TCA

TCA

Tricyclic Antidepressants

TCA

What are Tricyclic Antidepressants or TCA?

Tricyclic antidepressants, also known now as cyclic antidepressants or TCAs, were introduced in the late 1950s. They were one of the first antidepressants, and they’re still considered effective for treating depression. These drugs are a good choice for some people whose depression is resistant to other drugs. Although cyclic antidepressants can be effective, some people find their side effects difficult to tolerate. That’s why these drugs are not often used as a first treatment.

Cut-Off Levels (ng/mL)

1000 ng/mL (Urine)

Window of Detection

2 Hrs. – 4 Days (Urine)

 

How is it Used?

Clinicians usually only prescribe tricyclic antidepressants after other drugs have failed to relieve depression. Tricyclic antidepressants help keep more serotonin and norepinephrine available to your brain. These chemicals are made naturally by your body and are thought to affect your mood. By keeping more of them available to your brain, tricyclic antidepressants help elevate your mood.

Some tricyclic antidepressants are also used to treat other conditions, mostly in off-label uses. These conditions include obsessive compulsive disorder (OCD) and chronic bedwetting. In lower doses, cyclic antidepressants are used to prevent migraines and to treat chronic pain. They are also sometimes used to help people with panic disorder.

What are the Effects?

Tricyclic antidepressants treat depression, but they have other effects on your body as well. They can affect automatic muscle movement for certain functions of the body, including secretions and digestion. They also block the effects of histamine, a chemical found throughout your body. Blocking histamine can cause effects such as drowsiness, blurred vision, dry mouth, constipation, and glaucoma. These may help explain some of the more troublesome side effects associated with these drugs. Tricyclic antidepressants are more likely to cause constipation, weight gain, and sedation then other antidepressants. However, different drugs have different effects. 

Common Symptoms

    • dry mouth
    • dry eyes
    • blurred vision
    • dizziness
    • fatigue
    • headache
    • disorientation
    • seizure
    • drowsiness
    • constipation
    • urinary retention
    • sexual dysfunction
    • low blood pressure
    • weight gain
    • nausea

Common TCA’s

  • amitriptyline
  • amoxapine
  • desipramine (Norpramin)
  • doxepin
  • imipramine (Tofranil)
  • maprotiline
  • nortriptyline (Pamelor)
  • protriptyline (Vivactil)
  • trimipramine (Surmontil)

What does it Look Like?

TCA’s usually comes in the form of a tablet, pill or capsule varying in colors.

Legal Status

Currently not a controlled substance in the United States.

Testing Options

  • Integrated Urine Test Cup
  • Urine Dip Card

Contact us

Call Us

1-866-989-9300

Email Us

info@ntsbiz.com

Our Location

550 NW 77th Street

Boca Raton, FL 33487

Get in touch

PPX

PPX

Propoxyphene

PPX

What is PPX?

Propoxyphene (PPX) is an opioid pain reliever used to treat mild to moderate pain. In January 2009, an FDA advisory committee voted 14 to 12 against the continued marketing of propoxyphene products, based on its weak pain-killing abilities, addictiveness, association with drug deaths and possible heart problems. A subsequent re-evaluation resulted in a July 2009 recommendation to strengthen the boxed warning for propoxyphene to reflect the risk of overdose. Dextropropoxyphene subsequently carried a black box warning in the U.S., stating:

Propoxyphene should be used with extreme caution, if at all, in patients who have a history of substance/drug/alcohol abuse, depression with suicidal tendency, or who already take medications that cause drowsiness (e.g., antidepressants, muscle relaxants, pain relievers, sedatives, tranquilizers). Fatalities have occurred in such patients when propoxyphene was misused. Because of potential for side effects, this drug is on the list for high-risk medications in the elderly. On November 19, 2010, the FDA requested manufacturers withdraw propoxyphene from the US market, citing heart arrhythmia in patients who took the drug at typical doses. Tramadol, which lacks the cardiotoxicity, has been recommended instead of propoxyphene, as it is also indicated for mild to moderate pain, and is less likely to be misused or cause addiction than other opioids.

Cut-Off Levels (ng/mL)

300 ng/mL (Urine)

Window of Detection

2 Hrs. – 4 Days (Urine)

 

How is it Used?

PPX has been prescribed, usually in pill form, to treat mild to moderate pain. Since 2009 products containing PPX have been removed from US markets because of the it’s in effectiveness as a pain reliever and the harmful, and sometimes, fatal side effects, along with the high chance of abuse and misuse.

What are the Effects?

PPX can produce similar euphoric effects much like opioids which has led to the misuse and abuse of the drug. It is ineffective and treating and relieving pain leading to a high-risk for dependency and addiction. It can have adverse effects such and heart complications such as arrhythmia as well as drowsiness, shallow breathing, and altered behavior, especially in patients with history of depression and substance abuse. The effects of PPX can be heightened when mixed with other medications.

Common Symptoms

  • shallow breathing

  • slow heartbeat

  • feeling light-headed

  • fainting

  • confusion

  • hallucinations

  • unusual thoughts or behavior

  • seizure (convulsions) 

  • jaundice (yellowing of the skin or eyes).

  • feeling dizzy or drowsy

  • nausea

  • vomiting

  • stomach pain

  • constipation

  • headache

  • muscle pain

  • blurred vision

  • mild skin rash.

Common Brand Names

  • Darvon
  • Darvocet

What does it Look Like?

PPX usually comes in the form of a pill or capsule varying in colors, such as red, orange and green.

Legal Status

Schedule II & Schedule IV (when in dosage form)

Testing Options

  • Integrated Urine Test Cup

Contact us

Call Us

1-866-989-9300

Email Us

info@ntsbiz.com

Our Location

550 NW 77th Street

Boca Raton, FL 33487

Get in touch

NTS BLOG

NTS Blog

We love staying in the know. Now we blog about it. Keep up to date on company news and promotions. Enjoy educational seminars and stay informed with industry related news atricles, trends and compliance. 

New Test Option on the Horizon

New Test Option on the Horizon

If you read this blog with any regularity, you know I try to keep my topics educational. However, sometimes something new and interesting on the horizon is worthy of its own announcement, if only to determine if anyone else is excited about the potential as we are. In fact, more than ever, we would love to have feedback from you on the potential usefulness of this new test.

The Importance of Hydrocodone and Clonazepam Specific Panels

The Importance of Hydrocodone and Clonazepam Specific Panels

If you’ve watched our “Understanding the Limitations of Drug Testing” webinar or have had conversations with me about that subject, you’ve heard me talk about substances that many people expect to be detected on the tests they are using, but actually are not.  An excellent example of this that we are all hopefully familiar with is Fentanyl.

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The state of designer opioids is an ever changing landscape. When it comes to powerful street drugs such as designer opioids it is important to understand what is being produced and what to look out for. Chief Product Officer takes a deep dive into understanding current trends of designer opioids.

Testing for PPX and TCA: Is it Necessary?

Testing for PPX and TCA: Is it Necessary?

Today’s subject was sparked from a conversation that our sales consultants have fairly regularly. Usually this comes up in the context of us pressing to find out why a facility is using the specific tests that they are using. The answer we get more than any other is some variant of, “it’s just the way we’ve always done it.” If you’ve had any conversations with our sales team, you know they won’t simply let that answer stand alone. It is always our mission to understand the needs of each facility we work with, but sometimes this can entail explaining why some of the thought processes behind those needs might be misguided, outdated, or missing crucial bits of information.

Adulterant Demonstration

Adulteration is an issue that most have encountered at one time or another in drugs of abuse management programs. Patients, or donors, sometimes go to great lengths to adulterate a specimen in an attempt to avoid a positive test result. In this video, Chief Product Officer, Eric Malis, discusses the importance of using and reading adulteration test strips correctly along with a hands on demonstration.

CLIA Waived or Forensic Use Only: What You Need to Know

CLIA Waived or Forensic Use Only: What You Need to Know

Something you may have noticed while browsing our product catalogs and/or listings is that some of the tests have a designation of “CLIA Waived”, while others are designated as “FUO”. What do these two designations refer to, and how does it affect you? Let us look a little deeper and find out.

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In the latest NTS-U Webinar, join Chief Product Office, Eric Malis in discussing drugs of abuse commonly found at gas stations, convenience stores, and smoke shops; most of which are in legal gray areas. 

A Word on External Quality Controls

A Word on External Quality Controls

If you read the instructions that are included in each box of tests (stop laughing, some people have!) then you have seen the recommendation that “positive and negative controls be tested as good laboratory practice to confirm the test procedure and to verify proper test performance”. Every instant test does have built-in procedural controls

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