Tricyclic antidepressants are a class of medications that are used as antidepressants. TCAs were discovered in the early 1950s and were marketed in the decade, they are named after their chemical structure. Tetracyclic antidepressants, which contain four rings of atoms, are a related group of antidepressant compounds. Although TCAs are sometimes prescribed for depressive disorders, they have been replaced in clinical use in most parts of the world by newer antidepressants such as selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors and norepinephrine reuptake inhibitors. Adverse effects have been found to be of a similar level between SSRIs; the TCAs are used in the clinical treatment of mood disorders such as major depressive disorder and treatment-resistant variants. They are used in the treatment of a number of other medical disorders, including anxiety disorders such as generalized anxiety disorder, social phobia known as social anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, body dysmorphic disorder, eating disorders like anorexia nervosa and bulimia nervosa, certain personality disorders such as borderline personality disorder, neurological disorders such as attention-deficit hyperactivity disorder, Parkinson's disease as well as chronic pain, neuralgia or neuropathic pain, fibromyalgia, headache, or migraine, smoking cessation, tourette syndrome, irritable bowel syndrome, interstitial cystitis, nocturnal enuresis, insomnia, pathological crying and/or laughing, chronic hiccups, ciguatera poisoning, as an adjunct in schizophrenia.
For many years the TCAs were the first choice for pharmacological treatment of clinical depression. Although they are still considered to be effective, they have been replaced by antidepressants with an improved safety and side effect profile, such as the SSRIs and other newer antidepressants such as the novel reversible MAOI moclobemide. However, tricyclic antidepressants are more effective in treating melancholic depression than other antidepressant drug classes. Newer antidepressants are thought to have fewer and less severe side effects and are thought to be less to result in injury or death if used in a suicide attempt, as the doses required for clinical treatment and lethal overdose are far wider in comparison. Nonetheless, the TCAs are prescribed for treatment-resistant depression that has failed to respond to therapy with newer antidepressants, they tend to have fewer emotional blunting and sexual side effects than SSRI antidepressants, they are somewhat preferable to the monoamine oxidase inhibitors.
The side effects of the TCAs come to prominence before the therapeutic benefits against depression and/or anxiety do, for this reason, they may be somewhat dangerous, as volition can be increased giving the patient a greater desire to attempt or commit suicide. The TCAs were used in the past in the clinical treatment of ADHD, though they are not used anymore, having been replaced by more effective agents with fewer side effects such as atomoxetine and stimulants like methylphenidate, amphetamine. ADHD is thought to be caused by an insufficiency of dopamine and norepinephrine activity in the prefrontal cortex of the brain. Most of the TCAs inhibit the reuptake of norepinephrine, though not dopamine, as a result, they show some efficacy in remedying the disorder. Notably, the TCAs are more effective in treating the behavioral aspects of ADHD than the cognitive deficits, as they help limit hyperactivity and impulsivity, but have little to no benefits on attention; the TCAs show efficacy in the clinical treatment of a number of different types of chronic pain, notably neuralgia or neuropathic pain and fibromyalgia.
The precise mechanism of action in explanation of their analgesic efficacy is unclear, but it is thought that they indirectly modulate the opioid system in the brain downstream via serotonergic and noradrenergic neuromodulation, among other properties. They are effective in migraine prophylaxis, though not in the instant relief of an acute migraine attack, they may be effective to prevent chronic tension headaches. Many side effects may be related to the antimuscarinic properties of the TCAs; such side effects are common and may include dry mouth, dry nose, blurry vision, lowered gastrointestinal motility or constipation, urinary retention, cognitive and/or memory impairment, increased body temperature. Other side effects may include drowsiness, emotional blunting, restlessness, akathisia, changes in appetite and weight, muscle twitches, weakness and vomiting, hypotension and irregular heart rhythms. Twitching, hallucinations and coma are some of the toxic effects caused by overdose. Rhabdomyolysis or muscle breakdown has been reported with this class of drugs as well.
Tolerance to these adverse effects of these drugs develops if treatment is continued. Side effects may be less troublesome if treatment is initiated with low doses and gradually increased, although this may delay the beneficial effects. TCAs can behave like class 1A antiarrhythmics, as such, they can theoretically terminate ventricular fibrillation, decrease cardiac contractility and increase
Jake Zemke is an American former professional motorcycle road racer of partial Japanese ancestry. He turned pro in 1992. Zemke's race number has been 98 for most of his racing career, he started. 1996 AMA Speedway US National Championship Qualifier 1997 3rd, 66th 1998 9th 1999 52nd, 15th, 2nd 2000 8th, 2nd 2001 6th, 47th, 4th - Bruce Transportation Honda 2002 8th, 2nd - Bruce Transportation Honda 2003 5th, 3rd - Erion Honda 2004 3rd, 2nd - American Honda Racing 2005 11th, 2nd - American Honda Racing 2006 7th, 33rd - American Honda Racing 2007 3rd - American Honda Racing 2008 1st AMA and 2nd AMA - Erion Honda 2009 6th AMA - Erion Honda 2010 3rd AMA -Released from Michael Jordan Motorsports Suzuki 2011 28th BSB - WFR Honda 2012 7th AMA - Ducshop Ducati 2013 16th AMA - Riders Discount Racing Triumph 2014 7th AMA -Released from GEICO Motorcycles Honda 2015 Retired. Owner of Zemke Riding Development. 1.^ – E Denotes riders participating in the Evo class within the British Superbike Championship. Jake Zemke profile at AMAProRacing.com
Gogu Shyamala is a Telugu-language writer and women's activist and a prominent Dalit. Gogu Shyamala was born in 1969 in Peddemul village in Ranga Reddy district, her parents are agricultural workers. She was the leader of a vetti team that worked for the local landlord, she has stated that her brother Ramachandra was forced into agricultural labour, but she was the only one of her three siblings who obtained higher education. Financial constraints prevented her from enrolling in college, however she obtained a Bachelor of Arts from the Bhim Rao Ambedkar Open University. Around that time, she became an activist with the Communist Party of India, but insists that she never let the politics overshadow the education. In an interview in 2016, Gogu Shyamala described her awakening consciousness to casteism and discrimination in India as an adult, noting "I never realized that there was any discrimination as a kid, it was after growing up that I discovered it." As a student leader, she protested living conditions and food provisions in her hostel.
In college, she became an activist with the Communist Party of India, but since parted from them following the Tsundur massacre. It was at this point. "I began to read Ambedkar and understood how deep-rooted caste was in Indian society. That's when I understood that communism may have removed religion, but the caste divide still existed. Today, if you see any Dalit parliamentarians, it is only because of reservation," she says, she identifies herself as a Dalit feminist. Following the suicide of a Dalit student at the University of Hyderabad, Rohith Vemula, Gogu Shyamala made several statements in support of Vemula and his family, calling for greater participation from the English media on questions of caste and feminism, she represented Anveshi and Dalit Women’s Forum in the World Conference against Racism held in Durban,2001. She is a member of the Anveshi Executive Committee, her current work at the Anveshi Centre for Women's Studies focuses on creating biographies of significant Dalit female political leaders.
She is presently leading an Oxfam funded research project on domestic dalit women. A review of some of her stories in translation described Gogu Shyamala's writing as having "an evidently oral quality," which created detailed and authentic portraits of the people and situations she describes; this "oral quality" has been described as "the most striking thing" about her collection of short stories, Father May Be An Elephant And Mother Only A Small Basket, But..., a landmark in Telangana dalit literature in translation. This was part of her work on a project titled ‘Dalit Women’s Biographies, This project is part of the Dalits and Minorities Initiative, her earlier volume Nallapoddu is a collection of Telangana Madiga poetry and literature that has one critical acclaim in literary circles. Shyamala is a prolific short story writer, publishes in journals such as Bhumika, Pratighatana, Mana Telangana, Praja Kala Mandali and Nigha. Father May Be An Elephant And Mother Only A Small Basket, But... Tataki Wins Again & Brave Heart Badeyya Nene Balaanni: T.
N. Sadalakshmi bathuku katha Vaada pillala kathalu "Gender Consciousness in Dalit Women’s Literature." Gender Pratiphalanaalu. Gender Consciousness and its Consequences Co-editor, Nallaregatisallu: Maadiga, Maadiga Upakulala Adolla Kathalu. Profile