🕷️ Crawler Inspector

URL Lookup

Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 40 (from laksa026)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa040.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046983","crawl_time":1775016994,"first_indexed_time":1505153529,"http_code":200,"src_unparsed":"org,mayoclinic!www,\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046983 s443","src_root_hash":"1608882045018104440","history_drop_reason":null,"meta_title":"Tricyclic antidepressants and tetracyclic antidepressants - Mayo Clinic","meta_descriptions":["Tricyclic antidepressants can have more side effects than other antidepressants. But for some people, they may ease depression when other medicines fail."],"attrs_boilerpipe_text":"People may react differently to the same antidepressant. For example, one medicine may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does.\nTraits passed down in your family may play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a specific antidepressant. Pharmacogenomics — the study of how drugs work coupled with information about human genes — is sometimes available to tailor medications and their doses for people based on their genetic makeup. But other things besides genetics can affect your response to medicine.\nWhen choosing an antidepressant, your healthcare professional considers your symptoms, any health problems, other medicines you take, and what's worked for you in the past.\nTypically, it may take several weeks or longer before an antidepressant fully works and for early side effects to ease up. Your healthcare professional may recommend some dose changes or different antidepressants. With patience, you and your healthcare professional can find a medicine that works well for you.","attrs_markdown":"[Skip to content](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046983#main-content)\n\n[![Mayo Clinic Home Page](https:\/\/assets.mayoclinic.org\/content\/dam\/mayoclinic\/images\/logos\/mayo-clinic-logo.svg)](https:\/\/www.mayoclinic.org\/)\n\n[![Mayo Clinic Home Page](https:\/\/assets.mayoclinic.org\/content\/dam\/mayoclinic\/images\/logos\/mayo-clinic-logo.svg)](https:\/\/www.mayoclinic.org\/)\n\n- [Request appointment](https:\/\/www.mayoclinic.org\/appointments)\n- [Log in](https:\/\/onlineservices.mayoclinic.org\/content\/staticpatient\/showpage\/patientonline)\n- Search\n- Menu\n  \n  [Request appointment](https:\/\/www.mayoclinic.org\/appointments)\n  \n  [Donate](https:\/\/give.mayoclinic.org\/give\/609586\/#!\/donation\/checkout)\n  \n  [Diseases & conditions](https:\/\/www.mayoclinic.org\/diseases-conditions)\n  \n  [Find a doctor](https:\/\/www.mayoclinic.org\/appointments\/find-a-doctor)\n  \n  - 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Research & Education at Mayo Clinic\n    ## Research\n    [Research at Mayo Clinic](https:\/\/www.mayo.edu\/research)\n    \n    [Research Faculty](https:\/\/www.mayo.edu\/research\/faculty)\n    \n    [Laboratories](https:\/\/www.mayo.edu\/research\/labs)\n    \n    [Core Facilities](https:\/\/www.mayo.edu\/research\/core-facilities\/overview)\n    \n    [Centers & Programs](https:\/\/www.mayo.edu\/research\/centers-programs)\n    \n    [Departments & Divisions](https:\/\/www.mayo.edu\/research\/departments-divisions)\n    \n    [Clinical Trials](https:\/\/www.mayo.edu\/research\/clinical-trials)\n    \n    [Institutional Review Board](https:\/\/www.mayo.edu\/research\/institutional-review-board\/overview)\n    \n    [Postdoctoral Fellowships](https:\/\/jobs.mayoclinic.org\/search-jobs\/postdoctoral%20fellowships\/33647\/1)\n    \n    [Training Grant Programs](https:\/\/www.mayo.edu\/research\/training-grant-programs)\n    \n    ## Education\n    [Mayo Clinic College of Medicine and Science](https:\/\/college.mayo.edu\/)\n    \n    [Mayo Clinic Graduate School of Biomedical Sciences](https:\/\/college.mayo.edu\/academics\/biomedical-research-training\/)\n    \n    [Mayo Clinic Alix School of Medicine](https:\/\/college.mayo.edu\/academics\/mayo-clinic-alix-school-of-medicine\/)\n    \n    [Mayo Clinic School of Graduate Medical Education](https:\/\/college.mayo.edu\/academics\/residencies-and-fellowships\/)\n    \n    [Mayo Clinic School of Health Sciences](https:\/\/college.mayo.edu\/academics\/health-sciences-education\/)\n    \n    [Mayo Clinic School of Continuous Professional Development](https:\/\/ce.mayo.edu\/)\n    \n    [Mayo Clinic College of Medicine and Science](https:\/\/college.mayo.edu\/)\n    \n    ![](https:\/\/assets.mayoclinic.org\/content\/dam\/media\/global\/images\/2023\/06\/26\/mccms-Getty-1082003662-415x275.jpg)\n  - Giving to Mayo Clinic\n    [Give Now](https:\/\/give.mayoclinic.org\/campaign\/740556\/donate)\n    \n    [Giving to Mayo Clinic](https:\/\/www.mayoclinic.org\/giving-to-mayo-clinic)\n    \n    [Frequently Asked Questions](https:\/\/www.mayoclinic.org\/giving-to-mayo-clinic\/contact-us\/frequently-asked-questions)\n    \n    [Contact Us to Give](https:\/\/www.mayoclinic.org\/giving-to-mayo-clinic\/contact-us)\n    \n    [Make a Donation](https:\/\/give.mayoclinic.org\/campaign\/740556\/donate)\n    \n    ![](https:\/\/assets.mayoclinic.org\/content\/dam\/media\/global\/images\/2023\/10\/23\/giving-to-mayo-em100063715-p-195580295-415x275.png)\n\nSearch for a disease or condition . Type 3 or more letters to display suggested search options.\n\nWhen results are available, use up and down arrow keys to navigate. Press space key to fill the input with the suggestion or enter key to search with the suggestion.Search by keyword or phrase\n\nSearch\n\n[Home](https:\/\/www.mayoclinic.org\/)\n\n1. [Home](https:\/\/www.mayoclinic.org\/)\n2. [Diseases and Conditions](https:\/\/www.mayoclinic.org\/diseases-conditions)\n3. [Depression (major depressive disorder)](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/symptoms-causes\/syc-20356007)\n4. Tricyclic antidepressants and tetracyclic antidepressants\n\n# Tricyclic antidepressants and tetracyclic antidepressants\nTricyclic antidepressants affect brain chemicals to ease depression symptoms. Explore their possible side effects and whether one of these antidepressants may be a good option for you.\n\n[By Mayo Clinic Staff](https:\/\/www.mayoclinic.org\/about-this-site\/meet-our-medical-editors)\n\nOct. 08, 2024\n\nTricyclic antidepressants are among the earliest antidepressants developed. They're effective, but they've generally been replaced by antidepressants that cause fewer side effects. Tricyclic antidepressants may be a good option for some people. In certain cases, they ease depression when other treatments have failed.\n\n## How tricyclic antidepressants work\nTricyclic antidepressants ease depression by affecting chemical messengers called neurotransmitters. These chemical messengers communicate between brain cells. Like most antidepressants, tricyclic antidepressants work by causing changes in brain chemistry and communication in brain nerve cell circuitry known to affect mood. This helps lessen the symptoms of depression.\n\nTricyclic antidepressants block the neurotransmitters serotonin (ser-o-TOE-nin) and norepinephrine (nor-ep-ih-NEF-rin) from being taken back into nerve cells in the brain, a process called reuptake. Blocking reuptake raises the levels of these two neurotransmitters in the brain. Tricyclic antidepressants also affect other chemical messengers, which can lead to some of the antidepressants' side effects.\n\n## Tricyclic antidepressants approved to treat depression\nThe U.S. Food and Drug Administration, also called FDA, approved several tricyclic antidepressants to treat depression. Examples include:\n\n- Amitriptyline.\n- Desipramine (Norpramin).\n- Doxepin.\n- Imipramine.\n- Nortriptyline (Pamelor).\n- Protriptyline.\n\nSometimes tricyclic antidepressants are used to treat conditions other than depression. For example, the FDA approved clomipramine (Anafranil) to treat obsessive-compulsive disorder and imipramine to treat childhood bed-wetting. Some tricyclic antidepressants also are used to treat anxiety disorders and nerve-related pain called neuropathic pain and to prevent migraines.\n\nTricyclic antidepressants are a type of cyclic antidepressant. This type also includes tetracyclic antidepressants. Cyclic antidepressants are grouped depending on the number of rings in their chemical structure — three (tri) or four (tetra). In the United States, currently the FDA does not approve any tetracycline antidepressant to treat depression.\n\n## Possible side effects and cautions\nBecause of the different ways tricyclic antidepressants work, side effects vary somewhat from medicine to medicine. Some side effects may go away after a time. Others may lead you and your healthcare professional to try a different medicine. Side effects also may depend on the dose. Higher doses often cause more side effects.\n\nSome common possible side effects include:\n\n- Drowsiness.\n- Blurred vision.\n- Constipation.\n- Dry mouth.\n- Drop in blood pressure when moving from sitting to standing, which can cause lightheadedness.\n- Problems passing urine.\n\nOther possible side effects include:\n\n- Weight loss.\n- Urges to eat more, leading to weight gain.\n- Too much sweating.\n- Shakiness, also called tremor.\n- Sexual problems, such as trouble getting an erection, delayed orgasm or low sex drive.\n\nGenerally speaking:\n\n- **Amitriptyline, doxepin, imipramine and trimipramine** are more likely to make you sleepy than other tricyclic antidepressants are. Taking these medicines at bedtime may help.\n- **Amitriptyline, clomipramine, doxepin, imipramine and trimipramine** are more likely to cause weight gain than other tricyclic antidepressants are.\n- **Nortriptyline and desipramine** seem to have better tolerated side effects than other tricyclic antidepressants do.\n\nFor antidepressants that cause sleepiness, be careful about doing activities that require you to be alert until you know how the medicine will affect you. This can include not driving a car or operating heavy machinery such as construction equipment.\n\nWhich antidepressant is best for you depends on several factors, such as your symptoms and any other health conditions you may have. Ask your healthcare professional and pharmacist about the most common possible side effects for the antidepressant prescribed for you. Also read the patient medicine guide that comes with the prescription.\n\n## Safety issues\nSome tricyclic antidepressants are more likely to cause side effects that affect safety. These side effects include:\n\n- Disorientation or confusion, especially in older people when the dose is too high.\n- Heartbeat that is too fast or not regular.\n- Seizures that happen more often in people who have seizures.\n\nBefore you take a tricyclic antidepressant, talk with your healthcare professional about:\n\n- **Antidepressants and pregnancy.** Talk to your healthcare professional about the risks and benefits of using specific antidepressants. Some antidepressants may harm your baby if you take them during pregnancy or while you're breastfeeding. If you're taking an antidepressant and you're considering getting pregnant, talk with your healthcare professional about the possible risks. Don't stop taking your medicine without talking to your healthcare professional first. Stopping an antidepressant might put you at risk of withdrawal-like symptoms or returning depression.\n- **Interactions with other medicines and supplements.**  When taking an antidepressant, tell your healthcare professional about any other prescription or nonprescription medicines, herbs or other supplements you're taking. Some antidepressants can cause dangerous reactions when combined with some medicines or herbal supplements.\n- **Serotonin syndrome.** Rarely, an antidepressant can cause high levels of serotonin to build up in your body. Serotonin syndrome most often happens when two medicines that both raise the level of serotonin are taken together. These include other antidepressants, some pain or headache medicines, and the herbal supplement St. John's wort.\n  Symptoms of serotonin syndrome include anxiety, nervousness, high fever, sweating, confusion, tremors, restlessness, lack of coordination, major changes in blood pressure and a fast heartbeat. Get medical care right away if you have any of these symptoms.\n- **Safety and blood tests.**  Your healthcare professional may recommend blood tests to measure the medicine levels to decide on the most effective dose. Some side effects and benefits of tricyclic antidepressants depend on the dose. Overdose of tricyclic antidepressants can be dangerous.\n- **Long-term health conditions.**  Tricyclic antidepressants can cause problems in people with certain health conditions. For example, if you have narrow-angle glaucoma, an enlarged prostate, heart problems, diabetes or a history of seizures, talk with your healthcare professional to decide if a tricyclic antidepressant is a safe choice for you.\n\n## Suicide risk and antidepressants\nMost antidepressants are generally safe, but the FDA requires that all antidepressants carry boxed warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants. This may be more likely in the first few weeks after starting the medicine or when the dose is changed. There has been no evidence that this increase in suicidal thoughts or behaviors has resulted in completed suicides.\n\nAnyone taking an antidepressant should be watched closely for worsening depression or unusual behavior. If you or someone you know has suicidal thoughts when taking an antidepressant, call your healthcare professional right away or get emergency help.\n\nKeep in mind that depression that's not treated is a more concerning risk factor for suicide. And antidepressants may lessen suicide risk in the long run by improving mood for many people.\n\n## Stopping treatment with tricyclic antidepressants\nTricyclic antidepressants aren't considered habit-forming. But suddenly stopping antidepressant treatment or missing several doses can cause withdrawal-like symptoms. Symptoms may vary depending on how the medicine works. This is sometimes called discontinuation syndrome. Work with your healthcare professional to slowly and safely lower your dose over time.\n\nWithdrawal-like symptoms can include:\n\n- Restlessness, irritability or anxiety.\n- Upset stomach.\n- Feelings of tingling or burning.\n- Flu-like symptoms, such as chills, sweating and muscle aches.\n- Trouble sleeping.\n- Sluggishness, tiredness or sleepiness.\n- Headache.\n- Dizziness.\n\n## Finding the right antidepressant\nPeople may react differently to the same antidepressant. For example, one medicine may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does.\n\nTraits passed down in your family may play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a specific antidepressant. Pharmacogenomics — the study of how drugs work coupled with information about human genes — is sometimes available to tailor medications and their doses for people based on their genetic makeup. But other things besides genetics can affect your response to medicine.\n\nWhen choosing an antidepressant, your healthcare professional considers your symptoms, any health problems, other medicines you take, and what's worked for you in the past.\n\nTypically, it may take several weeks or longer before an antidepressant fully works and for early side effects to ease up. Your healthcare professional may recommend some dose changes or different antidepressants. With patience, you and your healthcare professional can find a medicine that works well for you.\n\nShow references\n\n1. Depression medicines. U.S. Food and Drug Administration. https:\/\/www.fda.gov\/consumers\/womens-health-topics\/depression-medicines. Accessed July 29, 2024.\n2. Depression. National Institute of Mental Health. https:\/\/www.nimh.nih.gov\/health\/topics\/depression. Accessed July 29, 2024.\n3. Mental health medications. National Institute of Mental Health. https:\/\/www.nimh.nih.gov\/health\/topics\/mental-health-medications\\#part\\_2364. Accessed July 29, 2024.\n4. Radosavljevic M, et al. The role of pharmacogenetics in personalizing the antidepressant and anxiolytic therapy. Genes. 2023; doi:10.3390\/genes14051095.\n5. Henssler J, et al. Incidence of antidepressant discontinuation symptoms: A systematic review and meta-analysis. Lancet Psychiatry. 2024; doi:10.1016\/S2215-0366(24)00133-0.\n6. Hirsch M, et al. Tricyclic and tetracyclic drugs: Pharmacology, administration, and side effects. https:\/\/www.uptodate.com\/contents\/search. Accessed July 29, 2024.\n7. Medicine for depression: Tricyclic and tetracyclic antidepressants. U.S. Department of Veterans Affairs. https:\/\/www.veteranshealthlibrary.va.gov\/MentalHealth\/Depression\/Treatment\/142,HW29398\\_VA. Accessed July 29, 2024.\n8. Tricyclic antidepressants. Facts & Comparisons eAnswers. https:\/\/fco.factsandcomparisons.com. Accessed July 29, 2024.\n9. Green C. Antidepressant discontinuation and the role of the pharmacist. Canadian Pharmacists Journal. 2023; doi:10.1177\/17151635231188340.\n10. Ritter JM, et al. Antidepressant drugs. In: Rang and Dale's Pharmacology. 10th ed. Elsevier; 2024. https:\/\/www.clinicalkey.com. Accessed July 30, 2024.\n11. Medical review (expert opinion). Mayo Clinic. Sept. 16, 2024.\n12. Medical review (expert opinion). Mayo Clinic. Sept. 16, 2024.\n\n[Print](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046983?p=1)\n\n## Related content\n- [Addison's disease](https:\/\/www.mayoclinic.org\/diseases-conditions\/addisons-disease\/symptoms-causes\/syc-20350293)\n- [Adjustment disorders](https:\/\/www.mayoclinic.org\/diseases-conditions\/adjustment-disorders\/symptoms-causes\/syc-20355224)\n- [Adrenal fatigue: What causes it?](https:\/\/www.mayoclinic.org\/diseases-conditions\/addisons-disease\/expert-answers\/adrenal-fatigue\/faq-20057906)\n- [Alzheimer's disease](https:\/\/www.mayoclinic.org\/diseases-conditions\/alzheimers-disease\/symptoms-causes\/syc-20350447)\n- [Alzheimer's genes: Are you at risk?](https:\/\/www.mayoclinic.org\/diseases-conditions\/alzheimers-disease\/in-depth\/alzheimers-genes\/art-20046552)\n- [Alzheimer's prevention: Does it 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right for you](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046273)\n- [Antidepressants: Which cause the fewest sexual side effects?](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/expert-answers\/antidepressants\/faq-20058104)\n- [Are you at risk of hidradenitis suppurativa?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/expert-answers\/risk-factors-hidradenitis-suppurativa\/faq-20182594)\n- [Atypical antidepressants](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/atypical-antidepressants\/art-20048208)\n- [Binge-eating disorder](https:\/\/www.mayoclinic.org\/diseases-conditions\/binge-eating-disorder\/symptoms-causes\/syc-20353627)\n- [Borderline personality disorder](https:\/\/www.mayoclinic.org\/diseases-conditions\/borderline-personality-disorder\/symptoms-causes\/syc-20370237)\n- [Can zinc supplements help treat hidradenitis suppurativa?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/expert-answers\/can-zinc-supplements-help-treat-hidradenitis-suppurativa\/faq-20476171)\n- [Care tips for hidradenitis suppurativa wounds](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/care-tips-for-hidradenitis-suppurativa-wounds\/art-20404807)\n- [Celiac disease](https:\/\/www.mayoclinic.org\/diseases-conditions\/celiac-disease\/symptoms-causes\/syc-20352220)\n- [Child abuse](https:\/\/www.mayoclinic.org\/diseases-conditions\/child-abuse\/symptoms-causes\/syc-20370864)\n- [Chronic traumatic encephalopathy](https:\/\/www.mayoclinic.org\/diseases-conditions\/chronic-traumatic-encephalopathy\/symptoms-causes\/syc-20370921)\n- [Cigar smoking](https:\/\/www.mayoclinic.org\/diseases-conditions\/nicotine-dependence\/expert-answers\/cigar-smoking\/faq-20057787)\n- [Clinical depression: What does that mean?](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/expert-answers\/clinical-depression\/faq-20057770)\n- [Clinical trials for hidradenitis suppurativa](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/expert-answers\/clinical-trials-for-hidradenitis-suppurativa\/faq-20448248)\n- [Coconut oil: Can it cure hypothyroidism?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypothyroidism\/expert-answers\/coconut-oil-thyroid\/faq-20058244)\n- [Complete blood count (CBC)](https:\/\/www.mayoclinic.org\/tests-procedures\/complete-blood-count\/about\/pac-20384919)\n- [Complicated grief](https:\/\/www.mayoclinic.org\/diseases-conditions\/complicated-grief\/symptoms-causes\/syc-20360374)\n- [Compulsive sexual behavior](https:\/\/www.mayoclinic.org\/diseases-conditions\/compulsive-sexual-behavior\/symptoms-causes\/syc-20360434)\n- [Concussion](https:\/\/www.mayoclinic.org\/diseases-conditions\/concussion\/symptoms-causes\/syc-20355594)\n- [Concussion in children](https:\/\/www.mayoclinic.org\/diseases-conditions\/concussion\/expert-answers\/concussion-in-children\/faq-20058282)\n- [Coping with the emotional ups and downs of psoriatic arthritis](https:\/\/www.mayoclinic.org\/diseases-conditions\/psoriatic-arthritis\/in-depth\/coping-with-the-emotional-ups-and-downs-of-psoriatic-arthritis\/art-20272594)\n- [Coping with the stress of hidradenitis suppurativa](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/hidradenitis-suppurativa-coping\/art-20168982)\n- [Coughing more after quitting smoking: What's the deal?](https:\/\/www.mayoclinic.org\/diseases-conditions\/nicotine-dependence\/expert-answers\/quit-smoking\/faq-20057818)\n- [COVID-19 and your mental health](https:\/\/www.mayoclinic.org\/diseases-conditions\/coronavirus\/in-depth\/mental-health-covid-19\/art-20482731)\n- [Creating a hidradenitis suppurativa care team](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/hidradenitis-suppurativa-care-team\/art-20308336)\n- [Creutzfeldt-Jakob disease](https:\/\/www.mayoclinic.org\/diseases-conditions\/creutzfeldt-jakob-disease\/symptoms-causes\/syc-20371226)\n- [Cushing syndrome](https:\/\/www.mayoclinic.org\/diseases-conditions\/cushing-syndrome\/symptoms-causes\/syc-20351310)\n- [Cyclothymia (cyclothymic disorder)](https:\/\/www.mayoclinic.org\/diseases-conditions\/cyclothymia\/symptoms-causes\/syc-20371275)\n- [Delirium](https:\/\/www.mayoclinic.org\/diseases-conditions\/delirium\/symptoms-causes\/syc-20371386)\n- [Delusional parasitosis](https:\/\/www.mayoclinic.org\/diseases-conditions\/mental-illness\/in-depth\/delusional-parasitosis\/art-20044996)\n- [Depression (major depressive disorder)](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/symptoms-causes\/syc-20356007)\n- [Depression and anxiety: Can I have both?](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/expert-answers\/depression-and-anxiety\/faq-20057989)\n- [Depression and anxiety: Exercise eases symptoms](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/depression-and-exercise\/art-20046495)\n- [Depression during pregnancy: You're not alone](https:\/\/www.mayoclinic.org\/healthy-lifestyle\/pregnancy-week-by-week\/in-depth\/depression-during-pregnancy\/art-20237875)\n- [Depression in women: Understanding the gender gap](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/depression\/art-20047725)\n- [Depression: Supporting a family member or friend](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/depression\/art-20045943)\n- [Diabetes and depression: Coping with the two conditions](https:\/\/www.mayoclinic.org\/diseases-conditions\/diabetes\/expert-answers\/diabetes-and-depression\/faq-20057904)\n- [Diagnosing Alzheimer's: How Alzheimer's is diagnosed](https:\/\/www.mayoclinic.org\/diseases-conditions\/alzheimers-disease\/in-depth\/alzheimers\/art-20048075)\n- [Did the definition of Alzheimer's disease change?](https:\/\/www.mayoclinic.org\/diseases-conditions\/alzheimers-disease\/expert-answers\/defining-alzheimers-disease\/faq-20436675)\n- [Dissociative disorders](https:\/\/www.mayoclinic.org\/diseases-conditions\/dissociative-disorders\/symptoms-causes\/syc-20355215)\n- [Drug addiction (substance use disorder)](https:\/\/www.mayoclinic.org\/diseases-conditions\/drug-addiction\/symptoms-causes\/syc-20365112)\n- [Electroconvulsive therapy (ECT)](https:\/\/www.mayoclinic.org\/tests-procedures\/electroconvulsive-therapy\/about\/pac-20393894)\n- [Fibromyalgia](https:\/\/www.mayoclinic.org\/diseases-conditions\/fibromyalgia\/symptoms-causes\/syc-20354780)\n- [Hangovers](https:\/\/www.mayoclinic.org\/diseases-conditions\/hangovers\/symptoms-causes\/syc-20373012)\n- [Hashimoto's disease](https:\/\/www.mayoclinic.org\/diseases-conditions\/hashimotos-disease\/symptoms-causes\/syc-20351855)\n- [Hidradenitis suppurativa](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/symptoms-causes\/syc-20352306)\n- [Hidradenitis suppurativa and biologics: Get the facts](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/biologics-and-hidradenitis-suppurativa\/art-20308338)\n- [Hidradenitis suppurativa and diet: What's recommended?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/expert-answers\/hidradenitis-suppurativa-diet\/faq-20182593)\n- [Hidradenitis suppurativa and sleep: How to get more zzz's](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/hidradenitis-suppurativa-and-sleep-how-to-get-more-zzzs\/art-20475494)\n- [Hidradenitis suppurativa: Tips for weight-loss success](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/hidradenitis-suppurativa-tips-for-weight-loss-success\/art-20473742)\n- [Hidradenitis suppurativa: What is it?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/expert-answers\/what-is-hidradenitis-suppurativa\/faq-20168976)\n- [Hidradenitis suppurativa: When does it appear?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/hidradenitis-suppurativa-appear\/art-20168979)\n- [Hidradenitis suppurativa: Where can I find support?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/expert-answers\/hidradenitis-suppurativa-where-can-i-find-support\/faq-20476173)\n- [Hookah smoking](https:\/\/www.mayoclinic.org\/diseases-conditions\/nicotine-dependence\/expert-answers\/hookah\/faq-20057920)\n- [How opioid use disorder occurs](https:\/\/www.mayoclinic.org\/diseases-conditions\/prescription-drug-abuse\/in-depth\/how-opioid-addiction-occurs\/art-20360372)\n- [How to tell if a loved one is abusing opioids](https:\/\/www.mayoclinic.org\/diseases-conditions\/prescription-drug-abuse\/in-depth\/how-to-tell-if-a-loved-one-is-abusing-opioids\/art-20386038)\n- [Hyperparathyroidism](https:\/\/www.mayoclinic.org\/diseases-conditions\/hyperparathyroidism\/symptoms-causes\/syc-20356194)\n- [Hypoparathyroidism](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypoparathyroidism\/symptoms-causes\/syc-20355375)\n- [Hypothyroidism (underactive thyroid)](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypothyroidism\/symptoms-causes\/syc-20350284)\n- [Hypothyroidism and joint pain?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypothyroidism\/expert-answers\/hypothyroidism\/faq-20057789)\n- [Hypothyroidism diet](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypothyroidism\/expert-answers\/hypothyroidism-diet\/faq-20058554)\n- [Hypothyroidism symptoms: Can hypothyroidism cause eye problems?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypothyroidism\/expert-answers\/hypothyroidism-symptoms\/faq-20058058)\n- [Hypothyroidism: Can calcium supplements interfere with treatment?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypothyroidism\/expert-answers\/hypothyroidism\/faq-20058536)\n- [Hypothyroidism: Should I take iodine supplements?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypothyroidism\/expert-answers\/hypothyroidism-iodine\/faq-20057929)\n- [Infographic: Pancreatic Cancer: Minimally Invasive Surgery](https:\/\/www.mayoclinic.org\/diseases-conditions\/pancreatic-cancer\/multimedia\/minimally-invasive-pancreatic-cancer-infographic\/ifg-20441211)\n- [Infographic: Pancreatic Cancers-Whipple](https:\/\/www.mayoclinic.org\/diseases-conditions\/pancreatic-cancer\/multimedia\/pancreatic-cancers-whipple-infographic\/ifg-20473414)\n- [Insomnia](https:\/\/www.mayoclinic.org\/diseases-conditions\/insomnia\/symptoms-causes\/syc-20355167)\n- [Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills](https:\/\/www.mayoclinic.org\/diseases-conditions\/insomnia\/in-depth\/insomnia-treatment\/art-20046677)\n- [Insomnia: How do I stay asleep?](https:\/\/www.mayoclinic.org\/diseases-conditions\/insomnia\/expert-answers\/insomnia\/faq-20057824)\n- [Intervention: Help a loved one overcome addiction](https:\/\/www.mayoclinic.org\/diseases-conditions\/mental-illness\/in-depth\/intervention\/art-20047451)\n- [Is depression a factor in rheumatoid arthritis?](https:\/\/www.mayoclinic.org\/diseases-conditions\/rheumatoid-arthritis\/expert-answers\/rheumatoid-arthritis-depression\/faq-20119780)\n- [Kratom for opioid withdrawal: Does it work?](https:\/\/www.mayoclinic.org\/diseases-conditions\/prescription-drug-abuse\/in-depth\/kratom-opioid-withdrawal\/art-20402170)\n- [Kratom: Unsafe and ineffective](https:\/\/www.mayoclinic.org\/diseases-conditions\/prescription-drug-abuse\/in-depth\/kratom\/art-20402171)\n- [Lack of sleep: Can it make you sick?](https:\/\/www.mayoclinic.org\/diseases-conditions\/insomnia\/expert-answers\/lack-of-sleep\/faq-20057757)\n- [Lecanemab for Alzheimer's disease: An option for you?](https:\/\/www.mayoclinic.org\/diseases-conditions\/alzheimers-disease\/in-depth\/lecanemab\/art-20548103)\n- [Low blood pressure (hypotension)](https:\/\/www.mayoclinic.org\/diseases-conditions\/low-blood-pressure\/symptoms-causes\/syc-20355465)\n- [Male depression: Understanding the issues](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/male-depression\/art-20046216)\n- [Managing hidradenitis suppurativa: Early treatment is crucial](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/hidradenitis-suppurativa-early-treatment\/art-20168981)\n- [Managing other health risks when you have hidradenitis suppurativa](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/managing-other-health-risks-when-you-have-hidradenitis-suppurativa\/art-20399321)\n- [MAOIs and diet: Is it necessary to restrict tyramine?](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/expert-answers\/maois\/faq-20058035)\n- [Marijuana and depression](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/expert-answers\/marijuana-and-depression\/faq-20058060)\n- [Medication overuse headaches](https:\/\/www.mayoclinic.org\/diseases-conditions\/medication-overuse-headache\/symptoms-causes\/syc-20377083)\n- [Meditation: A simple, fast way to reduce stress](https:\/\/www.mayoclinic.org\/tests-procedures\/meditation\/in-depth\/meditation\/art-20045858)\n- [Memory loss: When to seek help](https:\/\/www.mayoclinic.org\/diseases-conditions\/alzheimers-disease\/in-depth\/memory-loss\/art-20046326)\n- [Mental health providers: Tips on finding one](https:\/\/www.mayoclinic.org\/diseases-conditions\/mental-illness\/in-depth\/mental-health-providers\/art-20045530)\n- [Mental health: Overcoming the stigma of mental illness](https:\/\/www.mayoclinic.org\/diseases-conditions\/mental-illness\/in-depth\/mental-health\/art-20046477)\n- [Mental health: What's normal, what's not](https:\/\/www.mayoclinic.org\/healthy-lifestyle\/adult-health\/in-depth\/mental-health\/art-20044098)\n- [Mental illness](https:\/\/www.mayoclinic.org\/diseases-conditions\/mental-illness\/symptoms-causes\/syc-20374968)\n- [Migraine](https:\/\/www.mayoclinic.org\/diseases-conditions\/migraine-headache\/symptoms-causes\/syc-20360201)\n- [Migraine medicines and antidepressants](https:\/\/www.mayoclinic.org\/diseases-conditions\/migraine-headache\/expert-answers\/migraine-medications\/faq-20058166)\n- [Migraine treatment: Can antidepressants help?](https:\/\/www.mayoclinic.org\/diseases-conditions\/migraine-headache\/expert-answers\/migraine-treatment\/faq-20058410)\n- [Migraines and gastrointestinal problems: Is there a link?](https:\/\/www.mayoclinic.org\/diseases-conditions\/migraine-headache\/expert-answers\/migraines\/faq-20058268)\n- [Migraines: Are they triggered by weather changes?](https:\/\/www.mayoclinic.org\/diseases-conditions\/migraine-headache\/expert-answers\/migraine-headache\/faq-20058505)\n- [Migraines: Simple steps to head off the pain](https:\/\/www.mayoclinic.org\/diseases-conditions\/migraine-headache\/in-depth\/migraines\/art-20047242)\n- [Mild cognitive impairment (MCI)](https:\/\/www.mayoclinic.org\/diseases-conditions\/mild-cognitive-impairment\/symptoms-causes\/syc-20354578)\n- [Monoamine oxidase inhibitors (MAOIs)](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/maois\/art-20043992)\n- [Natural remedies for depression: Are they effective?](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/expert-answers\/natural-remedies-for-depression\/faq-20058026)\n- [Nervous breakdown: What does it mean?](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/expert-answers\/nervous-breakdown\/faq-20057830)\n- [New FDA-approved blood tests for diagnosing Alzheimer's disease](https:\/\/www.mayoclinic.org\/diseases-conditions\/alzheimers-disease\/in-depth\/new-blood-tests-alzheimers\/art-20585060)\n- [Nicotine dependence](https:\/\/www.mayoclinic.org\/diseases-conditions\/nicotine-dependence\/symptoms-causes\/syc-20351584)\n- [Occipital nerve stimulation: Effective migraine treatment?](https:\/\/www.mayoclinic.org\/diseases-conditions\/migraine-headache\/expert-answers\/occipital-nerve-stimulation\/faq-20057788)\n- [Ocular migraine: When to seek help](https:\/\/www.mayoclinic.org\/diseases-conditions\/migraine-headache\/expert-answers\/ocular-migraine\/faq-20058113)\n- [Opioid stewardship: What is it?](https:\/\/www.mayoclinic.org\/diseases-conditions\/prescription-drug-abuse\/expert-answers\/opioid-stewardship\/faq-20559908)\n- [Oppositional defiant disorder (ODD)](https:\/\/www.mayoclinic.org\/diseases-conditions\/oppositional-defiant-disorder\/symptoms-causes\/syc-20375831)\n- [Pain and depression: Is there a link?](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/expert-answers\/pain-and-depression\/faq-20057823)\n- [Pancreatic cancer](https:\/\/www.mayoclinic.org\/diseases-conditions\/pancreatic-cancer\/symptoms-causes\/syc-20355421)\n- [Perimenopause](https:\/\/www.mayoclinic.org\/diseases-conditions\/perimenopause\/symptoms-causes\/syc-20354666)\n- [Pituitary tumors and adenomas](https:\/\/www.mayoclinic.org\/diseases-conditions\/pituitary-tumors\/symptoms-causes\/syc-20350548)\n- [Polymyalgia rheumatica](https:\/\/www.mayoclinic.org\/diseases-conditions\/polymyalgia-rheumatica\/symptoms-causes\/syc-20376539)\n- [Poppy seed tea: Beneficial or dangerous?](https:\/\/www.mayoclinic.org\/diseases-conditions\/drug-addiction\/expert-answers\/poppy-seed-tea\/faq-20559907)\n- [Premenstrual dysphoric disorder](https:\/\/www.mayoclinic.org\/diseases-conditions\/premenstrual-syndrome\/expert-answers\/pmdd\/faq-20058315)\n- [Premenstrual syndrome (PMS)](https:\/\/www.mayoclinic.org\/diseases-conditions\/premenstrual-syndrome\/symptoms-causes\/syc-20376780)\n- [Prescription drug abuse](https:\/\/www.mayoclinic.org\/diseases-conditions\/prescription-drug-abuse\/symptoms-causes\/syc-20376813)\n- [Prescription sleeping pills: What's right for you?](https:\/\/www.mayoclinic.org\/diseases-conditions\/insomnia\/in-depth\/sleeping-pills\/art-20043959)\n- [Progressive supranuclear palsy](https:\/\/www.mayoclinic.org\/diseases-conditions\/progressive-supranuclear-palsy\/symptoms-causes\/syc-20355659)\n- [Psychotherapy](https:\/\/www.mayoclinic.org\/tests-procedures\/psychotherapy\/about\/pac-20384616)\n- [Quit-smoking products: Boost your chance of success](https:\/\/www.mayoclinic.org\/diseases-conditions\/nicotine-dependence\/in-depth\/quit-smoking-products\/art-20045599)\n- [Quitting smoking: 10 ways to resist tobacco cravings](https:\/\/www.mayoclinic.org\/diseases-conditions\/nicotine-dependence\/in-depth\/nicotine-craving\/art-20045454)\n- [Reducing the discomfort of hidradenitis suppurativa: Self-care tips](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/hidradenitis-suppurativa-self-care\/art-20168983)\n- [Restless legs syndrome](https:\/\/www.mayoclinic.org\/diseases-conditions\/restless-legs-syndrome\/symptoms-causes\/syc-20377168)\n- [Salt craving: A symptom of Addison's disease?](https:\/\/www.mayoclinic.org\/diseases-conditions\/addisons-disease\/expert-answers\/salt-craving\/faq-20057988)\n- [Schizoaffective disorder](https:\/\/www.mayoclinic.org\/diseases-conditions\/schizoaffective-disorder\/symptoms-causes\/syc-20354504)\n- [Seasonal affective disorder (SAD)](https:\/\/www.mayoclinic.org\/diseases-conditions\/seasonal-affective-disorder\/symptoms-causes\/syc-20364651)\n- [Seasonal affective disorder treatment: Choosing a light box](https:\/\/www.mayoclinic.org\/diseases-conditions\/seasonal-affective-disorder\/in-depth\/seasonal-affective-disorder-treatment\/art-20048298)\n- [Selective serotonin reuptake inhibitors (SSRIs)](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/ssris\/art-20044825)\n- [Serotonin and norepinephrine reuptake inhibitors (SNRIs)](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/snris\/art-20044970)\n- [Sleep tips: 6 steps to better sleep](https:\/\/www.mayoclinic.org\/healthy-lifestyle\/adult-health\/in-depth\/sleep\/art-20048379)\n- [Smokeless tobacco products](https:\/\/www.mayoclinic.org\/diseases-conditions\/nicotine-dependence\/in-depth\/chewing-tobacco\/art-20047428)\n- [Soy: Does it worsen hypothyroidism?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hypothyroidism\/expert-answers\/hyperthyroidism\/faq-20058188)\n- [Staying active with hidradenitis suppurativa](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/hidradenitis-suppurativa-exercise\/art-20182592)\n- [Stress symptoms: Effects on your body and behavior](https:\/\/www.mayoclinic.org\/healthy-lifestyle\/stress-management\/in-depth\/stress-symptoms\/art-20050987)\n- [Suicide grief](https:\/\/www.mayoclinic.org\/diseases-conditions\/complicated-grief\/in-depth\/suicide\/art-20044900)\n- [Sundowning: Late-day confusion](https:\/\/www.mayoclinic.org\/diseases-conditions\/alzheimers-disease\/expert-answers\/sundowning\/faq-20058511)\n- [Support groups: Make connections, get help](https:\/\/www.mayoclinic.org\/healthy-lifestyle\/stress-management\/in-depth\/support-groups\/art-20044655)\n- [Surgery for hidradenitis suppurativa](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/surgery-and-hidradenitis-suppurativa\/art-20308339)\n- [Symptom Checker](https:\/\/www.mayoclinic.org\/symptom-checker\/select-symptom\/itt-20009075)\n- [Tapering off opioids: When and how](https:\/\/www.mayoclinic.org\/diseases-conditions\/prescription-drug-abuse\/in-depth\/tapering-off-opioids-when-and-how\/art-20386036)\n- [Thyroid peroxidase antibody test: What is it?](https:\/\/www.mayoclinic.org\/diseases-conditions\/hashimotos-disease\/expert-answers\/thyroid-disease\/faq-20058114)\n- [Tianeptine: Is safe use possible?](https:\/\/www.mayoclinic.org\/healthy-lifestyle\/consumer-health\/in-depth\/tianeptine-is-safe-use-possible\/art-20562252)\n- [Tinnitus and antidepressants](https:\/\/www.mayoclinic.org\/diseases-conditions\/tinnitus\/expert-answers\/tinnitus-causes\/faq-20057804)\n- [Transcranial magnetic stimulation](https:\/\/www.mayoclinic.org\/tests-procedures\/transcranial-magnetic-stimulation\/about\/pac-20384625)\n- [Traumatic brain injury](https:\/\/www.mayoclinic.org\/diseases-conditions\/traumatic-brain-injury\/symptoms-causes\/syc-20378557)\n- [Treating hidradenitis suppurativa with antibiotics and hormones](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/antibiotics-and-hidradenitis-suppurativa\/art-20308337)\n- [Treating hidradenitis suppurativa: Explore your options](https:\/\/www.mayoclinic.org\/diseases-conditions\/hidradenitis-suppurativa\/in-depth\/treating-hidradenitis-suppurativa\/art-20308335)\n- [Treatment-resistant 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All rights reserved.\n\nLanguage:\n\nEnglish\n\n- [English](https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046983)\n- [Español](https:\/\/www.mayoclinic.org\/es\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046983)\n- [العربية](https:\/\/www.mayoclinic.org\/ar\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046983)\n- [简体中文](https:\/\/www.mayoclinic.org\/zh-hans\/diseases-conditions\/depression\/in-depth\/antidepressants\/art-20046983)","attrs_readable_markdown":"People may react differently to the same antidepressant. For example, one medicine may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does.\n\nTraits passed down in your family may play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a specific antidepressant. Pharmacogenomics — the study of how drugs work coupled with information about human genes — is sometimes available to tailor medications and their doses for people based on their genetic makeup. But other things besides genetics can affect your response to medicine.\n\nWhen choosing an antidepressant, your healthcare professional considers your symptoms, any health problems, other medicines you take, and what's worked for you in the past.\n\nTypically, it may take several weeks or longer before an antidepressant fully works and for early side effects to ease up. Your healthcare professional may recommend some dose changes or different antidepressants. With patience, you and your healthcare professional can find a medicine that works well for you.","meta_canonical":null}

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Boilerpipe Text	People may react differently to the same antidepressant. For example, one medicine may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does. Traits passed down in your family may play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a specific antidepressant. Pharmacogenomics — the study of how drugs work coupled with information about human genes — is sometimes available to tailor medications and their doses for people based on their genetic makeup. But other things besides genetics can affect your response to medicine. When choosing an antidepressant, your healthcare professional considers your symptoms, any health problems, other medicines you take, and what's worked for you in the past. Typically, it may take several weeks or longer before an antidepressant fully works and for early side effects to ease up. Your healthcare professional may recommend some dose changes or different antidepressants. With patience, you and your healthcare professional can find a medicine that works well for you.
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Type 3 or more letters to display suggested search options. When results are available, use up and down arrow keys to navigate. Press space key to fill the input with the suggestion or enter key to search with the suggestion.Search by keyword or phrase Search [Home](https://www.mayoclinic.org/) 1. [Home](https://www.mayoclinic.org/) 2. [Diseases and Conditions](https://www.mayoclinic.org/diseases-conditions) 3. [Depression (major depressive disorder)](https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007) 4. Tricyclic antidepressants and tetracyclic antidepressants # Tricyclic antidepressants and tetracyclic antidepressants Tricyclic antidepressants affect brain chemicals to ease depression symptoms. Explore their possible side effects and whether one of these antidepressants may be a good option for you. [By Mayo Clinic Staff](https://www.mayoclinic.org/about-this-site/meet-our-medical-editors) Oct. 08, 2024 Tricyclic antidepressants are among the earliest antidepressants developed. They're effective, but they've generally been replaced by antidepressants that cause fewer side effects. Tricyclic antidepressants may be a good option for some people. In certain cases, they ease depression when other treatments have failed. ## How tricyclic antidepressants work Tricyclic antidepressants ease depression by affecting chemical messengers called neurotransmitters. These chemical messengers communicate between brain cells. Like most antidepressants, tricyclic antidepressants work by causing changes in brain chemistry and communication in brain nerve cell circuitry known to affect mood. This helps lessen the symptoms of depression. Tricyclic antidepressants block the neurotransmitters serotonin (ser-o-TOE-nin) and norepinephrine (nor-ep-ih-NEF-rin) from being taken back into nerve cells in the brain, a process called reuptake. Blocking reuptake raises the levels of these two neurotransmitters in the brain. Tricyclic antidepressants also affect other chemical messengers, which can lead to some of the antidepressants' side effects. ## Tricyclic antidepressants approved to treat depression The U.S. Food and Drug Administration, also called FDA, approved several tricyclic antidepressants to treat depression. Examples include: - Amitriptyline. - Desipramine (Norpramin). - Doxepin. - Imipramine. - Nortriptyline (Pamelor). - Protriptyline. Sometimes tricyclic antidepressants are used to treat conditions other than depression. For example, the FDA approved clomipramine (Anafranil) to treat obsessive-compulsive disorder and imipramine to treat childhood bed-wetting. Some tricyclic antidepressants also are used to treat anxiety disorders and nerve-related pain called neuropathic pain and to prevent migraines. Tricyclic antidepressants are a type of cyclic antidepressant. This type also includes tetracyclic antidepressants. Cyclic antidepressants are grouped depending on the number of rings in their chemical structure — three (tri) or four (tetra). In the United States, currently the FDA does not approve any tetracycline antidepressant to treat depression. ## Possible side effects and cautions Because of the different ways tricyclic antidepressants work, side effects vary somewhat from medicine to medicine. Some side effects may go away after a time. Others may lead you and your healthcare professional to try a different medicine. Side effects also may depend on the dose. Higher doses often cause more side effects. Some common possible side effects include: - Drowsiness. - Blurred vision. - Constipation. - Dry mouth. - Drop in blood pressure when moving from sitting to standing, which can cause lightheadedness. - Problems passing urine. Other possible side effects include: - Weight loss. - Urges to eat more, leading to weight gain. - Too much sweating. - Shakiness, also called tremor. - Sexual problems, such as trouble getting an erection, delayed orgasm or low sex drive. Generally speaking: - Amitriptyline, doxepin, imipramine and trimipramine are more likely to make you sleepy than other tricyclic antidepressants are. Taking these medicines at bedtime may help. - Amitriptyline, clomipramine, doxepin, imipramine and trimipramine are more likely to cause weight gain than other tricyclic antidepressants are. - Nortriptyline and desipramine seem to have better tolerated side effects than other tricyclic antidepressants do. For antidepressants that cause sleepiness, be careful about doing activities that require you to be alert until you know how the medicine will affect you. This can include not driving a car or operating heavy machinery such as construction equipment. Which antidepressant is best for you depends on several factors, such as your symptoms and any other health conditions you may have. Ask your healthcare professional and pharmacist about the most common possible side effects for the antidepressant prescribed for you. Also read the patient medicine guide that comes with the prescription. ## Safety issues Some tricyclic antidepressants are more likely to cause side effects that affect safety. These side effects include: - Disorientation or confusion, especially in older people when the dose is too high. - Heartbeat that is too fast or not regular. - Seizures that happen more often in people who have seizures. Before you take a tricyclic antidepressant, talk with your healthcare professional about: - Antidepressants and pregnancy. Talk to your healthcare professional about the risks and benefits of using specific antidepressants. Some antidepressants may harm your baby if you take them during pregnancy or while you're breastfeeding. If you're taking an antidepressant and you're considering getting pregnant, talk with your healthcare professional about the possible risks. Don't stop taking your medicine without talking to your healthcare professional first. Stopping an antidepressant might put you at risk of withdrawal-like symptoms or returning depression. - Interactions with other medicines and supplements. When taking an antidepressant, tell your healthcare professional about any other prescription or nonprescription medicines, herbs or other supplements you're taking. Some antidepressants can cause dangerous reactions when combined with some medicines or herbal supplements. - Serotonin syndrome. Rarely, an antidepressant can cause high levels of serotonin to build up in your body. Serotonin syndrome most often happens when two medicines that both raise the level of serotonin are taken together. These include other antidepressants, some pain or headache medicines, and the herbal supplement St. John's wort. Symptoms of serotonin syndrome include anxiety, nervousness, high fever, sweating, confusion, tremors, restlessness, lack of coordination, major changes in blood pressure and a fast heartbeat. Get medical care right away if you have any of these symptoms. - Safety and blood tests. Your healthcare professional may recommend blood tests to measure the medicine levels to decide on the most effective dose. Some side effects and benefits of tricyclic antidepressants depend on the dose. Overdose of tricyclic antidepressants can be dangerous. - Long-term health conditions. Tricyclic antidepressants can cause problems in people with certain health conditions. For example, if you have narrow-angle glaucoma, an enlarged prostate, heart problems, diabetes or a history of seizures, talk with your healthcare professional to decide if a tricyclic antidepressant is a safe choice for you. ## Suicide risk and antidepressants Most antidepressants are generally safe, but the FDA requires that all antidepressants carry boxed warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants. This may be more likely in the first few weeks after starting the medicine or when the dose is changed. There has been no evidence that this increase in suicidal thoughts or behaviors has resulted in completed suicides. Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior. If you or someone you know has suicidal thoughts when taking an antidepressant, call your healthcare professional right away or get emergency help. Keep in mind that depression that's not treated is a more concerning risk factor for suicide. And antidepressants may lessen suicide risk in the long run by improving mood for many people. ## Stopping treatment with tricyclic antidepressants Tricyclic antidepressants aren't considered habit-forming. But suddenly stopping antidepressant treatment or missing several doses can cause withdrawal-like symptoms. Symptoms may vary depending on how the medicine works. This is sometimes called discontinuation syndrome. Work with your healthcare professional to slowly and safely lower your dose over time. Withdrawal-like symptoms can include: - Restlessness, irritability or anxiety. - Upset stomach. - Feelings of tingling or burning. - Flu-like symptoms, such as chills, sweating and muscle aches. - Trouble sleeping. - Sluggishness, tiredness or sleepiness. - Headache. - Dizziness. ## Finding the right antidepressant People may react differently to the same antidepressant. For example, one medicine may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does. Traits passed down in your family may play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a specific antidepressant. Pharmacogenomics — the study of how drugs work coupled with information about human genes — is sometimes available to tailor medications and their doses for people based on their genetic makeup. But other things besides genetics can affect your response to medicine. When choosing an antidepressant, your healthcare professional considers your symptoms, any health problems, other medicines you take, and what's worked for you in the past. Typically, it may take several weeks or longer before an antidepressant fully works and for early side effects to ease up. Your healthcare professional may recommend some dose changes or different antidepressants. With patience, you and your healthcare professional can find a medicine that works well for you. Show references 1. Depression medicines. U.S. Food and Drug Administration. https://www.fda.gov/consumers/womens-health-topics/depression-medicines. Accessed July 29, 2024. 2. Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression. Accessed July 29, 2024. 3. Mental health medications. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/mental-health-medications\#part\_2364. Accessed July 29, 2024. 4. Radosavljevic M, et al. The role of pharmacogenetics in personalizing the antidepressant and anxiolytic therapy. Genes. 2023; doi:10.3390/genes14051095. 5. Henssler J, et al. Incidence of antidepressant discontinuation symptoms: A systematic review and meta-analysis. Lancet Psychiatry. 2024; doi:10.1016/S2215-0366(24)00133-0. 6. Hirsch M, et al. Tricyclic and tetracyclic drugs: Pharmacology, administration, and side effects. https://www.uptodate.com/contents/search. Accessed July 29, 2024. 7. Medicine for depression: Tricyclic and tetracyclic antidepressants. U.S. Department of Veterans Affairs. https://www.veteranshealthlibrary.va.gov/MentalHealth/Depression/Treatment/142,HW29398\_VA. Accessed July 29, 2024. 8. Tricyclic antidepressants. Facts & Comparisons eAnswers. https://fco.factsandcomparisons.com. Accessed July 29, 2024. 9. Green C. Antidepressant discontinuation and the role of the pharmacist. Canadian Pharmacists Journal. 2023; doi:10.1177/17151635231188340. 10. Ritter JM, et al. Antidepressant drugs. In: Rang and Dale's Pharmacology. 10th ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed July 30, 2024. 11. Medical review (expert opinion). Mayo Clinic. Sept. 16, 2024. 12. Medical review (expert opinion). Mayo Clinic. Sept. 16, 2024. 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Readable Markdown	People may react differently to the same antidepressant. For example, one medicine may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does. Traits passed down in your family may play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a specific antidepressant. Pharmacogenomics — the study of how drugs work coupled with information about human genes — is sometimes available to tailor medications and their doses for people based on their genetic makeup. But other things besides genetics can affect your response to medicine. When choosing an antidepressant, your healthcare professional considers your symptoms, any health problems, other medicines you take, and what's worked for you in the past. Typically, it may take several weeks or longer before an antidepressant fully works and for early side effects to ease up. Your healthcare professional may recommend some dose changes or different antidepressants. With patience, you and your healthcare professional can find a medicine that works well for you.
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