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Tricyclic antidepressant drugs

Tricyclic anti -depressant drugs Preparations Comments
Increased risk of cardiotoxicity with tricyclic antidepressants and more dangerous in overdose than SSRIs. See HPFT Guidelines on Prescribing TCAs.
Amitriptyline hydrochloride 10mg, 25mg and 50mg tablets
25mg/5ml and 50mg/5ml oral solution
 
Clomipramine hydrochloride 10mg, 25mg and 50mg capsules
75mg modified release tablets
MR preparation considered to be less suitable for prescribing by BNF. MR preparation more expensive.

Dosulepin

25mg capsules
75mg tablets

DO NOT SWITCH TO, OR START dosulepin because evidence supporting its tolerability relative to other antidepressants is outweighed by the increased cardiac risk and toxicity in overdose. NICE CG90

Imipramine hydrochloride 10mg and 25mg tablets
25mg/5ml oral solution
 
Lofepramine hydrochloride 70mg tablets
70mg/5ml oral suspension
Lower incidence of side-effects and less dangerous in overdose.
Nortriptyline 10mg and 25mg tablets  
Trazodone hydrochloride 50mg and 100mg capsules
150mg tablets
50mg/5ml sugar free oral solution
Oral liquid significantly more expensive than tabs/caps. Restricted to those unable to swallow solid dose forms.

 

Back to 4.3.2 Monoamine-oxidase inhibitors (MAOI's)

Back to 4.3.3 Selective serotonin re-uptake inhibitors (SSRI's)

Continue to 4.3.4 Other antidepressant drugs

 

Back to BNF Chapter 4

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