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Amitriptyline (Elavil, Endep)
Doxepin (Sinequan, Adapin)
Imipramine (Tofranil)
Clomipramine (Anafranil) - particularly effective for Obsessive-Compulsive Disorder
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Uses:
Most effective for depression inolving decreased appetite, weight loss, early morning awakening and other sleep disturbances, psychomotor retardation, anhedonia, and family history of depression with non-responsiveness to medication
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Uses:
Successful in alleviating vegatative, somatic symptoms.
Takes 2-4 weeks to have effect (use ECT for high risk, severe depression clients).
Prescribed for severe phobic, hypochondriacal, and obsessiove states, Panic Disorder, chronic pain.
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Cardiotoxic Side Effects:
- tachycardia
- palpitations
- hypertension
- severe hypotention (drop in blood pressure)
- cardiac arrhythmia
- * Use with caution in people with heart disease
- * Many side-effects common with elderly; alleviated by lower dose
- * Overdose can be lethal (prescribe low quantities for high suicide risk)
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Anticholinergic Effects:
- Dry Mouth
- Blurred Vision
- Urinary Retention
- Constipation
- Sexual Dysfunction
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Other Side Effects:
- Confusion
- Drowsiness
- Fatigue
- Blood Dyscrasia
- Weight Gain
- Tine Tremor
- Paresthesia (subjective sensation experienced as numbness, tingling, or "pins and needles")
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