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Tricyclic Antidepressants

Tricyclic antidepressants (TCAs) were the primary pharmacologic treatment for depression from the 1960s until the early 1990s when they were supplanted by the safer and better-tolerated selective serotonin reuptake inhibitors (SSRIs). TCAs are still used in the mid-2010s, often for nonpsychiatric problems, such as insomnia, headaches, and chronic pain. They are no longer considered first-line (or even second-line) treatment for mental health disorders.

This entry discusses the history of TCAs, how they are purported to work in the brain, their uses and side effects, and the subclasses of TCAs.

Historical Context

The first class of antidepressants was the monoamine oxidase inhibitors (MAOIs). The first MAOI was iproniazid. Because of the dietary restrictions required with the use of MAOIs and the potential for serious interactions between MAOIs and many ...

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