • Depression
  • Neuropathy
  • Fibromyalgia
  • Anxiety
  • Insomnia

Mode of Action

• Increases the effect of serotonin and norepinephrine in the CNS

Side Effects

• Sedation
• Orthostatic hypotension
• Anticholinergic effects:
  • Urinary retention
  • Constipation
  • Dry mouth
  • Photophobia
  • Tachycardia
• Sweating
• Seizures
• Arrhythmias

Memory Aids

• Rhyme: Can’t see, can’t pee, can’t spit, and can’t poop
• Cool Chicken Hint: Amy tripping over a tricycle in the desert (dry effects)

Patient Teaching Points

• Change positions slowly (due to orthostatic hypotension)
• Chewing gum or sucking on hard candy for dry mouth
• Increase fluid and fiber intake to prevent constipation

Quiz Questions

1. Question: Diarrhea is a key side effect of amitriptyline. True or false?
   • Answer: False – Anticholinergic effects include constipation
2. Question: Bradycardia is a key side effect of imipramine. True or false?
   • Answer: False – Anticholinergic effects include tachycardia
3. Question: You should teach your patient to change positions slowly due to the risk for blank when taking a tricyclic antidepressant.
   • Answer: Orthostatic hypotension