Below is a list of TCAs that affect serotonin and norepinephrine to a similar extent.Although most affect one neurotransmitter slightly more than the other, differences are considered minimal.Perhaps the reason why I’m still able to talk to you today and not dead is because I changed from amitriptyline to Cipramil. If I had overdosed and there was a period of one week between overdosing. I think if you’re going to prescribe an antidepressant you should prescribe an SSRI, fluoxetine, Prozac or one of these sooner, and not prescribe tricyclics.
Back when TCAs were approved, they were considered a first-line treatment option for depression.
Although some TCAs tend to affect serotonin and norepinephrine equally, some affect one to a significantly greater extent.