Asendin belongs to a class of medications called tricyclic antidepressants, although it is sometimes classified as a "tetracyclic" antidepressant, due to its chemical structure. It is not entirely clear how Asendin works. It does affect several chemicals in the brain, including serotonin and norepinephrine. It is thought that perhaps Asendin allows these chemicals to stay in the brain longer, which can help with depression symptoms.
Asendin also blocks dopamine receptors, which is why it is especially useful for psychotic depression. People with psychotic conditions often have too much dopamine in the brain, and blocking the dopamine can help treat hallucinations, delusions, and other psychotic features. In fact, Asendin is sometimes thought of as a hybrid antidepressant and antipsychotic, due to its effects on dopamine.
Asendin is not recommended for use in people under 18 years old, as it has not been thoroughly studied in children or teens. Antidepressants have been shown to increase the risk of suicidal thinking and behavior in short-term research studies involving children and teenagers (see Amoxapine and Suicide for more information on the risks of suicide with Asendin). Talk to your healthcare provider about treatment options for childhood or teen depression.
On occasion, your healthcare provider may recommend Asendin for treating something other than depression. This is called an "off-label" use. At this time, there are no universally accepted off-label uses for Asendin.