Tricyclic Antidepressants: What They Are, How They Work, and Alternatives
When you hear tricyclic antidepressants, a class of prescription medications first developed in the 1950s to treat depression by balancing brain chemicals like serotonin and norepinephrine. Also known as TCAs, they were the go-to treatment before SSRIs became popular—but they’re still used today for depression, chronic pain, and even anxiety or sleep issues. Unlike newer drugs, TCAs affect more than one neurotransmitter at once, which makes them powerful but also more likely to cause side effects like dry mouth, drowsiness, or weight gain.
These meds don’t work the same way for everyone. Some people find relief when SSRIs fail, especially if they’re dealing with nerve pain from diabetes or shingles. Amitriptyline, a common TCA often prescribed for depression and neuropathic pain, is one of the most studied. Nortriptyline, a metabolite of amitriptyline with fewer side effects, is another popular choice. Doctors might pick one over another based on your age, other health issues, or how your body handles medications. You won’t feel better right away—it usually takes 2 to 6 weeks. And because they can be dangerous in overdose, your doctor will monitor you closely, especially if you have heart problems or a history of seizures.
Many people wonder why anyone still uses TCAs when there are so many newer antidepressants. The answer? They work—especially for tough cases. If you’ve tried fluoxetine, sertraline, or bupropion and still feel stuck, your doctor might suggest a TCA. They’re also cheaper than many brand-name options. But they’re not for everyone. If you’re older, have heart rhythm issues, or struggle with constipation or urinary problems, TCAs might not be the best fit. That’s why knowing your options matters. You’ll find detailed comparisons here between TCAs and other meds like SSRIs, SNRIs, and even herbal or non-drug approaches. You’ll see real side effect profiles, cost differences, and what patients actually report after using them. This isn’t theory—it’s what people experience when they switch from one antidepressant to another.
Nortriptyline for ADHD: A Controversial Treatment Option Explained
Posted by Ellison Greystone on Oct, 24 2025
Explore the controversial off‑label use of nortriptyline for ADHD, covering how it works, evidence, side effects, and when it might be considered.