TRICYCLIC ANTIDEPRESSANTS - EFFECTIVE, CHEAP BUT ARE THEY SAFE

Tricyclic antidepressants (TCAs) are still widely considered to be the drugs of first choice for the treatment of depression, particulary in general practice. The tolerability, side effects at therapeutic doses , safety in overdose and cost of treatment are factors which must be c onsidered carefully when allocating the TCAs to such a prominent posit ion. When such factors are considered critically, serious limitations of the use of the TCAs in the treatment of depression are apparent. It is considered that such drugs should no longer be used as the first c hoice, but be reserved for those patients who fail to respond to the s afer and equally effective second-generation antidepressants.