The most common side effects are dizziness, drowsiness, dry mouth, unpleasant taste, headache, nausea, mild tiredness or weakness, increased appetite or craving for sweets, and weight gain. These problems usually go away as the body adjusts to the drug and do not require medical treatment. Less common side effects, such as diarrhea, vomiting, sleep problems, sweating, and heartburn also may occur and do not need medical attention unless they do not go away or they interfere with normal activities.
More serious side effects are not common, but may occur. If any of the following side effects occur, check with the physician who prescribed the medicine as soon as possible:
movement problems, such as shuffling walk, stiff arms and legs, or slow movement
decreased sexual ability
fast or irregular heartbeat
Some side effects may continue after treatment with tricyclic antidepressants has ended. Check with a physician if these symptoms occur:
nausea, vomiting, or diarrhea
sleep problems, including vivid dreams
unusual excitement, restlessness, or irritability
Life-threatening reactions, such as extrememly high blood pressure, may occur when tricyclic antidepressants are taken with other antidepressants called monoamine oxidase (MAO) inhibitors (such as Nardil and Parnate). Do not take tricyclic antidepressants within 2 weeks of taking a MAO inhibitor. However, a patient can take an MAO inhibitor immediately after tricyclic antidepressant therapy is stopped by the physician.
Tricyclic antidepressants may interact with many other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes tricyclic antidepressants should let the physician know all other medicines he or she is taking. Among the drugs that may interact with tricyclic antidepressants are:
Central nervous system (CNS) depressants such as medicine for allergies, colds, hay fever, and asthma; sedatives; tranquilizers; prescription pain medicine; muscle relaxants; medicine for seizures; sleep aids; barbiturates; and anesthetics.
The list above does not include every drug that may interact with tricyclic antidepressants. Be sure to check with a physician or pharmacist before combining tricyclic antidepressants with any other prescription or non-prescription (over-the-counter) medicine.
Nancy Ross-Flanigan, The Gale Group Inc., Gale, Detroit,