by Caroline Fynn

Created on: January 08, 2011   Last Updated: February 16, 2012

Statistics show that approximately one in four people will at sometime during the lifespan suffer from depression. There are a number of methods in which to deal with this, such as lifestyle change and counselling. However, in some cases a doctor may decide that antidepressant medication is needed.

There may be an external cause of the depression, such as the death of a loved one, divorce or work related stress. On the other hand, depression can arise in what appears to be for no apparent reason.

A doctor will prescribe antidepressants when depression is severe, for example, low mood may be accompanied by feelings of hopelessness and desperation. A person may suffer from lethargy, feelings of apathy and loss of appetite. Little or no interest in life in general may be apparent, along with physical and/or emotional isolation and insomnia. Loss of libido may be experienced along with anxiety, agitation and low self esteem.

The term tricyclic antidepressants (TCAs) refer to one family of medications; they are not the same as antidepressants known as monoamine oxidase inhibitors (MAOIs) or selective serotonin re-uptake inhibitors (SSRIs).

Commonly prescribed tricyclic antidepressants include:

Amitriptyline

Clomipramine

Imipramine

Lofepramine

During a depressive illness, levels of the chemicals known as neurotransmitters are significantly reduced. Neurotransmitters bring about feelings of well being by stimulating certain brain cells. It is usual for specific brain cells to release the correct amount of neurotransmitters to stimulate the necessary brain cells for the regulation of mood, the neurotransmitters are then absorbed into other cells. Once re-absorbed the neurotransmitter then ceases to act on regulating mood and this process is, in normal circumstances, a continuous action. TCAs block the re-uptake, or re-absorption of the neurotransmitters serotonin and nor adrenaline (also known as nor epinephrine) this then increases the levels of neurotransmitters within the mood enhancing cells. SSRIs work in the same way except they only block serotonin.

Tricyclics need to be taken for approximately two weeks before any improvement becomes apparent, and it can take up to two months for the maximum effect to take place. However, amitriptyline and clomipramine have a sedative effect and for this reason they may be prescribed to those who have difficulty sleeping. This effect is immediate along with possibly dry mouth, blurred vision and dizziness. Incidentally,

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