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Tricyclic Antidepressants for Premenstrual Syndrome (PMS)

Table of Contents

Tricyclic Antidepressants for Premenstrual Syndrome (PMS)


Generic NameBrand Name
nortriptylineAventyl, Pamelor

How It Works

TCAs improve your mood by increasing the levels of certain chemicals in the brain (neurotransmitters).

In low doses, these medicines may cause drowsiness and sleep. This can be helpful when sleep disorders are a symptom of PMS.

Why It Is Used

TCAs may be used if PMS is causing:

How Well It Works

Some women who have severe premenstrual depression benefit from TCAs. TCAs have not been studied as much as selective serotonin reuptake inhibitors (SSRIs) for their specific effects on PMS mood symptoms.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

Call 911 or other emergency services right away if you have:

Call your doctor right away if you have:

Common side effects of this medicine include:

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

You may start to feel better in 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines or if you do not notice any improvement by 3 weeks, talk to your doctor.

Tricyclic antidepressants (TCAs) are taken orally every day throughout the menstrual cycle for premenstrual syndrome (PMS) symptoms. Typically, a low dose is given at first, and the dosage is increased slowly until the medicine takes effect. This helps minimize side effects.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) to help you understand this medication.

Credits for Tricyclic Antidepressants for Premenstrual Syndrome (PMS)

By Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer Kirtly Jones, MD - Obstetrics and Gynecology
Last Revised June 8, 2012

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