What kind of effects do TCAs have that can complicate their use?

The correct choice highlights the significant histaminergic and anticholinergic effects of tricyclic antidepressants (TCAs), which can complicate their use in patients.

Histaminergic effects, caused by the blockade of histamine H1 receptors, often lead to sedation and weight gain, which can be problematic for patients needing to maintain a certain level of alertness or those concerned about weight management.

Anticholinergic effects arise from the blockade of acetylcholine receptors and can lead to a variety of symptoms, such as dry mouth, constipation, urinary retention, blurred vision, and confusion, particularly in older adults. These side effects can not only affect patient adherence to the medication but also exacerbate existing medical conditions and impact overall quality of life.

In contrast, while cardiac effects are a valid concern with TCAs, especially regarding potential arrhythmias, they are generally more about the risk of overdose rather than everyday complications during normal use. Cognitive effects can be a consideration, but they are often secondary to the more prominent impact of anticholinergic symptoms. Kidney effects are not a common complication associated with TCAs.

Therefore, the combined histaminergic and anticholinergic effects are particularly significant in complicating the clinical use of