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112 bytes added ,  13:37, 9 September 2014
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==Adverse Effects<ref>Wiersma, J., Honig, A. & Peters, F. P. J. (2000). Clomipramine-induced allergic hepatitis: a case report. International Journal of Psychiatry in Clinical Practice 4, 69–71.</ref>==
 
==Adverse Effects<ref>Wiersma, J., Honig, A. & Peters, F. P. J. (2000). Clomipramine-induced allergic hepatitis: a case report. International Journal of Psychiatry in Clinical Practice 4, 69–71.</ref>==
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The main adverse effects of this class of drugs is mediated through their effect on histamine and Ach receptors.
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{| class="wikitable"
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|-
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! H<sub>1</sub> Blockade !! Ach (Muscarinic) Blockade
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|-
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| Sedation, hypotension, increased appetite, weight gain, anti-allergic activity || Delirium, hyperthermia, insomnia, seizure induction, tachycardia, constipation, decreased bronchial secretion, blurred vision, narrow angle glaucoma (exacerbation), photophobia, dry mouth
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|}
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Amitriptyline also antagonises α2-adrenoceptors, which can lead to agitation and tachycardia.
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TCAs can also cause loss of libido (breeding animals) and mild corneal drying. They can cause galactorrhea through increased prolactin secretion (especially in cats).
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Finally, those TCAs that depend upon NorAdrenaline reuptake inhibition for a part of their effect are sometimes associated with explosive emotional reactions including aggression. They should be used with some care.
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There are large differences in selectivity of re-uptakje inhibitor drugs, as can be seen in the following table.
 
There are large differences in selectivity of re-uptakje inhibitor drugs, as can be seen in the following table.
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The blocking ratio indicates the relative effect of the agent on reuptake of 5-HT vs. noradrenaline. Fluoxetine is 3 times more selective for 5-HT than clomipramine. Clomipramine was the first TCA whose ratio favours 5-HT reuptake inhibition, and hence its title of non-selective serotonin reuptake inhibitor (SRI). The level of anticholinergic effect is usually also decreased with increasing serotonergic selectivity.
 
The blocking ratio indicates the relative effect of the agent on reuptake of 5-HT vs. noradrenaline. Fluoxetine is 3 times more selective for 5-HT than clomipramine. Clomipramine was the first TCA whose ratio favours 5-HT reuptake inhibition, and hence its title of non-selective serotonin reuptake inhibitor (SRI). The level of anticholinergic effect is usually also decreased with increasing serotonergic selectivity.
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  −
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{| class="wikitable"
  −
|-
  −
! H<sub>1</sub> Blockade !! Ach (Muscarinic) Blockade
  −
|-
  −
| Sedation, hypotension, increased appetite, weight gain, anti-allergic activity || Delirium, hyperthermia, insomnia, seizure induction, tachycardia, constipation, decreased bronchial secretion, blurred vision, narrow angle glaucoma (exacerbation), photophobia, dry mouth
  −
|}
  −
Amitriptyline also antagonises α2-adrenoceptors, which can lead to agitation and tachycardia.
  −
TCAs can also cause loss of libido (breeding animals) and mild corneal drying. They can cause galactorrhea through increased prolactin secretion (especially in cats).
  −
  −
Finally, those TCAs that depend upon NorAdrenaline reuptake inhibition for a part of their effect are sometimes associated with explosive emotional reactions including aggression. They should be used with some care.
      
'''Caution should be taken if the animal suffers from any of the following pre-existing medical conditions:'''
 
'''Caution should be taken if the animal suffers from any of the following pre-existing medical conditions:'''
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