First generation tricyclic antidepressants are cheap and effective and still regarded as first-line drugs. However, they often cause unwanted effects which has led to a search for safer drugs. The second generation antidepressants, although not necessarily more effective, are often claimed to act faster, and to have fewer or milder unwanted effects. We have discussed two of these second generation drugs before, viloxazine (Vivalan),1 and lofepramine (Gamanil).2 We now reappraise these two drugs and look at amoxapine (Asendis), a recent addition.
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