Tricyclic Antidepressants (TCAs) Mnemonic: Study Smarter, Not Harder

TCAs are a class of medications that commonly end in -ipramine and -triptyline, including imipramine, clomipramine, amitriptyline, and nortriptyline. (except for doxepin and amoxapine)

Another way to remember TCAs is to use the mnemonic: Desperate for CANDI

• Desipramine
• Clomipramine
• Amitriptyline
• Nortriptyline
• Doxepin
• Imipramine

Side effects of Tricyclic Antidepressants (TCAs): Tachycardia, Cardiac Effects, Anticholinergic effects, Sexual dysfunction / Sedation.

A helpful way to remember TCA side effects is to use the mnemonic: TCAS

• Tachycardia (dizziness, palpitations)
• Cardiac Effects (arrhythmias, QT prolongation)
• Anticholinergic effects (dry mouth, constipation)
• Sexual dysfunction / Sedation (low libido, drowsiness)

For a nursing-focused breakdown of TCAs, check out this video:

Video Summary

• Think of "tricycles" to remember TCAs!
• Drugs names:
  • "-triptyline" drugs: Amitriptyline, Nortriptyline (electrician "tripping")
  • "-pramine" drugs: Imipramine, Clomipramine, Desipramine (“premier” clue)
  • Other TCAs: Doxepin (“Dock pin” mnemonic)
• Indications:
  • Depression (crying boy)
  • Nerve pain from chronic diabetic neuropathy & fibromyalgia (messy wires = nerve pain)
• Key side effects:
  • Orthostatic hypotension (dizzy electrician falling)
  • Anticholinergic effects: Dry mouth, urinary retention, tachycardia (symbolized by broken cola can)
• TCA overdose is lethal (the big tricycle is the one that’s falling)

Mnemonic: “I Tri Desi Club for Ami and Nori”

• Imipramine
• Trimipramine
• Desipramine
• Clomipramine
• Amitriptyline
• Nortriptyline

Check out more mnemonics from this antidepressant mnemonic instagram post.

Amitriptyline, a common tricyclic antidepressant (TCA), has several anticholinergic side effects: dry mouth, blurred vision, urinary retention, constipation.

To help remember these side effects, you can use the classic mnemonic: "Hot as a hare, Blind as a bat, Dry as a bone, Red as a beet, Mad as a hatter"

• Hot as a hare: dry mouth
• Blind as a bat: blurred vission
• Dry as a bone: urinary retention
• Red as a beet: consitpation
• Mad as a hatter: Mental confusion or agitation (delirium)

While amitriptyline was once a widely prescribed antidepressant, its use has declined due to several factors:

• Side Effects: The severity of side effects, especially those related to its anticholinergic properties, can be intolerable for many patients.
• Toxicity and Lethality in Overdose: In cases of overdose, amitriptyline can be highly toxic and potentially fatal, making it less ideal for long-term use.
• Risk of Switch to Manic State: In individuals predisposed to mood disorders like bipolar disorder, amitriptyline can trigger a manic episode.
• Introduction of SSRIs: The development of Selective Serotonin Reuptake Inhibitors (SSRIs), which offer a better safety profile with fewer side effects, has made amitriptyline less commonly prescribed.

As a result, SSRIs like fluoxetine (Prozac) and sertraline (Zoloft) are now often preferred due to their more favorable side effect profiles and lower risk of toxicity.

Tricyclic Antidepressants (TCAs) like Amitriptyline (tertiary amine) and Nortriptyline (secondary amine) are both effective for neuropathic pain.

• Tertiary amines (e.g., Amitriptyline) primarily increase serotonin levels, making them potent for pain relief, but with more side effects.
• Secondary amines (e.g., Nortriptyline) focus more on norepinephrine and are generally better tolerated, with fewer side effects, while still being effective for pain.

Both types are highly effective, with tertiary amines offering stronger pain relief, and secondary amines providing a safer option for long-term use.

Check out our detailed guides on MAOIs and SNRIs drug mnemonics to further boost your pharmacology exam prep and master essential drug mnemonics!