Tricyclic antidepressants in the treatment of depression. Do they still have a place?
BACKGROUND
Over the past decade several new classes of antidepressants have become available for the treatment of depression. Their use has become widespread and some have suggested that the older tricyclic antidepressants (TCAs) should no longer be used as first line treatment.


OBJECTIVE
To examine the place of TCAs in the treatment of depression.


CONCLUSIONS
The TCAs still have an important place in the treatment of depression. The newer agents are equally effective as the TCAs for treatment of mild to moderate depression, but there are indicators the TCAs are more efficacious for severe depression. The newer drugs have a different side effect profile and some potentially serious problems such as drug interactions and the serotonin syndrome. TCAs are potentially lethal in overdose, so their use in the suicidal patient must be accompanied by comprehensive clinical care, taking precautions to minimise risk of suicide.
Judd
F
F
University of Melbourne.
Boyce
P
P
D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment
D000929:Antidepressive Agents, Tricyclic