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Types of medicine

What Is a Tricyclic Antidepressant? TCAs Explained

Tricyclic Antidepressant · say it: try-SY-klik an-tee-dih-PRES-untAlso written: TCA, tricyclics, tricyclic

Short answer

A tricyclic antidepressant (TCA) is an older type of antidepressant, such as amitriptyline, also used at low doses for nerve pain.

What it means

Tricyclic antidepressants (TCAs) are an older group of antidepressants named after their three-ring chemical shape. Examples include amitriptyline, nortriptyline, imipramine and clomipramine. They affect brain chemicals such as serotonin and noradrenaline. Besides depression, they are often used for nerve pain, migraine prevention and some other conditions.

TCA labels carry several warnings. They can cause drowsiness, dry mouth, constipation and dizziness on standing, and can affect heart rhythm. They are dangerous in overdose, which is why prescriptions may be limited in size. Labels also warn about interactions, including with MAOIs and other medicines that raise serotonin.

TCAs are different from SSRIs and SNRIs, the newer antidepressants used more often for depression. A low-dose TCA prescribed for pain does not mean you are being treated for depression.

Where you may see it

  • Antidepressant labels and leaflets
  • Pain clinic letters
  • The 'Drug interactions' section of other medicine labels

📄 How it looks on a report

Do not use with an MAOI or within 14 days of stopping an MAOI.

🙅 What it does not mean

  • Being prescribed a tricyclic for pain does not mean your doctor thinks the pain is 'in your head'.
  • Drowsiness is common at first but should be discussed if it does not settle.
  • It is not safe to stop suddenly after long use without advice.

🗒️ Questions to ask your doctor

💊 Medicines whose labels mention “Tricyclic Antidepressant”

Plain-English explanations of each medicine, from its official FDA label.

  • Amitriptyline

    An antidepressant of the tricyclic type

  • Carbamazepine

    a mood stabilizer, and an anticonvulsant (seizure) medicine, according to the label

  • Ciprofloxacin

    a fluoroquinolone antibacterial medicine

  • Citalopram

    a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant medicine

  • Escitalopram

    a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant

  • Fluoxetine

    a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant medicine

  • Lithium Carbonate

    A mood-stabilizing agent, which the label describes as a medicine used to treat bipolar I disorder

  • Mirtazapine

    An antidepressant medicine. The label describes it as having a tetracyclic chemical structure and belonging to the piperazino-azepine group of compounds.

  • Paroxetine

    A selective serotonin reuptake inhibitor (SSRI), a type of antidepressant medicine

  • Sertraline

    An SSRI (selective serotonin reuptake inhibitor), a type of antidepressant medicine, according to the label

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