Tripgen Special Precautions

The antimuscarinic effects of tricyclic antidepressants warrant care in patients with urinary retention, prostatic hyperplasia, or chronic constipation; caution has also been advised in untreated angle-closure glaucoma and in phaeochromocytoma.
The epileptogenic potential of tricyclic antidepressants requires care in patients with a history of epilepsy. In addition, because of their potential cardiotoxicity, tricyclics should be used with caution in patients with cardiovascular disease and avoided in those with heart block, cardiac arrhythmias, or in the immediate recovery period after myocardial infarction. Caution has also been recommended in patients with hyperthyroidism as tricyclics may increase the risk of developing cardiac arrhythmias.
Suicidal thoughts and behaviour may also develop during early treatment with antidepressants for other disorders; the same precautions observed when treating patients with depression should therefore be followed when treating patients with other disorders.
If tricyclic antidepressants are used for the depressive component of bipolar disorder, mania may be precipitated; similarly, psychotic symptoms may be aggravated if tricyclics are used for a depressive component of schizophrenia.