This major neurotrophic factor plays an essential role in the formation and survival of neurons during development and synaptic plasticity. The neurotrophic hypothesis of depression suggests that stress-related alterations in BDNF levels occur in critical limbic structures to contribute to the pathogenic processes in major depressive disorder(MDD). There have been comprehensive studies of brain-derived neurotrophic factor (BDNF). Amitryptiline is more sedating and has increased anticholinergic properties than other TCAs. As with other antidepressants, the onset of therapeutic action typically begins at approximately 2 to 4 weeks. Chronic treatment with amitriptyline desensitizes presynaptic autoreceptors and heteroreceptors, producing long-lasting changes in monoaminergic neurotransmission. Īmitriptyline increases noradrenergic or serotonergic neurotransmission by blocking the norepinephrine or serotonin transporter (NET or SERT) at presynaptic terminals. Amitriptyline is a tertiary amine with strong binding affinities for alpha-adrenergic, histamine (H1), and muscarinic (M1) receptors. The three-ring central structure and a side chain are the basic structure of tricyclic antidepressants. Amitriptyline is in the tricyclic antidepressant (TCA) drug classification and acts by blocking the reuptake of both serotonin and norepinephrine neurotransmitters.
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