Whats the difference between tricyclic and ssri anti depressants?

[GeetTallBird]

Just wondering. I was on sertraline for 3 years, came off slowly with the usual horrid ssri withdrawal symptoms.... and realised I still needed some form of medication.
Gp suggested citalopram which is working very well in some aspects (sex drive way better) but has some pretty odd side effects! I am so, so dreadfully tired, my eyes feel like they are hanging down my face! My appetite has increased so much I've put on a stone in a month :(

So I'm looking to change to something else, discussing it with GP first obviously! but any advice as to which ANTD you found useful would be great.
Thank you.

[madmouse]

In short tricyclics are the old fashioned anti depressants. They work in a different way and usually have more side effects. The general rule these days is that SSRIs work better for most people as they are easier to tolerate. But most is not all, and there are people who do not respond well to SSRIs and who benefit from using tricyclics. Personally I went completely mad on 10mg of citalopram, so there is no one size fits all rule.

[kizzie]

Hi - I take a tricyclic called clomipramine. My personal experience is that physical side effects are stronger with tricyclics - some of these ease after a few weeks but some continue. For this reason Ive only been able to take a certain dose (my blood pressure goes too low if I take anymore) - and if I needed higher dose would probably need to switch to an ssri again.

With both ssris and tricyclics i have very severe increased anxiety etc side effects in the first few weeks. For me - there is no difference in this between either type.

I do think its very personal though and its very difficult to judge from other peoples experience because we all respond to them so differently. Hope you find best one for you.

[notcitrus]

Tricyclics block seratonic transporters, SSRIs block re-uptake of seratonin...

More practically, tricyclics tend to have more side effects and there's a higher risk of danger from overdoses. The side effects tend to be drowsiness, dry mouth, constipation and difficulty urinating - whereas SSRIs seem to mess with your guts in the opposite direction.

Having said that, I've taken lofepramine (a tricyclic with less overdose risk than others) every winter for 15 years, and in combination with high-fibre cereals and lots of fruit and veg, and carrying water with me at all times, it's enabled me to hold down a job and have a virtually normal life.

Tricyclics also sometimes get used for chronic pain conditions.

(I'm not a doctor, just an experienced patient)

[orangeflutie]

I'm currently taking dosulepin, another tricyclic and the only side effect I get from it is a good sleep at night. So quite a good side effect really. When I first started taking it I had a dry mouth for a little while but this has now gone.

I have bad side effects from citalapram, the first AD I tried and a severe reaction to mirtazapine(an SNRI), so am happy to be on a tricyclic.

[orangeflutie]

Sorry should read 'I have had bad'

[GeetTallBird]

Thank you everybody.
I'm looking forward to discussing it with GP, I wonder if there are any ANTD's that have a bit of a stimulant???? I hate driving any distances as my eyes start to close!

[NanaNina]

Don't think there are any ADs that have a bit of a stimulant but you could be prescribed one with less sedative effect.

[GeetTallBird]

Trying fluoxetine now. Fingers crossed :)