Experience | Leaflets | Medicines | Support | Patient+ | Guidelines | Weblinks | Poems | Videos | News | Products | Other
Other options: 
Tricyclic Antidepressants
Post your experienceSee others (218 there)
| Tricyclic antidepressants are used to treat depression and some other conditions. They take 2-4 weeks to work fully. Treatment usually lasts six months or more. 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 not just for depression
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 drug.
How do antidepressants work?
Antidepressants alter the balance of some of the chemicals in the brain (neurotransmitters). These are thought to play some part in causing depression and other conditions.
Antidepressants and depression
Sometimes a life problem such as bereavement, redundancy, illness, etc, may trigger a depression. Sometimes there is no apparent cause for a depression. However, antidepressants treat the symptoms of depression, whatever the cause.
Symptoms of depression include: low mood, feelings of sadness, sleep problems, poor appetite, irritability, poor concentration, decreased sex drive, loss of energy, guilt feelings, headaches, aches, pains, and palpitations. If symptoms are eased, you not only feel better, but you may also be able to cope better with any problems or difficult circumstances.
How effective are tricyclic antidepressants?
About 5-7 in 10 people with depression improve within a few weeks of starting treatment with antidepressants. However, up to 3 in 10 people improve with dummy tablets (placebo) as some people would have improved in this time naturally. So, you are roughly twice as likely to improve with antidepressants compared to taking no treatment. But, they do not work in everybody.
Note: antidepressants do not necessarily make sad people happy. The word depressed is often used when people really mean 'sad', 'fed-up', or 'unhappy'. True depression is different to unhappiness and has persistent symptoms (which often includes persistent sadness).
The success rate of tricyclic antidepressants in treating the other conditions listed above (migraine, etc) varies.
How quickly do tricyclic antidepressants work?
An antidepressant takes 2-4 weeks to build up its effect and work fully. Some people stop treatment after a week or so thinking it is not helping. It is best to wait for 3-4 weeks before deciding if an antidepressant is helping or not. If poor sleep is a symptom of the depression, it is often helped first, within a week or so.
With some types of tricyclic antidepressant, the initial dose that is started is often small and is increased gradually to a full dose. (One mistake that sometimes occurs is that some people remain on the initial dose which is often too low to work fully.)
If you find that the treatment is helpful after 3-4 weeks, it is usual to continue. A normal course of antidepressants lasts up to six months or more after symptoms have eased. If you stop the drug too soon, your symptoms may rapidly return. Some people with recurrent depression need longer courses of treatment.
When you are taking tricyclic antidepressants
It is important to take the medication each day at the dose prescribed. Do not stop taking them abruptly. The dose is usually gradually reduced before stopping completely at the end of a course of treatment. But don't do this yourself - your doctor will advise on dosage reduction when the time comes. It is best not to stop treatment or change the dose without consulting a doctor.
Are there different types of tricyclic antidepressants?
There are several different types. They include: imipramine, amitriptyline, doxepin, mianserin, trazodone, and lofepramine. Each of these comes in different brand names.
There is no 'best buy' that suits everyone. A doctor makes a judgement as to which one would best suit. Things such as your age, other drugs that you may take, other medical problems, possible side-effects, and previous use of antidepressants are taken into account. If the one chosen does not suit, it is sometimes necessary to change the dose, or change the preparation. Also, if tricyclic antidepressants do not help then another type of antidepressant may be advised.
What about side-effects?
The most common side-effects are: a dry mouth, constipation, sweating, slight hesitancy in passing urine, slight blurring of vision, and drowsiness. These often ease after a week or so as the body becomes used to the drug. It is worth keeping on with treatment if side-effects are mild at first. Frequent drinks or water will help a dry mouth.
The leaflet that comes in the drug packet gives a full list of possible side-effects. Tell your doctor if a side-effect persists or is troublesome. A switch to a different drug may then suit you better.
Do not drive or operate machinery if you become drowsy whilst taking an antidepressant.
Are antidepressants addictive?
Tricyclic antidepressants are not tranquillisers, and are not thought to be addictive. Most people can stop tricyclic antidepressants without any problem. At the end of a course of treatment it is usual to reduce the dose gradually over about four weeks before finally stopping. This is because some people develop 'withdrawal' symptoms if an antidepressant is stopped abruptly.
Withdrawal symptoms that may occur include: dizziness, anxiety and agitation, sleep disturbance, 'flu-like symptoms, diarrhoea, abdominal cramps, pins and needles, mood swings, feeling sick, and low mood. 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.
References
- Depression, Clinical Knowledge Summaries (November 2007)
- MeReC bulletin; The drug treatment of depression in primary care. Volume 11, Number 9, 2000.
- Haddad P, Lejoyeux M, Young A; Antidepressant discontinuation reactions. BMJ. 1998 Apr 11;316(7138):1105-6.
- British National Formulary
The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.
Patient UK Hearing Impairment Survey
Patient UK are grateful to the 550 people who took part in this survey.
To see the results click here.
If you'd like to leave your feedback, please go to our interactive forum.
Experience | Leaflets | Medicines | Support | Patient+ | Guidelines | Weblinks | Poems | Videos | News | Products | Other
Other options:
Related pages in Patient UK
Your Experience (^ top of page)
Please add your experience about this condition / medicine View Patient Experience for 'Depression' (218 there)Health Topic information leaflets related to this topic (^ top of page)
Antidepressants - SSRIs Antidepressants - St John's Wort Bedwetting - Medicine Treatments Bipolar Disorder Cognitive Behaviour Therapy (CBT) Depression Depression - A Self Help Guide Depression - A Summary Epidurals for Pain Relief After Surgery Neuropathic Pain Post Natal Depression - A Self Help Guide Postnatal Depression TENS MachinesMedicine & Drug information leaflets related to this topic (^ top of page)
Doxepin cream Doxepin oral Imipramine Lofepramine TrazodoneSupport Groups related to this topic (^ top of page)
Action on Pain Association for Post-Natal Illness Bath Centre for Pain Services Breathing Space British Pain Society CALM - Campaign Against Living Miserably Charlie Waller Memorial Trust Chronic Pain Policy Coalition CITA - Council for Information on Tranquillisers and Antidepressants Depression Alliance Depression Alliance Scotland Depression UK Journeys MAMA - Meet A Mum Association MDF - the Bipolar Organisation Mental Health Foundation (Scotland) Mother's Voice (Postnatal illness support) Neuropathy Trust Pain Association Scotland Pain Concern Pain Relief Foundation PMS and PND Support PND Productions Post Natal Illness Web Site SupportLine Talking Life (self-help audio tapes) There4U UnwindPatientPlus articles related to this topic (^ top of page)
Antenatal Mental Health Problems Bipolar Disorder and Manic Depression Controlled Drugs Depression Depression in Pregnancy Edinburgh Postnatal Depression Score Calculator Geriatric Depression Scale (GDS) Managing Depression Neuropathic Pain and its Management Nutritional Support in Primary Care Pain and Pain Relief Pain Control in Terminal Care Pain Relief in Children Panic Disorder and its Management Patient Health Questionnaire (PHQ-9) Postnatal Care (Puerperium) Postnatal Depression Screening for Depression in Primary Care Selective Serotonin Reuptake Inhibitors (SSRIs) Serotonin and Norepinephrine Re-uptake Inhibitors (SNRIs) Syringe Drivers Tricyclic and Related Antidepressants Who Benefits from AntidepressantsUK guidelines related to this topic (^ top of page)
Guidelines on Depression Guidelines on Pain Guidelines on Post Natal Illness Guidelines on Pain ManagementLinks to other selected websites related to this topic (^ top of page)
Depression Pain Postnatal Illness / Depression TENS MachinesPoems and stories related to this topic (^ top of page)
A Golden Age Pink Carnations Made Me CryVideos related to this topic (^ top of page)
Links to online videos on Depression Links to online videos on Pain Links to online videos on Post Natal IllnessPatient UK Newspaper (^ top of page)
Recent related news items
Flying Scotsman Graeme Obree crashes with depression 'Female Viagra' discovery claim Suicide risk? Multi-tasking test spots onset of Alzheimer's Health staff prescribe comedy for patients with depressionAll news by related topic
Depression news Pain news Post Natal Illness news Neuropathic Pain news Antidepressant Drugs news Pain Management newsRelated Products (^ top of page)
Medical equipment
Pill/Tablet Equipment TENS Units
Books
Anxiety and Depression (Coping with) Back & Neck Pain for Dummies (Treating your) Control Your Depression Coping Successfully with Pain Coping with Anxiety and Depression Coping with Chronic Pain: The Complete Guide to Relief Coping with Depression and Elation Defeat Depression:Tips and Techniques for Healing a Troubled Mind Depression - A Simple Guide Depression (An Introduction to Coping With) Depression (Beating): At Your Fingertips (2nd Edition) Depression (Control Your) Depression (Overcoming) Depression (Understanding) Depression : British Medical Association's Family Doctor Series Depression and Elation (Coping with) Depression: What You Really Need to Know Living with a Black Dog Low Self Esteem (Overcoming) Managing Arthritis Pain Migraine & Other Headaches : British Medical Association's Family Doctor Series Migraine and Headaches: Answers At Your Fingertips Mood Swings (Overcoming) Overcoming Depression Pain (Coping Successfully with) Pain Explained: A Guide for Patients and Carers Shoot the Damn Dog The Compassionate MIND
Other - Useful resources (^ top of page)
Pictures, diagrams, photos, images, etc.Evidence based medicine
Online textbooks and journals
UK Guidelines
Online Videos
Medline
Other good health sites
Want to search some more? Use the Google Search box below to search our site.
Disclaimer: Patient UK has no control over the content of any external links above. Inclusion does not imply endorsement by Patient UK.
Want to advertise on this site? Find out how >>
Here you can follow a link to view existing patient experiences on this subject, or to add your own
This will offer you the usual PDF options i.e. document navigation, search, zoom and formatted print
Note: this is the best way to print the document
Note: this will open in a new window
Note: this will open in a new window
Here you can follow a link to view existing patient experiences on this subject, or to add your own
This will offer you the usual PDF options i.e. document navigation, search, zoom and formatted print
Note: this is the best way to print the document
Note: this will open in a new window
Note: this will open in a new window