Tricyclic Antidepressants (TCAs)

medication info

Tricyclic antidepressants (TCAs) were 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 [1][2]. For people who tried other treatments and found that they didn’t work, TCAs may be an option to consider.

TCAs can be used to treat ADHD, as an alternative to stimulants [3].

How do TCAs work?

Like other mental health medications, TCAs work by restoring the balance of the chemicals in your brain. These chemicals are called neurotransmitters. The main neurotransmitters affected by TCAs are [4]:

  • Serotonin, which affects your mood, energy level, appetite, and sleep
  • Norepinephrine, which affects your energy level, focus and attention. Related to adrenaline and has similar effects

Examples of TCAs

Generic name

Brand name(s)

Amitriptyline

Elavil

Amoxapine

Asendin

Clomipramine

Anfranil

Desipramine

Norpramin

Doxepin

Sinequan

Imipramine

Tofranil

Nortriptyline

Pamelor

Protriptyline

Vivactil

Side effects of TCAs

Common [4]:

  • Blurred vision
  • Constipation
  • Dry mouth
  • Drowsiness
  • Dizziness or fainting when standing up too quickly
  • Feeling like your bladder is full, even if you just used the bathroom

Less Common [4]:

  • Gaining or losing weight, increased appetite
  • Excessive sweating
  • Hands shaking
  • Low sex drive, or difficulty achieving an erection or orgasm

References

  1. Peretti et al. (2007). Safety and tolerability considerations: tricyclic antidepressants vs. selective serotonin reuptake inhibitors. Acta Psychiatrica Scandinavica 101(S403). Retrieved from https://doi.org/10.1111/j.1600-0447.2000.tb10944.x
  2. Zohar & Wetenberg. (2007). Anxiety disorders: a review of tricyclic antidepressants and selective serotonin reuptake inhibitors. Acta Psychiatrica Scandinavica 101(S403). Retrieved from https://doi.org/10.1111/j.1600-0447.2000.tb10947.x
  3. Budur et al. (2005). Non-Stimulant Treatment for Attention Deficit Hyperactivity Disorder. Psychiatry (Edgmont), 2(7), 44–48. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000197/
  4. Mayo Clinic Staff. (2019). “Tricyclic antidepressants and tetracyclic antidepressants.” Mayo Clinic, Mayo Foundation for Medical Education and Research. Retrieved from www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983

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