A pharmacist explains their benefits and risks.
Depression is a common but serious mental health condition that can significantly decrease quality of life and productivity.
However, they are typically not a first-line treatment (initial treatment choice).
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Tetra Images / Getty Images
What Are Tricyclic Antidepressants?
As their name implies, TCAs are medications that contain three rings and a side chain.
These lower dosages are effective and carry a lower risk of side effects.
If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor.
If you or a loved one are in immediate danger, call911.
How Do Tricyclic Antidepressants Work?
In addition, TCAs have analgesic effects.
They reduce nerve pain by increasing norepinephrine levels in the spinal cord.
Prescription SNRIs include Effexor (venlafaxine) and Cymbalta (duloxetine).
When Do You Use Tricyclic Antidepressants?
TCAs are generally not used for mild depression, but they may be helpful for severe cases.
Although they’re effective, side effects limit their use.
For this reason, TCAs are generally only used if other medications like SSRIs or SNRIs haven’t worked.
The TCA Anafranil (clomipromene) was the first medicine approved by the FDA for OCDin the 1980’s.
Today, it is considered second-line after trying an SSRI.
Research shows that TCAs are also effective forsymptoms of fibromyalgiaincluding fatigue, quality of sleep, and muscle stiffness.
Again, they are typically not prescribed first-line but may be recommended if other medicines haven’t helped.
Some clinical trials have shown that SSRIs and SNRIs are safer than TCAs from a side effect standpoint.
If you are experiencing side effects from a TCA, consult your healthcare provider or pharmacist.
Be sure to discuss treatment safety and effectiveness at follow-up appointments, or with your pharmacist.
Summary
TCAs have been used to treat depression since the 1950s.
Common ones are constipation, weight gain, and sedation.
More serious ones include seizures and heart problems.
In general, older people and those with heart disease or epilepsy should not take TCAs.
These drugs may also be dangerous during pregnancy.
If TCAs aren’t for you, there are many other medications that may help.
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