Amitriptyline (Elavil, Endep)
Doxepin (Sinequan, Adapin)
Clomipramine (Anafranil) - particularly effective for Obsessive-Compulsive Disorder
Most effective for depression inolving decreased appetite, weight loss, early morning awakening and other sleep disturbances, psychomotor retardation, anhedonia, and family history of depression with non-responsiveness to medication
Successful in alleviating vegatative, somatic symptoms.
Takes 2-4 weeks to have effect (use ECT for high risk, severe depression clients).
Prescribed for severe phobic, hypochondriacal, and obsessiove states, Panic Disorder, chronic pain.
Cardiotoxic Side Effects:
- severe hypotention (drop in blood pressure)
- cardiac arrhythmia
- * Use with caution in people with heart disease
- * Many side-effects common with elderly; alleviated by lower dose
- * Overdose can be lethal (prescribe low quantities for high suicide risk)
- Dry Mouth
- Blurred Vision
- Urinary Retention
- Sexual Dysfunction
Other Side Effects:
- Blood Dyscrasia
- Weight Gain
- Tine Tremor
- Paresthesia (subjective sensation experienced as numbness, tingling, or "pins and needles")