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Tricyclics were accidently discovered in the 1950s. While researching an effective treatment for schizophrenia, scientists learned that the drug, called imipramine (Tofranil), relieved depression. The medications are referred to tricyclics due to their molecular structure. The drugs contain three rings of atoms and are classified as secondary and tertiary amines. This means that they boost serotonin and nor-epinephrine by inhibiting the the reuptake of those inhibitors and that of dopamine by nerve cells in the brain.

Common tricylclics include amitriptyline (Elavil), desipramine (Norpramin), (Tofranil), and nortriptyline (Aventyl and Pamelor). No longer considered a first-line treatment due to the amount of side effects they produce, tricyclic are still effective. They are often prescribed as a second or third option if patients have not responded to other antidepressant medications.

Common side effects and suggested remedies for tricyclics are:

  • Dry mouth - drinking sips of water, chewing sugarless gum, and brushing teeth often
  • Constipation - Adding bran cereals, vegetables, prunes, and fruit to the diet is recommended
  • Bladder problems - Older men with enlarged prostates may be at particular risks for this. A weak urine stream and difficulty emptying the bladder are problems expected. See your doctor if you have any pain
  • Sexual problems - Sexual dysfunction may result, talk with you doctor for possible solutions
  • Blurred vision - Most often a temporary side effect, unless you have glaucoma, in which case your doctor should be informed
  • Dizziness - Getting out of a chair or bed slowly is recommended
  • Daytime drowsiness - Most often a temporary effect, but driving or operating heavy machinery when drowsy is not recommended. Some antidepressants have a sedative effect and should be taken at bedtime to help sleep and to minimize these effects
  • Increased heart rate - Older patients should have an electrocardiogram (EKG) before taking these medications.
  • Increased blood pressure - consult your doctor immediately