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 Although superseded today by the less side-effect prone selective serotonin reuptake inhibitors (SSRIs), they are still used in certain cases.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

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.

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.

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.