What do you know about Amoxapine?

Amoxapine tablets is a tricyclic antidepressant (TCA) used primarily to treat major depressive disorder (MDD). It was first introduced in the 1970s and is structurally similar to both TCAs and antipsychotic medications, as it has a unique chemical profile. This gives it certain properties that differentiate it from other TCAs. Here’s a breakdown:

Mechanism of Action:

Amoxapine tablets works by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin, which increases their levels in the brain, thereby improving mood. Unlike many other TCAs, it also has some dopamine-receptor-blocking properties, which are more typical of antipsychotic drugs. This is because amoxapine is structurally related to loxapine, an antipsychotic medication.

Uses:

1. Major Depressive Disorder (MDD) – Its primary use is to treat moderate to severe depression.
2. Anxiety Disorders – It can be prescribed to treat anxiety, particularly when co-occurring with depression.
3. Psychotic Depression – Due to its dopamine antagonist properties, it may have some efficacy in treating depression with psychotic features.

Side Effects:

Being a TCA, amoxapine shares some common side effects with other drugs in this class, including:

• Sedation: Drowsiness and fatigue are common, especially early in treatment.
• Dry mouth, constipation, urinary retention: These are anticholinergic effects typical of TCAs.
• Weight gain: Like many antidepressants, it can lead to an increase in weight.
• Orthostatic hypotension: Dizziness upon standing due to a drop in blood pressure.
• Extrapyramidal symptoms (EPS): Given its dopamine-blocking action, amoxapine can cause movement disorders like tardive dyskinesia, which is rare among antidepressants but more common in antipsychotics.

Risks:

• Seizures: Amoxapine tablets lowers the seizure threshold more than other antidepressants, which makes it risky for patients with a history of seizures.
• Cardiovascular risks: As with most TCAs, amoxapine can cause heart-related side effects, including arrhythmias, particularly in overdose situations.
• Suicidal Thoughts: Like many antidepressants, there’s a boxed warning about the increased risk of suicidal thoughts in children, adolescents, and young adults when first starting the drug.