VI. TRICYCLIC ANTIDEPRESSANTS moa

Inhibition of neurotransmitter reuptake: TCAs and amoxapine are potent inhibitors of the neuronal reuptake of norepinephrine and serotonin into presynaptic nerve terminals. At therapeutic concentrations, they do not block dopamine transporters. By blocking the major route of neurotransmitter removal, the TCAs cause increased concentrations of monoamines in the synaptic cleft. Maprotiline and desipramine are relatively selective inhibitors of norepinephrine reuptake. 2. Blocking of receptors: TCAs also block serotonergic, α-adrenergic, histaminic, and muscarinic receptors. It is not known if any of these actions produce TCAs’ therapeutic benefit. However, actions at these receptors are likely responsible for many of the adverse effects of the TCAs. Amoxapine also blocks 5-HT2 and D2