Tricyclic antidepressants, also known now as cyclic antidepressants or TCAs, were introduced in the late s. These drugs are a good choice for some people whose depression is resistant to other drugs.
Although cyclic antidepressants can be effective, some people find their side effects difficult to tolerate. Some doctors may also prescribe the cyclic drug clomipramine Anafranil for treatment of depression in an off-label use.
Clinicians usually only prescribe tricyclic antidepressants after other drugs have failed to relieve depression. Tricyclic antidepressants help keep more serotonin and norepinephrine available to your brain. These chemicals are made naturally by your body and are thought to affect your mood. By keeping more of them available to your brain, tricyclic antidepressants help elevate your mood. Some tricyclic antidepressants are also used to treat other conditions, mostly in off-label uses.
These conditions include obsessive compulsive disorder OCD and chronic bedwetting. In lower doses, cyclic antidepressants are used to prevent migraines and to treat chronic pain. They are also sometimes used to help people with panic disorder. Tricyclic antidepressants treat depression, but they have other effects on your body as well. They can affect automatic muscle movement for certain functions of the body, including secretions and digestion.
They also block the effects of histamine, a chemical found throughout your body. Blocking histamine can cause effects such as drowsiness, blurred vision, dry mouth, constipation, and glaucoma. These may help explain some of the more troublesome side effects associated with these drugs.
Tricyclic antidepressants are more likely to cause constipation, weight gain, and sedation than other antidepressants. However, different drugs have different effects.
If left untreated, an overdose may result in delirium, seizures, coma, cardiac arrest, and death. Some of the side effects of tricyclic antidepressants may be intensified if taken with other drugs. In other cases, it can affect the bioavailability concentration of the drug in the bloodstream. As such, you should always advise your doctor about any substances you may be taking, including over-the-counter medications, herbal remedies, and recreational drugs.
Tricyclic antidepressants can be effective in treating depression but may not work as well in some people as others. In some cases, the drug side effects may become intolerable and interfere with your very quality of life. If you are suffering serious side effects, call your doctor immediately but do not stop treatment until your doctor tells you to. Stopping abruptly can cause symptoms of withdrawal, including nausea, fever, chills, headache, dizziness, lethargy, and vomiting.
Your doctor may be able to lower your dosage to where treatment is tolerable. If not, he or she would need to gradually taper the dose until you are able to safely stop.
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Slomski, Anita. Somber Questions. Massachusetts General Hospital. Spring Anxiety and Depression Association of America. Updated July National Center for Biotechnology Information. Depression: How effective are antidepressants?
Updated Jan 12, Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose. It is beyond the scope of this leaflet to list all side-effects; however, the following highlights some of the more common or serious ones. As a rule, tell your doctor if a side-effect persists or is troublesome. Your doctor can advise on the best course of action - for example, to stop the medication, or a switch to a different medicine, etc.
These include diarrhoea, feeling sick, being sick vomiting and headaches. It is worth keeping on with treatment if these side-effects are mild at first as they may wear off after a week or so.
SSRIs can cause drowsiness a sedating effect in some people. This side-effect is not common and is not as much of a problem as with some other types of antidepressants.
However, you must be aware of the possibility, especially if you are a driver, as it may impair your ability to drive safely. Any sedative effect is likely to be greatest in the first month of starting treatment, or on increasing the dose. Some research has suggested that SSRIs may be associated with a small increased risk of bleeding into the gut; however, the evidence is inconclusive.
This is especially in older people and in people taking other medicines that have the potential to damage the lining of the gut or interfere with clotting. Therefore, ideally, SSRIs should be avoided if you take aspirin , warfarin , novel anticoagulants apixaban , edoxaban , dabigatran and rivaroxaban or non-steroidal anti-inflammatory drugs NSAIDs such as ibuprofen.
If no suitable alternative to an SSRI can be found and you have an increased risk of bleeding, your doctor may advise that you take an additional medicine. This will help to protect the lining of the gut. Research studies suggest that there is a small increased risk of fractures in people taking an SSRI.
However, the reason for this increased risk is not clear. Dizziness, agitation, anxiety, difficulty sleeping and tremor have all been reported as possible side-effects.
Problems with sexual function are a common symptom of depression. However, in addition to this, all antidepressants may cause some problems with sexual function.
For example, problems getting an erection, vaginal dryness and decreased sex drive have been reported as side-effects in some people. In recent years there have been some case reports which claim a link between taking antidepressants and feeling suicidal, particularly in teenagers and young adults.
This may be more of a risk in the first few weeks of starting medication or after a dose increase. It is debatable whether this possible risk is due to the medicine or to the depression. If it is due to the medication then the risk remains very small.
And, overall, the most effective way to prevent suicidal thoughts and acts is to treat depression. However, because of this possible link, see your doctor promptly if you become increasingly restless, anxious or agitated, or if you have any suicidal thoughts. In particular, you should speak with your doctor if these develop in the early stages of treatment or following an increase in dose.
SSRIs are not tranquillisers, and are not thought to be addictive. Most people can stop an SSRI without any problem. At the end of a course of treatment you should reduce the dose gradually over about four weeks before finally stopping. This is because some people develop withdrawal symptoms if the medication is stopped abruptly. If you have withdrawal symptoms it does not mean that you are addicted to the medicine, as other features of addiction such as cravings for the medicine do not occur.
These symptoms are unlikely to occur if you reduce the dose gradually. If withdrawal symptoms do occur, they will usually last less than two weeks. An option if they do occur is to restart the drug and reduce the dose even more slowly. Tricyclic antidepressants are used to treat depression and some other conditions. They often take weeks to work fully. Side-effects may occur but are often minor and may ease off. At the end of a course of treatment, you should gradually reduce the dose before stopping completely.
Tricyclic antidepressants are used to treat depression. They are also used to treat some other conditions such as migraine, panic disorder, obsessive-compulsive disorder, recurrent headaches, and some forms of pain. The word tricyclic refers to the chemical structure of the medicine. Tricyclic antidepressants alter the balance of some chemicals in the brain, called neurotransmitters. How neurotransmitters work may play a part in causing depression and other conditions.
Tricyclic antidepressants generally block the effects of two neurotransmitters called serotonin and noradrenaline norepinephrine. The role these chemicals have in causing, or treating, depression is unclear.
Video appointments with qualified counsellors are now available in Patient Access. However, they do not work in everybody. The word 'depressed' is often used when people really mean sad, fed up, or unhappy.
The success rate of tricyclic antidepressants can vary when used to treat the other conditions migraine , panic disorder , obsessive-compulsive disorder , recurrent headaches and some forms of pain.
Some people stop treatment after a week or so thinking it is not helping. It is best to wait for weeks before deciding if an antidepressant is helping or not.
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