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They may recommend increasing your dose or trying a different medicine.

A course of treatment usually lasts at least 6 months.

Examples of TCAs include amitriptyline (Tryptizol), clomipramine (Anafranil), imipramine (Tofranil), lofepramine (Gamanil) and nortriptyline (Allegron).

Some types of TCAs, such as amitriptyline, can also be used to treat chronic nerve pain.

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Side effects should improve within a few days or weeks of treatment, as the body gets used to the medicine.Increasingly, people with moderate to severe depression are treated using a combination of antidepressants and CBT.Antidepressants work quickly in reducing symptoms, whereas CBT takes time to deal with causes of depression and ways of overcoming it.Exceptions are sometimes made for people with severe depression that fail to respond to other treatments.TCAs may also be recommended for other mental health conditions, such as OCD and bipolar disorder.

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