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Tetracyclic antidepressants
Down? Tetracyclics are an antidepressant type that relieves depression symptoms and boosts mood. Discover how they work and what side effects they may cause.
By Mayo Clinic staffCertain brain chemicals called neurotransmitters are associated with depression, including the neurotransmitters serotonin (ser-oh-TOE-nin) and norepinephrine (nor-ep-ih-NEF-rin). Research suggests that abnormalities in neurotransmitter activity can affect mood and behavior.
How tetracyclic antidepressants work
Instead of inhibiting the reabsorption of certain neurotransmitters, as other antidepressants do, tetracyclic antidepressants prevent neurotransmitters from binding with nerve cell receptors called alpha-2 receptors. This indirectly increases the levels of norepinephrine and serotonin in the brain. In turn, that may improve and elevate mood.
Antidepressants, in general, may also work by playing a neuroprotective role in how they relieve anxiety and depression. It's thought that antidepressants may increase the effects of brain receptors that help nerve cells keep sensitivity to glutamate — an organic compound of a nonessential amino acid — in check. This increased support of nerve cells lowers glutamate sensitivity, providing protection against the glutamate overwhelming and exciting key brain areas related to anxiety and depression.
Therapeutic effects of antidepressants may vary in people, due in part to each person's genetic makeup. It's thought that people's sensitivity to antidepressant effects, especially selective serotonin reuptake inhibitor effects, can vary depending on:
- How each person's serotonin reuptake receptor function works
- His or her alleles — the parts of chromosomes that determine inherited characteristics, such as height and hair color, which combine to make each person unique
Antidepressant medications are often the first treatment choice for adults with moderate or severe depression, sometimes along with psychotherapy. Although antidepressants may not cure depression, they can help you achieve remission — the disappearance or nearly complete reduction of depression symptoms.
Tetracyclic antidepressants approved to treat depression
Here's the tetracyclic antidepressant approved by the Food and Drug Administration specifically to treat depression, with its generic, or chemical, name followed by available brand names in parentheses:
- Mirtazapine (Remeron, Remeron SolTab)
(1 of 2)
- Questions and answers on antidepressant use in children, adolescents, and adults. U.S. Food and Drug Administration. http://www.fda.gov/cder/drug/antidepressants/QA20070502.htm. Accessed Sept. 29, 2008.
- FDA proposes new warnings about suicidal thinking, behavior in young adults who take antidepressant medications. U.S. Food and Drug Administration. http://www.fda.gov/bbs/topics/NEWS/2007/NEW01624.html. Accessed Sept. 12, 2008.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 1, 2008.
- Antidepressants: Selecting one that's right for you. MayoClinic.com. http://www.mayoclinic.com/health/antidepressants/HQ01069. Accessed Oct. 16, 2008.
- Buss LK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 21, 2008.
- Remeron SolTab (prescribing information). Roseland, N.J.: Organon USA; 2007. http://www.spfiles.com/piremuronsoltab.pdf. Accessed Nov. 15, 2008.
- Phenylketonuria (PKU). MayoClinic.com. http://www.mayoclinic.com/health/phenylketonuria/DS00514. Accessed Nov. 15, 2008.
- Single interactions table. Micromedex Healthcare Series. http:www.micromedex.com. Accessed Nov. 15, 2008.
