What is the difference between ssri and tricyclic antidepressants

January 12, Fasipe, O. Neuropharmacological classification of antidepressant agents based on their mechanisms of action. Arc Med Heal Sci. DOI: Ramachandraih, C. Ind J Psychiatry. Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison. Innov Clin Neurosci. PMID: May 30, Laban TS. National Center for Biotechnology Information, U. Published April 7, J Clin Med. National Institute of Mental Health. February Simon LV.

Serotonin Syndrome. Published September 29, Friedman RA. Antidepressants' black-box warning years later. N Engl J Med. Hillhouse, T. A brief history of the development of antidepressant drugs: From monoamines to glutamate. Exp Clin Psychopharmacol. Your Privacy Rights. To change or withdraw your consent choices for VerywellMind. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page. These choices will be signaled globally to our partners and will not affect browsing data.

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Of these studies, only three reported data in an unambiguous format. Overall, the two classes of antidepressants did not differ significantly in efficacy. The slightly better performance of tricyclics that emerged when all six studies were analyzed disappeared when only the three unambiguous studies were analyzed.

Three studies totaling patients that reported clinical global impression as the measure of improvement also failed to show a statistically significant difference between the two classes of antidepressants. Assessment of tolerability was based on six studies 2, patients.

A significantly lower proportion of patients withdrew from treatment with an SSRI The relative risk of withdrawal was calculated as 0. Seven studies provided data specifically on withdrawal because of adverse events. A significantly lower proportion of patients withdrew because of adverse events during treatment with SSRIs The authors emphasize that although only limited high-quality data are currently available, SSRIs and tricyclics appear to be comparable in short-term efficacy in primary care, but SSRIs appear to be better tolerated by patients.

The authors call for much more high-quality research on the management of depression in primary care. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. MacGillivray S, et al. Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: systematic review and meta-analysis. If you stop the medicine too soon, your symptoms may rapidly return. Some people with recurrent depression are advised to take longer courses of treatment up to two years or longer.

When you are taking SSRI antidepressants it is important to take the medication each day at the dose prescribed. Do not stop taking an SSRI medicine abruptly.

This is because you may develop some withdrawal symptoms. The dose is usually gradually reduced before being stopped completely at the end of a course of treatment. But don't do this yourself - your doctor will advise on dosage reduction when the time comes. It is best not to stop treatment or change the dose without consulting a doctor.

There are several different types. They include citalopram , escitalopram , fluoxetine , paroxetine and sertraline. Each of these comes in different brand names. There is no best type that suits everyone. If the one chosen does not suit, it is sometimes necessary to change the dose, or change the preparation. Your doctor will advise. Also, if SSRI antidepressants do not help then another type of antidepressant may be advised.

Most people have either minor, or no, side-effects. Possible side-effects vary between different preparations. The leaflet that comes in the medicine packet gives a full list of possible side-effects.

You should read this before you start taking the medicine. It is beyond the scope of this leaflet to list all side-effects; however, the following highlights some of the more common or serious ones. As a rule, tell your doctor if a side-effect persists or is troublesome. Your doctor can advise on the best course of action - for example, to stop the medication, or a switch to a different medicine, etc.

These include diarrhoea, feeling sick, being sick vomiting and headaches. It is worth keeping on with treatment if these side-effects are mild at first as they may wear off after a week or so. SSRIs can cause drowsiness a sedating effect in some people. This side-effect is not common and is not as much of a problem as with some other types of antidepressants. However, you must be aware of the possibility, especially if you are a driver, as it may impair your ability to drive safely.

Any sedative effect is likely to be greatest in the first month of starting treatment, or on increasing the dose. Some research has suggested that SSRIs may be associated with a small increased risk of bleeding into the gut; however, the evidence is inconclusive.

This is especially in older people and in people taking other medicines that have the potential to damage the lining of the gut or interfere with clotting. Therefore, ideally, SSRIs should be avoided if you take aspirin , warfarin , novel anticoagulants apixaban , edoxaban , dabigatran and rivaroxaban or non-steroidal anti-inflammatory drugs NSAIDs such as ibuprofen. If no suitable alternative to an SSRI can be found and you have an increased risk of bleeding, your doctor may advise that you take an additional medicine.

This will help to protect the lining of the gut. Research studies suggest that there is a small increased risk of fractures in people taking an SSRI. However, the reason for this increased risk is not clear. Dizziness, agitation, anxiety, difficulty sleeping and tremor have all been reported as possible side-effects. Problems with sexual function are a common symptom of depression. However, in addition to this, all antidepressants may cause some problems with sexual function.

For example, problems getting an erection, vaginal dryness and decreased sex drive have been reported as side-effects in some people. In recent years there have been some case reports which claim a link between taking antidepressants and feeling suicidal, particularly in teenagers and young adults. This may be more of a risk in the first few weeks of starting medication or after a dose increase.

It is debatable whether this possible risk is due to the medicine or to the depression. If it is due to the medication then the risk remains very small. And, overall, the most effective way to prevent suicidal thoughts and acts is to treat depression. However, because of this possible link, see your doctor promptly if you become increasingly restless, anxious or agitated, or if you have any suicidal thoughts.

In particular, you should speak with your doctor if these develop in the early stages of treatment or following an increase in dose. SSRIs are not tranquillisers, and are not thought to be addictive. Most people can stop an SSRI without any problem. At the end of a course of treatment you should reduce the dose gradually over about four weeks before finally stopping.

This is because some people develop withdrawal symptoms if the medication is stopped abruptly. If you have withdrawal symptoms it does not mean that you are addicted to the medicine, as other features of addiction such as cravings for the medicine do not occur.

These symptoms are unlikely to occur if you reduce the dose gradually. If withdrawal symptoms do occur, they will usually last less than two weeks. An option if they do occur is to restart the drug and reduce the dose even more slowly. Tricyclic antidepressants are used to treat depression and some other conditions.

They often take weeks to work fully. Side-effects may occur but are often minor and may ease off. At the end of a course of treatment, you should gradually reduce the dose before stopping completely. Tricyclic antidepressants are used to treat depression. They are also used to treat some other conditions such as migraine, panic disorder, obsessive-compulsive disorder, recurrent headaches, and some forms of pain.

The word tricyclic refers to the chemical structure of the medicine. Tricyclic antidepressants alter the balance of some chemicals in the brain, called neurotransmitters. How neurotransmitters work may play a part in causing depression and other conditions. Tricyclic antidepressants generally block the effects of two neurotransmitters called serotonin and noradrenaline norepinephrine.

The role these chemicals have in causing, or treating, depression is unclear. Video appointments with qualified counsellors are now available in Patient Access. However, they do not work in everybody. The word 'depressed' is often used when people really mean sad, fed up, or unhappy.

The success rate of tricyclic antidepressants can vary when used to treat the other conditions migraine , panic disorder , obsessive-compulsive disorder , recurrent headaches and some forms of pain.

Some people stop treatment after a week or so thinking it is not helping. It is best to wait for weeks before deciding if an antidepressant is helping or not.