Tricyclic antidepressant medications are a second-line therapy used in treating ADHD when stimulants cannot be used. They are typically prescribed when patients have a co-existing mood disorder, substance abuse problem, or when patients cannot tolerate or show no signs of improvement on stimulants. The effectiveness and safety of these compounds has also been studied extensively. The research has found that antidepressants are generally less effective in treating the core symptoms of ADHD and have a higher rate of side effects. Most Tricyclic antidepressants work by inhibiting the re-uptake of the neurotransmitters norepinephrine and serotonin by nerve cells. Medications in this class of compounds include the following:
Amitriptyline (Elavil, Tryptanol, Endep)
Amoxapine (Asendin)
Clomipramine (Anafranil)
Dothiepin hydrochloride(Prothiaden, Thaden)
Doxepin (Adapin, Sinequan)
Imipramine (Tofranil)
Lofepramine (Gamanil, Lomont)
Nortriptyline(Pamelor Aventyl
Protriptyline(Vivactil)
trimipramine (Surmontil)
Desipramine (Norpramin Pertofrane)-- less prescribed due to some unexplained sudden deaths which appeared to be related to heart conduction patterns.
Side Effects of Tricyclic Antidepressants
Drowsiness
Anxiety
Restlessness,
Dry mouth
Constipation
Urinary retention or difficulty with urination
Cognitive and memory difficulties,
Weight gain
Sweating
Dizziness
Hypotension
Akathsia
Mecrease in sexual ability and desire
Muscle twitches
Weakness
Nausea
Increased heart rate and irregular heart rhythms (rare)
In some cases, physicians may also prescribe other anti-depressants to treat ADHD. Although there is some research evidence that these medications can be helpful in treating ADHD, relatively few controlled studies of their effectiveness exist. These medications include