Introduction

Tetracyclic antidepressants (TeCAs) are a class of antidepressants that were first introduced in the 1970s.

They are named after their tetracyclic chemical structure, containing four rings of atoms, and are closely related to the tricyclic antidepressants (TCAs), which contain three rings of atoms.

List of TeCAs

Marketed

• Maprotiline (Ludiomil): can also be classified as a TCA and grouped with the secondary amines
• Mianserin (Tolvon).
• Mirtazapine (Remeron).
• Setiptiline (Tecipul).
• Drugs that contain four rings not all fused together but are sometimes still classified as TeCAs include:
  • Amoxapine (Asendin):– often classified as a TCA and grouped with the secondary amines.
• Miscellaneous:
  • Benzoctamine (Tacitin): a tetracyclic compound and is closely related to maprotiline, with the two compounds differing only in the length of their side chain, but benzoctamine is not used as an antidepressant and is instead used as an anxiolytic.
  • Loxapine (Adasuve, Loxitane): a typical antipsychotic that produces amoxapine as a…