Tricyclic Antidepressants

medication

Tricyclic antidepressants are some of the first antidepressants developed. Today, they are not prescribed as often because newer antidepressants like SSRI’s or SNRI’s have fewer side effects. For people who tried other treatments and found that they didn’t work, tricyclic antidepressants may be an option to consider.

According to Budur[1], in cases where stimulants were ineffective, tricyclic antidepressants can be used to treat ADHD.

The Mayo Clinic[2] explains that tricyclic antidepressants ease depression by impacting chemical messengers, neurotransmitters, used to communicate between brain cells. Similar to other types of antidepressants, tricyclic antidepressants work by causing changes in brain chemistry and how brain cells communicate in ways which regulate mood, in an effort to help relieve depression.

Tricyclic antidepressants block the absorption or reuptake of the neurotransmitters serotonin and norepinephrine increasing the levels of these two neurotransmitters in the brain. Cyclic antidepressants also affect other chemical messengers, which can lead to a number of side effects.

Examples (brand name italicized):

  • Amitriptyline
  • Amoxapine
  • Desipramine (Norpramin)
  • Doxepin
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Protriptyline (Vivactil)
  • Trimipramine (Surmontil)

Side Effects[2]:

Common:

  • Blurred vision
  • Constipation
  • Dry mouth
  • Drowsiness
  • Drop in blood pressure when moving from sitting to standing, which can cause lightheadedness
  • Urine retention

Less Common:

  • Increased appetite leading to weight gain
  • Weight loss
  • Excessive sweating
  • Tremor
  • Sexual problems, such as difficulty achieving an erection, delayed orgasm or low sex drive

[1] Budur, K., Mathews, M., Adetunji, B., Mathews, M., & Mahmud, J. (2005). Non-Stimulant Treatment for Attention Deficit Hyperactivity Disorder. Psychiatry (Edgmont), 2(7), 44–48.

[2] Mayo Clinic Staff. “Tricyclic Antidepressants (TCAs).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 June 2016, www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983.

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