When it comes to treating depression, tricyclic antidepressants, a class of older but still used antidepressants that work by balancing brain chemicals like serotonin and norepinephrine. Also known as TCAs, they’re not the first choice anymore—but for many people, they’re the one that finally works. Unlike newer SSRIs, TCAs hit multiple neurotransmitters at once, which can make them more effective for severe or treatment-resistant depression. But they also come with a heavier side effect profile, so picking the right one matters a lot.
Not all TCAs are created equal. amitriptyline, a potent TCA often used for depression and chronic pain tends to cause more drowsiness and dry mouth, making it a common pick for people who also struggle with sleep. nortriptyline, a metabolite of amitriptyline with fewer sedating effects is often preferred for older adults or those who need to stay alert during the day. Then there’s imipramine, one of the first TCAs ever made, still used for depression and bedwetting in children. Each has different strengths: some are better for anxiety, others for nerve pain, and some are easier to tolerate long-term.
What you’re looking for determines the best fit. If fatigue is your biggest symptom, a more sedating TCA might help. If you’re worried about weight gain or heart rhythm issues, you’ll want to avoid certain ones. And if you’ve tried SSRIs and nothing changed, a TCA could be the missing piece. The posts below break down real-world comparisons—how these drugs stack up against each other in side effects, dosing, cost, and effectiveness. You’ll see what works for people with similar symptoms, what to watch out for, and how to talk to your doctor about switching or starting one.
A thorough side‑by‑side review of Prothiaden (Dosulepin) versus common antidepressant alternatives, covering how it works, benefits, risks, dosing, and practical tips for patients.
