Tricyclic and tetracyclic compounds are categorized on the basis of their chemical structure (Figure 12-1). The tricyclics have a central three-ring structure, hence the name. The tertiary-amine tricyclics, such as amitriptyline and imipramine, have two methyl groups at the end of the side chain. These compounds can be demethylated to secondary amines, such as desipramine and nortriptyline. The tetracyclic compound maprotiline (Ludiomil) has a four-ring central structure. Five tertiary amines have been marketed in the United States—amitriptyline (Elavil), clomipramine (Anafranil), doxepin (Sinequan), imipramine (Tofranil), and trimipramine (Surmontil). The three secondary-amine compounds are desipramine (Norpramin, Pertofrane), nortriptyline (Aventyl, Pamelor), and protriptyline (Vivactil). All of these compounds, in addition to amoxapine (Asendin) and maprotiline (Ludiomil), have been approved for use in major depression with the exception of clomipramine (Anafranil), which in the United States is approved for use only in obsessive-compulsive disorder (OCD).
FIGURE 12-1. Drugs marketed in the United States as tricyclics (1-9) and a tetracyclic (10).
1. Imipramine ego ch3
3. Amitriptyline oco ÇH3
5. Clomipramine oça CI ch3
7. Doxepin oCo CH3
9. Amoxapine H
Was this article helpful?
Stop Nicotine Addiction Is Not Easy, But You Can Do It. Discover How To Have The Best Chance Of Quitting Nicotine And Dramatically Improve Your Quality Of Your Life Today. Finally You Can Fully Equip Yourself With These Must know Blue Print To Stop Nicotine Addiction And Live An Exciting Life You Deserve!