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Which is safer tricyclic antidepressants or SSRI ? thanks
25 أغسطس 2014
رأي ثانوي

Thank
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Disclaimer
د. Rania Mousa الطب العام
Tricyclic antidepressants are one of the oldest classes of antidepressants and are still used extensively. Before the introduction of Selective Serotonin Reuptake Inhibitors, TCAs were the standard treatment for depression.

Selective Serotonin Reuptake Inhibitors have replaced TCAs as the drugs of choice in the treatment of depressive disorders, mainly because of their improved tolerability and safety.

SSRIs affect fewer sites of action than TCAs, and as a result cause fewer types of adverse effects. The SSRIs have a better overall tolerability profile than the TCAs in both acute and long-term treatment .
SSRIs induce significantly less anticholinergic, antihistaminergic and cardiotoxic side-effects than TCAs

Main similarities and differences, which explain why SSRIs are more commonly prescribed than TCAs in the treatment for depression:

>SSRIs and TCAs have similar efficacy for the treatment of depression
>SSRIs have fewer anticholinergic and cardiovascular side effects
>TCA have fewer sexual and gastrointestinal side effects
>SSRIs are better tolerated by patients
>TCAs are associated with more frequent treatment discontinuations (more people dropping out tricyclics than SSRIs)
>SSRIs are safer in overdose than TCAs

However if you are asking concerning sexual dysfunction such as decreased sexual desire, erectile difficulties and delayed ejaculation has been reported with all classes of antidepressants

Sexual dysfunction is one of the most frequent and persistent SSRI adverse effect. These drugs are more likely to cause sexual dysfunction than the tricyclic antidepressents (TCAs)
but you must look for the overall benefit and consult your doctor for best for you or to switch between and see what is more working with you .
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