1. Several drugs are metabolized in the liver to other well-known tricyclic antidepressants such as amitriptyline to nortriptyline and imipramine to desipramine. This process is called biotransformation.
2. TCA poisoning should be suspected in any patients with lethargy, coma, seizures accompanied by QRS interval prolongation.
3. Ingestions of >35 mg/kg are lucky to be fatal without treatment.
4. Other names or street names of TCA are blue birds and blue angels.
Frequently Asked Questions (FAQs)
1. Why do people abuse TCA?
People wanted TCA because of its overdose effects. These includes a feeling of euphoria which causes hallucinations that the user is looking for.
2.Why do a hemolyzed (red blood cells in the serum sample) is avoided for the test kits (SIEMENS Syva) for TCA?
Because a hemolyzed serum has red blood cells. TCA levels are also present in red blood cells. When these red cells lyse or destroyed, TCA will be released. Thus, a hemolyzed serum could cause false positive result, meaning the result should be negative but because of the lysed red cells TCA is released thus the test kit will show positive result.
3. What do ‘endogenous depression’ mean?
A depression is said to be endogenous if it occurs without a particular bad event, stressful situation or other definite, outside cause being present in the person’s life. Endogenous depression usually responds well to medication. Some authorities do not consider this to be a useful diagnostic category.Read more: http://stason.org/TULARC/health/mind/depression-faq/08-What-is-Endogenous Depression.html#.U3IWTvmSy7w#ixzz31bG1rVDD
4. Does high TCA levels can be fatal?
Yes. The increasing popularity of these drugs lead to the misuse and abuse of its required dosages. According to the American Association of Poison Control Centers’ National Poison Data System Annual Report, TCA were associated with 80 deaths in 2008 and 2007. Among the BIG FIVE, the Amitryptiline is ingested frequently followed by Nortryptiline and Doxepin. Fatality is usally associated with suicides.Read more: http://emedicine.medscape.com/article/819204-overview#a0199
5. How quickly do TCAs work?
It depends. Some people in just few days of treatment can notice an improvement. But antidepressants often takes 2-4 weeks to work. If the treatment is going well in 3-4 weeks, it is likely to continue.Read more: http://www.patient.co.uk/health/tricyclic-antidepressants