In addition to their well known actions on monoamine reuptake, tricyclic antidepressants have been shown to modulate ligand-gated ion channels (LGICs). Since the muscle nicotinic acetylcholine receptor (AChR) has been the model for studying structure-function relationships of LGICs, we analyzed the action of tricyclic antidepressants on this type of AChR at both single-channel and macroscopic current levels. We also determined their effects on ACh equilibrium binding and their interactions with the different conformational states of the AChR. Antidepressants produce a significant concentration-dependent decrease in the duration of clusters of single-channels (eight fold at 20 muM). They also decrease the peak amplitude and increase the decay rate of currents elicited by rapid perfusion of ACh to outside-out patches. In equilibrium binding assays, antidepressants promote the typical high-affinity desensitized state and inhibit binding of [piperidyl-3,4-(3)H (N)]-(N-(1-(2-thienyl)cyclohexyl)-3,4-piperidine ([(3)H]TCP) to its locus in resting and desensitized AChRs. The results indicate that tricyclic antidepressants: (i) interact with resting (closed), open, and desensitized channels; (ii) do not affect significantly channel opening and closing rates; (iii) do not act as fast open-channel blockers; (iv) inhibit activation of resting channels; and (v) may increase the rate of long-lived desensitization from the open state.
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http://dx.doi.org/10.1016/s0028-3908(03)00247-8 | DOI Listing |
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric psychiatric disorders and is frequently diagnosed and treated by pediatricians. Stimulant medications are the first-line treatment for ADHD but may not be a good fit for many patients due to side effects, inadequate treatment response, or family preference. Non-stimulant ADHD medications provide a useful alternative for patients that cannot tolerate stimulants, have an incomplete treatment response to stimulants, are at risk for stimulant diversion, or whose family prefers to avoid stimulants.
View Article and Find Full Text PDFCNS Spectr
January 2025
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Background: Antidepressants are commonly prescribed for mood disorders. Epidemiological studies suggest antidepressant use may be associated with cataracts and glaucoma. We aim to investigate the association between antidepressants and cataracts and glaucoma.
View Article and Find Full Text PDFBackground: Although there is clear evidence that therapeutic drug monitoring (TDM) has beneficial effects for patients treated with tricyclic antidepressants, it is generally not recommended for second-generation antidepressants (SGA). However, it has been suggested that methodological shortcomings might influence the results in TDM studies with SGA.
Aim: A qualitative assessment of randomized controlled trials (RCTs) that specifically investigated drug concentration-effect relationships of SGA in patients with major depressive disorder (MDD) to analyze the potential benefit of TDM during treatment with these agents.
Cleve Clin J Med
January 2025
Medical Director, Hartford Behavioral Health, Hartford, CT; Community Faculty, University of Connecticut, Farmington, CT.
Insomnia is a common and challenging complaint in older adults (> 65 years) because of age-related alterations in sleep physiology. Cognitive behavioral therapy for insomnia is the gold standard for treatment of insomnia in young as well as older patients. Both clinicians and patients often prefer the simplicity of medication, but risks associated with some hypnotics increase with age.
View Article and Find Full Text PDFDiseases
December 2024
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA.
Background: Chronic pain is defined as any persistent or recurring pain lasting longer than 3 months that significantly affects a person's quality of life. Millions worldwide are impacted by chronic pain, but its subjective nature makes it difficult to quantify and compare between individuals.
Methods: This retrospective analysis aimed to examine the differences in pain perception and reporting between male and female patients, as well as how their pain was managed.
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