The way the drug works is nearly identical to Amitriptyline, except it affects the Alpha-1 receptors to a significantly lesser extent (60x less) and has among the weakest effects on acetylcholine receptors.
Butriptyline (Evadyne): This is a TCA that was introduced in Europe in 1974.
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Perhaps the reason why I’m still able to talk to you today and not dead is because I changed from amitriptyline to Cipramil. If I had overdosed and there was a period of one week between overdosing. I think if you’re going to prescribe an antidepressant you should prescribe an SSRI, fluoxetine, Prozac or one of these sooner, and not prescribe tricyclics.
I later found that amitriptyline’s quite toxic, can put you in a coma. I took my overdose then changed from amitriptyline to Cipramil.
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TCAs are usually prescribed as a second-line treatment option prior to trying Monoamine Oxidase Inhibitors (MAOIs).
Below are several lists of TCAs grouped by how they function.
These days they are still used for depression, but are considered a second-line treatment to newer drugs like SSRIs/SNRIs and atypical antidepressants.
Many still consider them to be highly effective, but newer medications are typically favored by professionals and patients because they carry less side effects and are regarded as being safer.