For many years, the tricyclics were the most popular antidepressants. Although superseded today by the less side-effect prone selective serotonin reuptake inhibitors (SSRIs), they are still used in certain cases.

Antidepressants in this family include:

  • Amitriptyline hydrochloride (Elavil)
  • Amoxapine (Asendin)
  • Clomipramine hydrochloride (Anafranil)
  • Desipramine hydrochloride (Norpramin)
  • Doxepin hydrochloride (Sinequan)
  • Imipramine (Tofranil)
  • Nortriptyline hydrochloride (Aventyl, Pamelor)
  • Protriptyline hydrochloride (Vivactil)
  • Trimipramine maleate (Surmontil)
  • and others

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Coenzyme Q 10 (CoQ 10 ) ]]>

Supplementation Possibly Helpful

Preliminary evidence suggests that tricyclic antidepressants might deplete the body of coenzyme Q 10 (CoQ 10 ), a substance that appears to be important for normal heart function. ]]>1,2]]> Based on this observation, it has been suggested (but not proved) that CoQ 10 supplementation might help prevent the heart-related side effects that can occur with the use of tricyclic antidepressants.

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St. John's Wort]]> , ]]>Yohimbe]]> , ]]>5-Hydroxytryptophan (5-HTP)]]> , ]]>S-Adenosylmethionine (SAMe)]]>

Possible Dangerous Interactions

Based on one case report ]]>3]]> and our general knowledge about the actions of these supplements, taking any of these in combination with some tricyclic antidepressants could conceivably present a risk of elevating serotonin levels too high.

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St. John's Wort]]>

Possible Harmful Interaction

St. John’s wort might decrease the effectiveness of tricyclic antidepressants by reducing blood levels of the drug. ]]>4-5]]> Conversely, if you are taking St. John's wort already and your physician adjusts your dose of medication, suddenly stopping the herb could cause blood levels of the drug to rise dangerously high.