Tricyclic antidepressants for treatment-resistant depression

William V. Bobo, Elliott Richelson

Research output: Chapter in Book/Report/Conference proceedingChapter


Tricyclic antidepressants (TCAs) are effective treatments for unipolar depressive syndromes, including major depressive disorder. However, despite decades of clinical use, the efficacy of TCAs for treatment-resistant depression (TRD) has received relatively little attention. In this chapter, we review the pharmacological properties (including their relative affinities for human cloned neuroreceptors, side effects, toxicological profiles, pharmacokinetic properties, and drug-drug interactions) and clinical evidence supporting the use of TCAs for a range of depressive disorders in adults, including those with TRD. We close by providing practical advice on the prescribing and monitoring of TCA treatment for patients with TRD, including strategies that may be effective for optimizing their clinical effectiveness, tolerability, and safety for depressed patients.

Original languageEnglish (US)
Title of host publicationManaging Treatment-Resistant Depression
Subtitle of host publicationRoad to Novel Therapeutics
Number of pages29
ISBN (Electronic)9780128240670
ISBN (Print)9780128240687
StatePublished - Jan 1 2022


  • CYP450 isoenzyme
  • Melancholic depression
  • Persistent depressive disorder
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Treatment-resistant depression (TRD)
  • Tricyclic antidepressants (TCAs)

ASJC Scopus subject areas

  • Medicine(all)


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