Tricyclic Antidepressants

Coenzyme Q 10 (CoQ 10) —Supplementation Possibly Helpful St. John's Wort, Yohimbe, 5-Hydroxytryptophan (5-HTP), S-Adenosylmethionine (SAMe) —Possible Dangerous Interactions St. John's Wort —Possible Harmful Interaction

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 Although superseded today by the less side-effect prone selective serotonin reuptake inhibitors (SSRIs), they are still used in certain cases.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

Coenzyme Q 10 (CoQ 10 ) 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.

St. John's WortYohimbe5-Hydroxytryptophan (5-HTP)S-Adenosylmethionine (SAMe) 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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