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Treating Depression with Medication: Tricyclic Antidepressants

Although Tricyclic Antidepressants are rarely prescribed, there are certain situations when they are the best choice. In some cases, patients will simply not see any improvement after undergoing regimens of treatment with other types of antidepressants. Occasionally, a patient will not be able to take any other type of medication and will have TCAs as their only option. Also, some patients simply show much more improvement with a TCA than with any other drug. When these situations occur, there are a number of TCAs available that have a long history of success.

Doxepin: This drug is used to treat depression, anxiety and, in low doses, insomnia. Doxepin was first developed in Germany and Sweden during the 1960’s. This drug was said to be very effective when used to treat a patient’s depressive symptoms. Over the years, it was discovered that Doxepin also had strong sedative properties and effectively combated anxiety. These were considered to be favorable effects because insomnia and anxiety so frequently manifest in tandem with depression.

Although this medication has a proven history of effective depression treatment, it can also cause a relatively high number of side effects, some of which can be fatal. In fact, some of these side effects can become so severe or persistent that the patient may have to ask their physician to help them find another treatment. Side effects can include rapid weight gain, constipation, drowsiness or fatigue, sexual side effects and, rarely, altered liver function. Despite the possibility of these side effects, Doxepin is still considered to be a powerful treatment in the fight against clinical depression.

Elavil (Amitriptyline): Elavil is used to treat a wider array of conditions than any other Tricyclic Antidepressant. It is used to treat depression, anxiety and panic-related conditions, insomnia, various eating disorders and even ADHD. This versatile medication has so many applications that it really stands out among the other medications in its class. It is a fine example of the usefulness of the entire class of TCAs as a whole.

However, the power of TCAs must always be taken into consideration alongside their trademark side effects. Elavil is known to cause dry mouth and some sedation. It can also cause weight gain, changes in appetite, dizziness, nausea and it can have a negative impact on sexual function. In very rare cases, Elavil can cause more dangerous conditions like worsening depression, suicidal ideation and an increased risk of death in elderly patients.

Like so many medications, Tricyclic Antidepressants have to be viewed in the context of both their efficacy and their practicality. If a patient cannot deal with a particular medication’s side effects, they should have no fear in asking their doctor for help. There are many, many effective medications out there and patients should not get discouraged if their first few attempts do not work perfectly. A great treatment plan takes time to construct.


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