Tricyclic Antidepressants (Tcas)

If you have problems with these less IF YOU HAVE ANY OTHER SIDE serious side effects, talk with your EFFECTS THAT YOU THINK ARE Integrated Pain Service doctor or pharmacist: CAUSED BY THIS MEDICATION, „ Nervousness, trouble sleeping TELL YOUR DOCTOR OR PHARMACIST. „ Tiredness, dizziness Tricyclic „ Blurred vision „ If this medication upsets your stomach, try taking it with food. „ Stomach upset Antidepressants „ This medication may make your „ Trouble with urination skin more sensitive to sunlight. Try (TCAs) to stay out of direct sunlight and „ Diarrhea or constipation wear protective clothing and a sun „ Dry mouth block with SPF 15 or higher. „ If you experience dry mouth try „ Weight changes chewing sugarless gum, taking sips of water or using a saliva substitute. Call your doctor right away if you have any of these side effects: Please contact the Integrated Pain „ Confusion, agitation, hallucinations Service at 604-875-2345 ext 5108 (toll-free within BC: 1-888-3088 ext „ Seizures 5108) if you have further questions „ Fainting about your pain medication.

„ Fast or irregular heartbeat

„ Muscle stiffness Developed by the health care professionals „ Shortness of breath or trouble of the Integrated Pain Service with breathing assistance from the Department of 4480 Oak Street, Vancouver BC, V6H 3V4 www.bcchildrens.ca Learning & Development „ Skin rash or hives Integrated Pain Service Phone: 604-875-2345 Local 5108 Toll-free within BC:1-888-300-3088 ext. 5108 Fax: 604-875-2767 BCCH1452 © December 2007 Toll-free: 1-888-300-2767 BC Children’s Hospital Email: [email protected] Tricyclic Antidepressants HOW TO USE AND STORE THIS DRUGS AND FOOD TO AVOID: (TCAs) MEDICATION: „ Ask your doctor or pharmacist „ Take this medication with or before using any other medication, „ Amitriptyline without food. including non-prescription (Elavil®, Apo-amitriptyline®) medications, vitamins and herbal „ If you take only one dose a day, products. „ Nortriptyline (Aventyl®, other) take it at bedtime. „ Imipramine „ Store the medication out of reach of WARNINGS: (Impril®, Apo-imipramine®) children. „ Make sure your doctor knows if „ Doxepin you are pregnant or breastfeeding, „ (Triadapin®, Novo-Doxepin®) Store the medication at room or if you have kidney, liver or heart temperature away from heat, „ Trimipramine (Rhotrimine®, disease, glaucoma or seizures. moisture and direct light. Apo-Trimip®) „ Do NOT stop taking this „ Clomipramine (Anafranil®) medication suddenly without asking „ Desipramine (Norpramin®) IF YOU MISS A DOSE: your doctor – this medication is usually decreased slowly before it „ If you miss a dose or forget to take is stopped completely. WHAT ARE TCAs? your medication, take it as soon as This group of medications was first you remember. However, if it is „ This medication may make you made to treat depression. Tricyclic almost time for your next dose, do dizzy or drowsy. Avoid driving or antidepressants (TCAs) have since been not take the missed dose or double doing anything dangerous until you found to be effective for many types of your next dose. Instead, continue know how this medication makes pain, including headache pain, nerve your regular dosing schedule. If you feel. pain and other chronic pain conditions. you are unsure what to do about a When used for pain, the TCA doses are missed dose, contact your doctor or lower than those used for depression. pharmacist. SIDE EFFECTS: We know that this group of medications This list of side effects is important for works by altering the levels of „ If you take only one dose at you to be aware of; however, it is also certain transmitters in the brain (eg. bedtime and you miss the dose, important to remember that not all side noradrenalin, serotonin). TCAs may be do not take the medication in the effects happen to all people. used alone or in combination with other morning. Wait until the next night. medications. „ Do NOT take extra medication to These are some less serious side make up for a missed dose. effects of taking TCAs. Many of these You should take this medication less serious side effects will improve regularly to prevent or reduce the pain. over the first few days of taking the It may take several weeks before you medication. start to feel better.