ABSTRACT
Antidepressants are among the medications most often prescribed in the United States. In addition to depression, these agents are used to treat a broad spectrum of anxiety disorders, menstrual and menopausal symptoms, pain disorders, and nicotine dependence. The majority of antidepressants that are most often prescribed can be divided into two main groups: tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). There are, however, a number of antidepressants that fall outside these groups. TCAs have chemical structures based on three connected molecular rings; SSRIs share a marked selectivity in their effect on brain serotonin. The cardiotoxicity caused by tricyclic antidepressants in turn leads to a number of major metabolic changes, which further complicates the management of poisoning cases. Sodium bicarbonate is an appropriate initial treatment for arrhythmias and hypotension produced by tricyclic antidepressants.
