Tricyclic Antidepressants: What They Are, How They Work, and What to Know Before Taking Them

When you hear tricyclic antidepressants, a class of prescription drugs first developed in the 1950s to treat depression by balancing brain chemicals. Also known as TCAs, they were the go-to treatment before SSRIs came along—but they’re still used today for specific cases, especially when other meds fail. Unlike newer antidepressants, TCAs affect multiple neurotransmitters at once, including serotonin and norepinephrine. That makes them powerful, but also more likely to cause side effects like dry mouth, drowsiness, weight gain, and dizziness.

One of the most well-known tricyclic antidepressants, a group of medications that include amitriptyline, nortriptyline, and clomipramine. Also known as TCAs, they is Anafranil, the brand name for clomipramine, often prescribed for OCD and severe depression. It’s one of the few TCAs still commonly used because it works well for obsessive-compulsive disorder, even when SSRIs don’t. Other TCAs like amitriptyline, a first-generation TCA used for depression, nerve pain, and insomnia are often picked for patients who struggle with sleep or chronic pain alongside depression. These drugs aren’t just about mood—they’re used off-label for migraines, nerve pain, and even bedwetting in kids.

But here’s the catch: TCAs have a narrow safety window. Taking too much can be deadly, especially in overdose. That’s why doctors monitor heart function and blood levels closely, especially in older adults or people with heart conditions. They also interact with many other meds—like beta-blockers, antihistamines, and even some OTC sleep aids. If you’re on a TCA, you need to be careful about mixing it with anything else. And while newer antidepressants have fewer side effects, TCAs still work for people who’ve tried everything else and still feel stuck.

The posts below cover real-world issues you might face if you’re taking or considering TCAs. You’ll find comparisons between Anafranil and other antidepressants, how to spot dangerous side effects, what to do if your meds aren’t working, and how to manage the physical toll they can take. Some of these articles talk about medication adherence, how to read safety guides, and what to watch for when switching drugs—all critical when you’re on a TCA. Whether you’re a patient, caregiver, or just trying to understand why your doctor chose this older class of meds, this collection gives you the facts you need to make smart choices.