Tricyclic Antidepressant Side Effects
Elavil, Norpramin and other TSA Depression Medication
Sep 23, 2009
Tricyclic antidepressants (TSAs) are some of the oldest depression medications available, and have been prescribed for depression since the 1950s. Second generation depression medication such as SSRIs are now the first choice for depression treatment. Should SSRIs or SNRIs prove ineffective, tricyclic antidepressants may be considered.
How Tricyclic Antidepressant Work
Tricyclic depression medication works by increasing levels of serotonin and norepinephrine in the brain. Both serotonin and norepinephrine are neurotransmitters – chemicals used to transmit messages from one nerve cell to another. Low neurotransmitter levels are associated with clinical depression. Tricyclic antidepressants may also affect levels of the neurotransmitter dopamine.
Tricyclic Antidepressant Side Effects
Tricyclic antidepressant side effects limit the medication’s usefulness. TSAs affect a boarder range of body functions than second generation antidepressant drugs, which target specific nervous system cell activity. As a result, TSAs have a wider range of side effects than SSRIs or SNRIs.
Common tricyclic side effects include:
- craving sweet food
- dizziness
- drowsiness
- dry mouth
- headaches
- increased appetite
- mild weakness
- nausea
- unpleasant taste in the mouth.
Heartburn, sweating, diarrhea, vomiting and sleep difficulties are also possible side effects. Most people find these side effects clear up as their bodies adjust to TSA doses. Consult a doctor if tricyclic side effects do not clear up, or if any of the following serious side effects occur:
- confusion
- difficulty swallowing
- eye pain
- fainting
- hallucinations
- hypotension (low blood pressure)
- increase in heart rate
- nervousness
- photosensitivity (increased sensitivity to sunlight)
- problems or changes to normal movement
- sexual difficulties
- shakiness
- urinary retention.
Common TSAs
Commonly prescribed tricyclic antidepressants include:
- Amoxapine
- Elavil (amitriptyline)
- Norpramin (desipramine)
- Pamelor (nortriptyline)
- Sinequan (doxepin)
- Surmotil (trimipramine)
- Tofranil (imipramine)
- Vivactil (protripyline).
Other uses for TSAs
In addition to depression, tricyclic antidepressant drugs are used to treat obsessive compulsive disorders and panic disorder. Additionally, TSAs are used to treat conditions as diverse as bed-wetting, bulimia, chronic pain and cocaine withdrawal.
Tricyclic Antidepressants and Medical Conditions
Tricyclic antidepressants can affect medical conditions other than depression. Prescribing doctors should be informed of all existing health conditions and current medication. pregnant or breast-feeding women should discuss the possible effects of TSAs on their fetuses and babies before taking the antidepressant.
Conditions that should definitely be reported to doctors before starting tricyclic depression medication include:
- alcoholism
- asthma
- drug abuse
- enlarged prostate (benign prostate hyperplasia)
- gastrointestinal conditions
- glaucoma
- heart conditions
- hypertension (high blood pressure)
- kidney or liver disease
- previous reactions to TSAs
- schizophrenia
- seizures
- thyroid problems
- urinary tract conditions.
TSAs, Serotonin Syndrome and Medication Interactions
Tricyclic antidepressants can cause serotonin syndrome when taken in combination with other depression medication, triptan migraine medication, or the dietary supplement St. John’s Wort. Serotonin syndrome is a serious condition caused by excessively high levels of serotonin in the nervous system. Serotonin syndrome is a relatively rare condition.
TSAs can cause a wide range of interactions with other medications, including other depression medication, diet pills, anticoagulants (blood thinners), anti-anxiety medications, blood pressure medications, seizure medication and tranquilizers. Be sure to report all medication, including herbal supplements and over-the-counter products to doctors who are prescribing any type of antidepressant.
Tricyclic antidepressants and Suicidal Behavior
Suicidal behavior is a possible tricyclic antidepressant side effect. Most antidepressants carry with them the possibility of worsening depression symptoms or suicidal behavior. The risk of suicidal behavior is highest in young adults and tends to develop within the first two months of tricyclic antidepressant treatment. During this period patients need to be monitored for suicide warning signs.
While tricyclic antidepressants are used less often than SSRIs (selective serotonin reuptake inhibitors) to treat major depression, TSAs still have a role to play in depression treatment, and may provide depression symptom relief if other treatment options fail.
Resources
Mayo Clinic. (Retrieved 19 September, 2009). Tricyclic Antidepressants (TCAs)
Ross-Flanigan, N. (Retrieved 19 September, 2009). Antidepressants, Tricyclic
Disclaimer: The information contained within this article is for informational purposes only, and is not intended to be a substitute in any way for care and treatment by a qualified health professional.
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