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Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs01:28

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Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
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Related Experiment Video

Updated: Jun 16, 2026

A Protocol for Measuring Cue Reactivity in a Rat Model of Cocaine Use Disorder
07:51

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Published on: June 18, 2018

WITHDRAWN: Antidepressants for cocaine dependence.

Mauricio Silva de Lima1, Michael Farrell, Anelise Arl Lima Reisser

  • 1Medical, Eli Lilly & Co, Lilly House, Priestley Road, Basingstoke, Hampshire, UK, RG24 9NL.

The Cochrane Database of Systematic Reviews
|February 19, 2010
PubMed
Summary
This summary is machine-generated.

Current antidepressants show no significant efficacy in treating cocaine dependence. While some drugs trended better, none proved effective, and supportive psychotherapy may help retain patients in treatment.

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Area of Science:

  • Pharmacology
  • Psychiatry
  • Addiction Medicine

Background:

  • Cocaine abuse disrupts dopamine, serotonin, and norepinephrine systems.
  • This disruption may cause depression and craving during abstinence.
  • Antidepressants could potentially alleviate these symptoms by augmenting monoamine levels.

Purpose of the Study:

  • To evaluate the efficacy of antidepressants for cocaine dependence.
  • To assess the acceptability of antidepressants in cocaine-dependent patients.

Main Methods:

  • Systematic review of randomized controlled trials and controlled clinical trials.
  • Searched multiple databases including Cochrane, MEDLINE, CINAHL, and SCOPUS.
  • Independent data extraction and quality assessment by authors.

Main Results:

  • 18 studies with 1177 participants were analyzed.
  • No antidepressant demonstrated significant efficacy in reducing cocaine metabolite levels.
  • Desipramine showed a non-significant trend, and imipramine showed a non-significant improvement in self-reported clinical response.
  • Fluoxetine (SSRI) suggested a reduced dropout rate in one trial.

Conclusions:

  • No current evidence supports the use of antidepressants for cocaine dependence treatment.
  • High dropout rates necessitate supportive psychotherapeutic measures to improve treatment retention.