generally considered inactive. Amoxapine and Maprotiline both have active metabolites.
The average elimination half-life of TCAs is approximately 24 hours and can range from 6 to 36 hours at therapeutic doses. This number can however increase to 72 hours after an overdose. Inhibition of TCA metabolism by othe drugs that use the same hepatic enzymes can prolong the half-life of TCAs. This carries the risk of elevating TCA plasma levels and producing clinical TCA toxicity at therapeutic doses. Approximately 7 percent of North American population are generically slow metabolizers of TCAs and are prone to develop higher plasma levels at any given daily TCA dose.
TCA's are exetremely dangerous when taken in overdose quantities, and depressed patients are more likly than others to be suicidal. Patients prescriptons should be given out on a no refill basis, and those patients with strong suicide possibility should have medication entrusted to a family member.
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