Tetracyclic antidepressant

There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline.

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A tetracyclic antidepressant is an antidepressant drug from the tetracyclic drug group.

The name tetracyclic is derived from the drug's molecular structure which consists of four ring-like structures in a T-shape (compare tricyclic antidepressant).

Maprotiline, trade named Ludiomil®, and Mirtazapine, trade named Remeron® in the USA, Zispin® in Europe and Avanza® in Australia, are the only two drugs from this group widely used for the treatment of clinical depression. The tetracyclic antidepressant Mianserin was previously available internationally, however in most markets it has been phased out in favor of Mirtazapine.

Research on other tetracyclic antidepressant compounds (for example setiptiline) have been reported in the scientific literature. These other tetracyclic antidepressants are not publicly available.

List of tetracyclic antidepressants

According to MeSH the tetracyclic antidepressants have the following effects:

	Adrenergic uptake inhibitor	Adrenergic alpha-antagonist	Dopamine antagonist	Serotonin uptake inhibitor	Serotonin antagonist	Histamine H1 antagonist
Amoxapine	yes	-	yes	yes	-	-
Maprotiline	yes	-	-	-	-	-
Mianserin	-	yes	-	-	yes	yes
Mirtazapine	-	yes	-	-	-	yes
Trazodone	-	-	-	yes	-	-

v • d • e

Psychoanaleptics: antidepressants (N06A)

MAOIs

Iproclozide • Iproniazid • Isocarboxazid • Nialamide • Pargyline • Phenelzine • Rasagiline • Selegiline • Toloxatone • Tranylcypromine
RIMAs: Brofaromine • Beta-carbolines (Harmaline) • Moclobemide

RIs

S RI	SS RI (Alaproclate, Citalopram, Dapoxetine, Escitalopram, Etoperidone, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Zimelidine) • TCAs/Tetras (Clomipramine, Nefazodone, Trazodone)
N RI / A RI	Atomoxetine • Maprotiline • Reboxetine • Viloxazine • TCAs/Tetras (Amitriptyline, Amoxapine, Butriptyline, Desipramine/Lofepramine, Dibenzepin, Dothiepin, Doxepin, Imipramine, Iprindole, Melitracen, Nortriptyline, Opipramol, Protriptyline, Trimipramine, Maprotiline)
D RI	Vanoxerine • Phenmetrazine • TCAs (Amineptine)
SN RI	Bicifadine • Desvenlafaxine • Duloxetine • Milnacipran • Nefazodone • Venlafaxine
ND RI	Bupropion
SND RI	Brasofensine • Tesofensine • Nomifensine