Introduction
Tricyclic antidepressants (TCAs) are used less commonly now for depression due to their side-effects and toxicity in overdose. They are however used widely in the treatment of neuropathic pain, where smaller doses are typically required.
Choice of tricyclic
*trazodone is technically a 'tricyclic-related antidepressant'
Choice of tricyclic
- Low-dose amitriptyline is commonly used in the management of neuropathic pain and the prophylaxis of headache (both tension and migraine)
- lofepramine has a lower incidence of toxicity in overdose
- Amitriptyline and dosulepin (dothiepin) are considered the most dangerous in overdose
| More sedative | Less sedative |
|---|---|
| Amitriptyline Clomipramine Dosulepin Trazodone* | Imipramine Lofepramine Nortriptyline |
*trazodone is technically a 'tricyclic-related antidepressant'
Adverse effects
Common side-effects
- Drowsiness
- Dry mouth
- Blurred vision
- Constipation
- Urinary retention
- Lengthening of QT interval