Tricyclic Antidepressants

Tricyclic antidepressants (TCAs) are antidepressant medications that work by affecting neurotransmitters. A neurotransmitter is a chemical produced by the body that enables one neuron (nerve cell) to communicate with another. They enable nerve impulses to travel. Serotonin and norepinepherine are such neurotransmitters. Tricyclic antidepressants slow down the body’s clearing away of the neurotransmitter—enabling it to do its work for a longer time. This has an effect on mood. TCAs approved by the US Food and Drug Administration include: amitriptyline, desipramine (Norpramin), trimipramine (Surmontil), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil, Tofranil-PM), amoxapine, protriptyline (Vivactil).
TCAs tend to have side effects. These include: dry mouth, impaired sexual function, drowsiness, dizziness, blurred vision, sensitivity to sunlight, increased heart rate, constipation, urinary retention, weight gain, nausea, or weakness. These drugs are to be avoided by patients with certain types of heart disease, as they are associated with an increased risk of heart attack. Also, patients with glaucoma or an enlarged prostate should also avoid TCAs. Also, antidepressant medication has been linked to suicidal thoughts in adolescents.

These drugs should not be discontinued without doctor supervision. Suddenly stopping their use can cause withdrawal symptoms. Symptoms of sudden withdrawal can include headache, nausea, dizziness, and lethargy.