It is recommended that Tricyclic Antidepressants (TCA) should be initiated as a second line treatment for depression. If the patient has severe depression or has not appropriately responded to SSRI treatment in the past, then a TCA may be an appropriate choice. Tricyclic Antidepressants are often not used as a first line antidepressant in practice due to their significant side effects. This includes increased weight gain, constipation, orthostatic hypotension, reflex tachycardia and a dry month sensation. When assessing TCAs and SSRIs, TCA have a significant increased risk of overdose. Overdose associated with TCA can cause significant effects such as hypertension, respiratory depression, cardiac arrhythmias, seizures and hallucinations. Education
