Tricyclics (TCAs)

• Amitriptyline
• Desipramine
• Imipramine
• Nortriptyline
• Other “‐triptyline” or “‐ipramine” drugs
• Being phased out due to their many side effects and drug interactions
• Mechanism of Action
  • ↓ Reuptake of norepinephrine and serotonin in the synapse
• Clinical Implications
  • Continue drug perioperatively
  • If discontinued, have patient continue when surgery completed
  • Can have synergistic sedation effects
  • Drug interactions that can increase risk of tachycardia and hypertension [46, 47]
    • Anticholinergics
    • Ephedrine
    • Epinephrine
    • Meperidine
    • Norepinephrine
    • Phenylephrine
    • Tramadol

Monoamine Oxidase Inhibitors (MAOIs)