Potential Side Effects with Cyclic Antidepressants
Common Side Effects
- Unpleasant taste
- Dry mouth
- Sensitivity to sunlight
- Excessive sweating
Infrequent Adverse Effects
- Eye pain
- Slow pulse
- Joint pain
- Visual changes
- Muscle aches
- Nasal congestion
- Difficult and/or frequent urination
- Abnormal dreams
- Diminished sex drive
- Inflamed tongue
- Hair loss
- Abdominal pain
- Back pain
- Irregular heartbeat
Rare Adverse Effects
- Itchy skin
- Swollen testicles
- Swollen breasts
- Involuntary movements of jaw, lips, and tongue
- Sore throat
Side Effects More Common To People Over Age 60
- Urination problems
Contact Lenses. You may experience problems with your
contact lenses if you take cyclics. Because these drugs can cause dry eyes,
your lenses may get gummed up with deposits of thick secretions, making them
feel gritty, itchy, or painful. If this happens, your doctor may be able to
prescribe a different antidepressant, reduce your dose, or prescribe artificial
Dizziness. Some tricyclics, especially amitriptyline, might
make you dizzy when you stand up (this is called "orthostatic
hypotension"). If you notice this, try standing up more slowly. In the
morning, dangle your feet over the side of the bed for a few minutes before
slowly standing up. If you have a serious problem with dizziness, your doctor
may be able to adjust your dose or switch you to another cyclic. The tricyclics
least likely to cause this problem are amoxapine and nortriptyline
Drowsiness. Sedation is a common side effect of many
tricyclics and tetracyclics; three of the most sedating are doxepin,
amitriptyline, and trimipramine.
"I found the sleepiness to be fairly pleasant," Sally, 52, reports.
"I was sleepy all the time, but it was a blissful sort of sleepiness. And
since I'd been having trouble sleeping before I started taking imipramine, I
didn't mind it so much."
If you think that "drugged" feeling is unpleasant, you can try
taking cyclics right before bedtime or ask your doctor about lowering your
dosage. Or you may have more luck with one of the nonsedating tricyclics:
amoxapine, desipramine, nortriptyline, or protriptyline. These are a good
choice if you experience lethargy and tiredness in addition to your depression.
On the other hand, they may interfere with sleep, especially if you take your
medication late in the day.
Neuroleptic Malignant Syndrome. If you use amoxapine too
long, you run the small risk of developing a group of symptoms called
"neuroleptic malignant syndrome," including fever, fast or irregular
heartbeat, sweating, weakness, muscle stiffness, seizures, or loss of bladder
Sexual Problems. Most antidepressants affect sexual
functioning in one way or another, and cyclics aren't any different. You may
experience either an increase or a decrease in sexual interest. Men may
experience problems with erection or ejaculation or suffer from impotence.
Cyclics may trigger swollen testicles or breast enlargement in men and women.
If you experience significant problems with sexual functioning, your doctor may
choose to switch you to a different antidepressant that doesn't cause these
problems, such as Wellbutrin (bupropion).
Sun Sensitivity. If you take a cyclic antidepressant and
you go out into the sun even briefly, you may end up with a rash, red or
discolored skin, or a dreadful sunburn. Before going out into the sun, study
the accompanying list of "Sunlight Precautions When Taking Cyclic
Antidepressants" (see box). If you do get a severe reaction from the sun,
consult your doctor.