Antidepressant causing Tardive dyskinesia is ?
**Core Concept**
Tardive dyskinesia is a side effect of long-term use of antipsychotic medications, characterized by repetitive, involuntary movements of the face and other parts of the body. However, certain antidepressants can also cause this condition due to their dopaminergic blocking effects.
**Why the Correct Answer is Right**
Amoxapine is a tricyclic antidepressant (TCA) with a unique chemical structure and pharmacological profile. Unlike other TCAs, amoxapine has a strong affinity for dopamine receptors, particularly D2 receptors, which are also targeted by antipsychotics. This dopaminergic blocking effect can lead to the development of tardive dyskinesia, especially with long-term use. Amoxapine's ability to block dopamine receptors is a key factor in its association with this side effect.
**Why Each Wrong Option is Incorrect**
**Option A:** MAO inhibitors do not have a significant dopaminergic blocking effect, making them less likely to cause tardive dyskinesia. MAOIs primarily work by inhibiting the breakdown of monoamines, such as serotonin and norepinephrine.
**Option B:** Mianserin is a tetracyclic antidepressant with a different mechanism of action. It has a weak affinity for dopamine receptors and is not associated with tardive dyskinesia.
**Option C:** Imipramine is a classic TCA, but it does not have a strong dopaminergic blocking effect like amoxapine. Imipramine's primary mechanism of action involves blocking the reuptake of serotonin and norepinephrine.
**Clinical Pearl / High-Yield Fact**
When considering the risk of tardive dyskinesia, it's essential to remember that medications with significant dopaminergic blocking effects, such as antipsychotics and certain antidepressants like amoxapine, carry a higher risk of this side effect.
**β Correct Answer: D. Amoxapine**