ABSTRACT
Tricyclic Antidepressants (TCAs) ...................................................................................... 192 12.4 Analysis of Tricyclic Antidepressants (TCAs) .................................................................... 195 12.5 Newer, Second and Third Generation, Non-Tricyclic Antidepressants (TCAs) ................. 198 12.6 Analysis of Non-Tricyclic Antidepressants (TCAs) ............................................................202 12.7 Conclusions .........................................................................................................................204 References ......................................................................................................................................206
Depression is a common and widespread psychiatric disorder. It is estimated that 10-20% of adults in the United States experience depression in their lifetime and 3% of the population is depressed at any given time. Depression negatively impacts on individuals, families, economy, productivity and society in general. Patients with depression are at a greater risk of suicide and development of many other serious illnesses such as cardiovascular disease and myocardial infarction. Over the decades a number of antidepressant drugs have been developed and used clinically. Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOI) were one of the earliest developed medications and are generally referred as the first generation antidepressants. Though still in widespread use this class of antidepressant has a number of side effects resulting in a poor safety profile therefore, therapeutic drug monitoring (TDM) of these antidepressants is required. More recently developed antidepressants include selective serotonin reuptake inhibitors (SSRIs), tetracyclic antidepressants and other atypical noncyclic compounds. These newer antidepressants have an improved margin of safety but some of these drugs may still need monitoring due to side effects and other reasons such as compliance issues and drug-drug interactions. Immunoassays are available for monitoring of TCAs but lack specificity. For the most part, immunoassays are not available for newer antidepressants. Chromatographic methods are an essential part for TDM of antidepressants.
