Precautions and Warnings With Tricyclic Antidepressants

Some Tricyclic Antidepressant Warnings and Precautions

Some precautions and warnings with tricyclic antidepressants to be aware of include:
  • Antidepressants (including tricyclic antidepressants) may increase the risk of suicidal thoughts or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Therefore, if you notice any changes in symptoms or develop new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thoughts or behavior (see Tricyclic Antidepressants and Suicide for more information).
  • Before prescribing tricyclic antidepressants for depression, your healthcare provider should make sure that you do not have bipolar disorder (instead of depression). Sometimes, the symptoms of bipolar disorder and depression are very similar, and tricyclic antidepressants can cause problems in people with bipolar disorder.
  • Tricyclic antidepressants can make schizophrenia worse. Discuss this with your healthcare provider before taking tricyclic antidepressants.
  • For people taking tricyclic antidepressants, caution should be used when driving, operating heavy machinery, or performing other tasks that require concentration, especially when first starting tricyclic antidepressants or when switching dosages. This is because these medications may affect a person's mental or physical ability to perform these tasks. Make sure to understand how a tricyclic antidepressant affects you before performing any task that requires mental or physical concentration.
  • Tricyclic antidepressants may enhance the effects of alcohol, barbiturates, and other medicines that affect the brain. This can lead to an increased risk for drowsiness, dizziness, suicidal thoughts, and other symptoms of a tricyclic antidepressant overdose. Make sure to talk with your healthcare provider about drinking alcohol while taking a tricyclic antidepressant.
  • Tricyclic antidepressants may not be safe for use during pregnancy. Discuss the benefits and risks of using tricyclic antidepressants during pregnancy with your healthcare provider (see Tricyclic Antidepressants and Pregnancy for more information).
  • Tricyclic antidepressants may pass through breast milk and may cause harm to your baby. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about what makes the most sense for your particular situation (see Tricyclic Antidepressants and Breastfeeding).
  • Special care should be used when taking a tricyclic antidepressant if you have a history of seizures, bladder problems, or glaucoma. Tricyclic antidepressants can make these conditions worse.
  • Talk to your healthcare provider before taking a tricyclic antidepressant if you have any heart problems, as these medications can affect the heart and its electrical system.
  • Talk to your healthcare provider before taking a tricyclic antidepressant if you have hyperthyroidism (overactive thyroid) or take thyroid medication.
  • Taking a tricyclic antidepressant while receiving electroshock or electroconvulsive therapy (ECT) can increase your risk of side effects. Talk to your healthcare provider about these risks.
  • Tricyclic antidepressants may cause a dry mouth. Sucking on hard candy, chewing gum, or melting bits of ice in your mouth can provide relief.
  • The elderly appear to be more sensitive to tricyclic antidepressants because these medications can increase their risk of side effects, such as delirium and confusion. In these particular situations, the healthcare provider will start people at lower doses and monitor them more closely.
  • People with diabetes should make sure to check their blood sugar levels more often when starting a tricyclic antidepressant (or increasing their dosages). There have been reports of increased or decreased blood sugar levels in people who take tricyclic antidepressants.
  • Do not treat yourself for the common cold, a cough, or allergies without first talking to your healthcare provider. Some of these medicines can increase the risk for developing side effects of tricyclic antidepressants.
  • Do not stop taking a tricyclic antidepressant without first discussing it with your healthcare provider.
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