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What are tricyclic antidepressants?

Tricyclic antidepressants (TCAs) have been used since the 1970s to treat panic disorder and obsessive-compulsive disorder. Their name derives from their three-ring molecular structure. Medications of this class are thought to relieve anxiety and depression mainly by increasing the availability of norepinephrine and serotonin. TCAs do so by slowing the reabsorption of these neurotransmitters by the neurons that released them and by changing the sensitivity of the receptors.

But compared with antidepressants called dual reuptake inhibitors or selective serotonin reuptake inhibitors (SSRIs ), TCAs can cause more severe side effects, including dizziness, constipation, blurred vision, and trouble urinating. TCAs can also cause weight gain and disturbances in heart rhythm. Thus, people with heart disease should usually avoid these drugs unless they've tried other medications without a good response.

Because of their side effects, TCAs are considered second-line treatments for generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and panic disorder. They're sometimes paired with an SSRI when such a drug doesn't work well enough alone. They may also be used as a sleep aid. TCAs are often prescribed as an alternative for people who can't use or tolerate SSRIs. For some people, TCAs work better and cause fewer troublesome side effects than SSRIs. A period of trial and error can help determine which drug will work best.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.