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CNS is the main site of therapeutic action of TCAs and these have direct effects on the CNS. The TCAs antidepressant effect is recognized to be the blockade of monoamine reuptake, at both noradrenergic and serotonergic nerve endings. Tricyclic compounds have anticholinergic effects and predominantly action on myocardium sodium channels then this group has a various symptoms; Since TCA has various presentation; we must ready to find different signs and symptoms of that. We must know all of sign and symptoms to be ready for manage it or them because cannot predict what patients will manifest.