Possible side effects and cautions

Because of the different ways tricyclic antidepressants work, side effects vary somewhat from medicine to medicine. Some side effects may go away after a time. Others may lead you and your healthcare professional to try a different medicine. Side effects also may depend on the dose. Higher doses often cause more side effects.

Some common possible side effects include:

• Drowsiness.
• Blurred vision.
• Constipation.
• Dry mouth.
• Drop in blood pressure when moving from sitting to standing, which can cause lightheadedness.
• Problems passing urine.

Other possible side effects include:

• Weight loss.
• Urges to eat more, leading to weight gain.
• Too much sweating.
• Shakiness, also called tremor.
• Sexual problems, such as trouble getting an erection, delayed orgasm or low sex drive.

Generally speaking:

• Amitriptyline, doxepin, imipramine and trimipramine are more likely to make you sleepy than other tricyclic antidepressants are. Taking these medicines at bedtime may help.
• Amitriptyline, clomipramine, doxepin, imipramine and trimipramine are more likely to cause weight gain than other tricyclic antidepressants are.
• Nortriptyline and desipramine seem to have better tolerated side effects than other tricyclic antidepressants do.

For antidepressants that cause sleepiness, be careful about doing activities that require you to be alert until you know how the medicine will affect you. This can include not driving a car or operating heavy machinery such as construction equipment.

Which antidepressant is best for you depends on several factors, such as your symptoms and any other health conditions you may have. Ask your healthcare professional and pharmacist about the most common possible side effects for the antidepressant prescribed for you. Also read the patient medicine guide that comes with the prescription.