SSRIs antidepressants are considered to have better tolerability and safety than TCAs. But both classes of antidepressants are associated with the following risks:
Suicidal thinking. Although this risk applies to children, adolescents, and young adults, talk with your doctor if you are thinking about harming yourself, no matter what your age.
Drowsiness. Don't drive a car or operate machinery until you know how the medication affects you. Avoid drinking alcohol, which can increase the medicine's sedative effects.
Drug interactions. Don't use a monoamine oxidase inhibitor (MAOI), which is another type of antidepressant, while you're taking an SSRI or TCA. Because antidepressants interact with many other drugs, tell your doctor about all prescription and over-the-counter medicine and supplements you are taking.
Unknown effects on the fetus. Tell your doctor if you are pregnant or planning to become pregnant. And do not use at all if you are nursing.
Withdrawal symptoms. If you want to stop taking an antidepressant talk with your doctor, who can minimize this risk by reducing your dose gradually.
Tinnitus. Ironically, this might occur as a side effect of antidepressants depending upon the patient, drug, and dose. (This can happen with many medications.) The condition often improves during treatment, after a dose adjustment, or within a few weeks of discontinuing the drug.
Additional side effects. SSRIs might cause a loss of libido and an inability to reach orgasm. Talk with your doctor if you experience a change in sexual desire or performance during treatment. Other SSRI side effects include diarrhea, nausea, headaches, dry mouth, insomnia, and weight gain.
TCAs are associated with arrhythmias, heart attacks, and strokes. They should be used with caution if you have a history of cardiovascular disease. TCAs might cause confusion, constipation, blurred vision, dry mouth, sedation, and difficulty passing urine, especially in older people. Weight gain has also been reported.