Antidepressants, Tricyclic Health Article

Definition

Tricyclic antidepressants are medicines that relieve mental depression.

Purpose

Since their discovery in the 1950s, tricyclic antidepressants have been used to treat mental depression. Like other antidepressant drugs, they reduce symptoms such as extreme sadness, hopelessness, and lack of energy. Some tricyclic antidepressants are also used to treat bulimia, cocaine withdrawal, panic disorder, obsessive-compulsive disorders, certain types of chronic pain, and bed-wetting in children.

Description

Named for their three-ring chemical structure, tricyclic antidepressants work by correcting chemical imbalances in the brain. But because they also affect other chemicals throughout the body, these drugs may produce many unwanted side effects.

Tricyclic antidepressants are available only with a physician's prescription and are sold in tablet, capsule, liquid, and injectable forms. Some commonly used tricyclic antidepressants are amitriptyline (Elavil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline (Vivactil). Different drugs in this family have different effects, and physicians can choose the drug that best fits the patient's symptoms. For example, a physician might prescribe Elavil for a person with depression who has trouble sleeping, because this drug is more likely to make people feel calm and sleepy. Other tricyclic antidepressants might be more appropriate for depressed people with low energy.

Recommended dosage

The recommended dosage depends on many factors, including the patient's age, weight, general health and symptoms. The type of tricyclic antidepressant and its strength also must be considered. Check with the physician who prescribed the drug or the pharmacist who filled the prescription for the correct dosage.

Always take tricyclic antidepressants exactly as directed. Never take larger or more frequent doses, and do not take the drug for longer than directed. Do not stop taking the medicine just because it does not seem to be working. Several weeks may be needed for its effects to be felt. Visit the physician as often as recommended so that the physician can check to see if the drug is working and to note for side effects.

Do not stop taking this medicine suddenly after taking it for several weeks or more. Gradually tapering the dose may be necessary to reduce the chance of withdrawal symptoms.

Taking this medicine with food may prevent upset stomach.

Precautions

The effects of this medicine may continue for three to seven days after patients stop taking it. All precautions should be observed during this period, as well as throughout treatment with tricyclic antidepressants.

Some people feel drowsy, dizzy, or lightheaded, when taking these drugs. The drugs may also cause blurred vision. Anyone who takes these drugs should not drive, use machines or do anything else that might be dangerous until they have found out how the drugs affect them.

Because tricyclic antidepressants work on the central nervous system, they may add to the effects of alcohol and other drugs that cause drowsiness, such as antihistamines, cold medicine, allergy medicine, sleep aids, medicine for seizures, tranquilizers, some pain relievers, and muscle relaxants. Anyone taking tricyclic antidepressants should check with his or her physician before drinking alcohol or taking any drugs that cause drowsiness.

These medicines make some people feel lightheaded, dizzy, or faint when they get up after sitting or lying down. To lessen the problem, get up gradually and hold onto something for support if possible.

Tricyclic antidepressants may interact with medicines used during surgery, dental procedures, or emergency treatment. These interactions could increase the chance of side effects. Anyone who is taking tricyclic antidepressants should be sure to tell the health care professional in charge before having any surgical or dental procedures or receiving emergency treatment.

These drugs may also change the results of medical tests. Before having medical tests, anyone taking this medicine should alert the health care professional in charge.

This medicine may increase sensitivity to sunlight. Even brief exposure to sun can cause a severe sunburn or a rash. While being treated with this tricyclic antidepressants, avoid being in direct sunlight, especially between 10 A.M. and 3 P.M.; wear a hat and tightly woven clothing that covers the arms and legs; use a sunscreen with a skin protection factor (SPF) of at least 15; protect the lips with a sun block lipstick; and do not use tanning beds, tanning booths, or sunlamps.

Tricyclic antidepressants may cause dry mouth. To temporarily relieve the discomfort, chew sugarless gum, suck on sugarless candy or ice chips, or use saliva substitutes, which come in liquid and tablet forms and are available without a prescription.

Children and older people are especially sensitive to the effects of tricyclic antidepressants. This increased sensitivity may increase the chance of side effects.