Tricyclic Antidepressants and their Side Effects

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning 10 take any over-the-counter or prescription medications or dietary supplements with tricyclic antidepressants. Doses of one or both drug may need to be modified or a different drug may need to be pre­scribed. The following drugs and drug classes interact with tricyclic anti depressants.

  • Alcohol lithium (eg, Eskalith)
  • Anticoagulants (eg, warfarin)
  • Barbiturates (eg, phenobarbital)
  • Cholestyramine (eg, Ouestran)
  • Furazolidone (Furoxone)
  • Hydantoins (eg, phenytoin)
  • Levodopa (eg, Larodopa)
  • Lithium (eg, Eskalith)
  • Propafenone (Rythmol)
  • Primidone (eg, Mysoline)

Side Effects:

Every drug is capable of producing side effects. Many tricyclic antidepressant users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Enuretic (Bedwetting) Children: Consider side effects reported with adult use. Most common are nervousness, sleep disorders, tiredness, and mild stomach disturbances. These usually disappear with continued therapy or dosage reduction. Other reported reactions include constipation, convulsions, anxiety, emotional instability, and fainting.

Clomipramine only: Tremors; sleeplessness; nervousness; muscle twitches or spasms; memory impairment; anxiety; impaired concentration; breathing problems; abnormal dreams; irritability; emotional liability; deperson allusion; hot flashes; menstrual disorder; vaginal irritation; ejaculation disorder; acne; dry skin; abnormal vision; abnormal tears; muscle aches; back pain; joint pain.

Digestive Tract: Dry mouth; constipation; decreased bowel movement; nausea; vomiting; loss of appetite; diarrhea; stomach discomfort; peculiar taste in mouth; stomach cramps; black tongue; mouth sores.

Nervous System: Confusion with hallucinations (especially in the elderly); disorientation; delusions; anxiety; restlessness; agitation; sleeplessness; tremors; nightmares; hypomania; exacerbation of psychosis; numb­ness, tingling, and decreased sensations in hands and feet; incoordination; unsteady walking; extrapyramidal symptoms; seizures; ringing in ears; changes in brain wave pattern.

Circulatory System: Increased or decreased blood pressure; increased heart rate; pounding in chest (palpitations); heart attack; abnormal heart rhythms; stroke; dizziness when sitting or standing up.

Skin: Rash; itching; red spots; flushing; hair loss.

Urinary and Reproductive Tract: Urinary retention; decreased urination; dilation of urinary tract.

Other: Blurred vision; problems focusing eyes; dilated pupils; increased pressure in eyes; light sensitivity; face and tongue swelling; decreased blood counts; breast enlargement in men; breast enlargement and milk production in women; increased or decreased sex drive; impotence; testicular swelling; increased or decreased blood sugar; weight gain or loss; perspiration; drowsiness; dizziness; weakness; fatigue; head­ache; changes in liver function; parotid gland swelling; increased appetite.

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