Tricyclic antidepressants help to preserve catecholamines* in the brain. They include amitriptyline (Elavil®), protriptyline (Vivactil®), nortriptyline (Pamelor®), imipramine (Tofranil®), desipramine (Norpramin® and Pertofrane®), and doxepin (Sinequan®). These medications are often used in patients who experience frequent, daily or near-daily headaches.

Doses of the tricyclic antidepressants needed for control of headaches are often less than what is needed to treat depression.

Tricyclic antidepressants may take several weeks to show their effectiveness. Some of the possible side effects include drowsiness, dryness of the mouth, weight gain, urinary retention, tingling fingers, and blurred vision. Changes in pulse, heart rhythm, blood pressure, and behavior may also occur.