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The side effects of the tricyclics
are many, and some can be dangerous. Initially, patients can experience dry
mouth, constipation, urinary retention, orthostatic hypotension (sudden
lowering of blood pressure upon standing up), blurred vision, tachycardia
(increased heart rate), and rarely, cardiac arrhythmias (with high doses). In
the long-run, it is common to see weight gain and sexual dysfunction. If one
overdoses on these medicines, the result can be fatal.
Common side effects of the MAOIs
include orthostatic hypotension, headache, insomnia, weight gain, sexual
dysfunction, peripheral edema (swelling), and afternoon sleepiness. If taken
with certain forbidden foods or beverages (ones that contain tyramine—including
aged cheeses, smoked meats, and certain wines), blood pressure can escalate and
lead to a hypertensive crisis and possible stroke. Individuals taking these
medications must be on a restricted diet.
Sedation is common in these
medications, and some of them help individuals sleep better. Unfortunately,
anxiety symptoms may worsen on initiation of these medicines—and any other
antidepressants. The initial doses are best started low and slowly increased to
therapeutic doses to keep this side effect to a minimum. Some doctors will
start patients on a combination of an antidepressant and a benzodiazepine. It
takes several weeks for the antidepressant to have an antianxiety or
antidepressant effect. The benzodiazepines work quickly and can help the
patient until the antidepressant kicks in.
Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD
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