Amoxapine: uses and side effects of this antidepressant

This Antidepressant psychopharmaceutical is mainly used in patients with major depression.

Different mental health problems often cause great suffering to those who suffer from them and/or limit their daily life. And one of the most common worldwide, and probably throughout history, is depression.

This disorder is characterized by the presence of a sad mood and difficulties in feeling pleasure, as well as passivityIt is also characterized by passivity, hopelessness, feelings of guilt, difficulties in sleeping, eating, concentrating, thinking and relating to others, and even suicidal ideation. It is therefore a condition that has serious repercussions and affects all areas of life.

Because of this, throughout history there have been attempts to generate different strategies and methods to treat depression. One of the different ways to do this is through pharmacology, which can help control the symptoms and can serve as a support while working on their causes. And there are many drugs that have been created for this purpose. One of them is amoxapineof which we will speak next.

What is amoxapine?

Amoxapine is one of the so-called antidepressant drugs, substances with psychoactive properties that have been found to be effective in combating the symptoms of depression because they generate an alteration in brain chemistry that increases the levels of certain neurotransmitters.

It is one of the most one of the best known components of the tricyclic antidepressant group.amoxapine, which receive this name because their chemical composition is formed by three rings of atoms and they have an important effect on noradrenaline and serotonin.

Amoxapine usually comes in tablet form, to be taken orally with water, and it has been observed that it tends to present its first effects in a shorter period of time than other tricyclics such as imipramine, being visible between two and six weeks after the first intake.

Although amoxapine and the other tricyclics are effective drugs in the treatment of depression, and in fact for a long period they were the predominant antidepressants, at present they have been overtaken by the other tricyclics. have been superseded by specific serotonin reuptake inhibitors (SSRIs), which have a similar efficacy but are not as effective as the other tricyclics.which have similar efficacy but act in a more targeted manner and tend to have fewer side effects.

This is because amoxapine acts at a non-specific level, affecting both areas of the brain where its effects are beneficial and others where they are not. In fact, in excessive doses they can be toxic and even cause death by overdose.

Mechanisms of action.

The action of amoxapine on the body and its effects on mood improvement are due to its mechanism of action, which is based on the inhibition of serotonin and noradrenaline reuptake.

This means that noradrenaline and serotonin are released into the synaptic space, blocking the process that would cause part of these neurotransmitters to be returned to the sending neuron. As a result we have increased levels of noradrenaline and serotonin in the brain.We can therefore take advantage of and use a greater amount of these substances.

Likewise, it has been observed that amoxapine presents an antagonist activity of dopamine, that is to say, it hinders the activity and transmission of this neurotransmitter. Although this may seem to be a negative point and may in fact give rise to side effects, it may also be clinically useful in some conditions.

Main indications

Amoxapine is, as we have said, an effective antidepressant, and as such, one of its main indications is depression. one of its main indications is major depression.

Although, as we have indicated above, both this drug and the other tricyclics have been superseded by specific serotonin reuptake inhibitors or SSRIs or other types of drugs with greater specificity, the fact is that they are still used when there is no response to treatment with other drugs.

Its use may also be indicated in dysthymia or persistent depressive disorder, as well as in anxious depressions or mixed anxious-depressive disorders. It is also sometimes used in reactive depressions.

In addition, it is particularly indicated in patients whose depressions have psychotic characteristics and has been used in the treatment of bipolar disorder, as it helps to control these types of depression.It has also been used in the treatment of bipolar disorder, as it helps to control these types of symptoms (something in which the antagonism of dopamine can benefit).

Possible side effects

Although it is true that amoxapine is a useful drug, it is also necessary to take into account that it can present certain toxicity and that it can generate various types of side effects.

Among the most relevant and common side effects, the following can be highlighted drowsiness and fatigue, as well as nausea and vomiting and dry mouth.. Headaches, difficulty urinating or excessive urination, alterations in appetite and weight (increase), anxiety reactions, hypotension, hyperhidrosis, fever, photophobia or tachycardia or motor rigidity may also appear. In some cases the presence of dyspareunia, or pain during sexual intercourse, has also been observed.

Tardive dyskinesia may also occur. More serious reactions may also include the appearance of convulsions, confusion or alterations of consciousness or respiratory problems, as well as suicidal ideation. It should be noted that if treatment is discontinued, treatment should be discontinued in a gradual and controlled manner or withdrawal syndrome may occur..

One of the most serious possible side effects is agranulocytosis. Another (albeit less frequent) is neuroleptic malignant syndrome, which, although usually caused by antipsychotics, has also been observed in some cases with other drugs (including amoxapine). Both can have serious health repercussions and even lead to death.

Contraindications

Because of these and other possible side effects, amoxapine is not a drug that can be taken freely by any type of person but must be regulated and is contraindicated for certain types of population.

Obviously, one of the first groups that should avoid taking it is all those who are allergic to amoxapine or to any of the components with which it is made. Its consumption should also be avoided by people who have recently had a heart attack or cardiovascular problem.It is not recommended for people with Parkinson's disease, since it may have effects on blood pressure and heart rate (it may cause tachycardia). It is also not recommended for people with Parkinson's disease, as it may worsen their motor problems.

People who have suffered seizures, have epilepsy or glaucoma, kidney problems or genitourinary diseases should avoid it or should discuss with their doctor the possible suitability of using this drug. Pregnant women and nursing mothers should also avoid it.It has been shown to be excreted in breast milk.

Diabetics and people with thyroid problems, as well as those with kidney or liver problems, should also avoid it or have very strict medical control. Finally, it should be taken into account that this drug should never be used in combination with an MAOI, since there is a great risk of dangerous alterations to health due to their interaction.

The suitability of its use should be consulted with a professional in case of consuming other drugs. It should not be taken with alcohol or other psychoactive substances (especially if they are depressants, since the effects are potentiated).

Bibliographic references:

• Gabriel, M; Sharma, V (29 May 2017). "Antidepressant discontinuation syndrome". Canadian Medical Association Journal. 189 (21): E747.
• Koren G, Nordeng HM (2013). "Selective serotonin reuptake inhibitors and malformations: case closed?". Semin Fetal Neonatal Med. 18 (1): 19-22.