Tricyclic Antidepressant (ATC) Screening

This test checks whether tricyclic antidepressants (TCAs) can be found in your blood or urine. It can also measure the amount of ATC in your blood or urine. TCAs are a type of antidepressant. Antidepressants are prescription medications that treat depression, a serious mood disorder. Depression can affect how you think, feel, and behave.

There are several types of antidepressants. Each of them works in a slightly different way. TCAs were one of the first types of antidepressants developed. They may be effective, but they tend to cause more side effects than newer types of antidepressants. Most new antidepressants fall into one of these three groups:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and noradrenaline reuptake inhibitors (SNRIs)
• Atypical antidepressants, which are newer antidepressants that do not fit into the other groups.

Health professionals often use newer antidepressants rather than TCAs because they are safer and have fewer side effects. But TCAs may be a good option for treating depression when other antidepressants don't work.

Health professionals sometimes use TCAs to treat other health conditions, such as anxiety, chronic pain, migraines, and insomnia.

Some commonly prescribed TCAs include:

• Doxepin
• Nortriptyline
• amitriptyline
• Imipramine
• Desipramine

TCAs should be dosed carefully. Finding a dose that works without being dangerous can be difficult. In fact, TCAs are the cause of numerous prescription drug overdose deaths in the United States.

Other names: ATC test, ATC test, tricyclic screening

A TCA test is used to:

• Help your provider prescribe the right dose of TCA.
• Determine if you are abusing TCAs (taking them without a prescription or taking more than the prescribed dose). The test may be included as part of a drug test (toxicology), which checks for the presence of multiple prescription medications and illegal drugs.
• Diagnosing TCA overdose. Timely treatment of an overdose can save lives.

You may need this test if you have been prescribed a TCA to ensure that you are getting a dose that is safe and effective. You may also need this test if you have symptoms of an TCA overdose. These include:

• Dry mouth
• Blurred vision
• Constipation
• Difficulty urinating
• Sleepiness
• Dizziness
• Crises
• Confusion
• Tremors

If you think you have taken too much TCA, or if you have symptoms of an TCA overdose, call 911 or go to the nearest emergency center.

You do not need special preparations for a TCA screening.

There is very little risk in taking a blood test. You may feel a slight pain or bruise where the needle was inserted, but most symptoms go away quickly.

There is no risk in doing a urine test.

Your blood test results will show the levels of TCA in your bloodstream. Depending on the TCA you are taking and the levels, your provider may adjust your dosage.

There are two types of urine test results. A type will show if TCA was found but not in what quantity. The other type shows TCA levels.

If blood or urine test results show that you have dangerously high TCA levels, you will be treated immediately.

If you have questions about your results, talk to your provider.

Learn more about lab tests, reference ranges, and understanding results.

Tricyclic antidepressants (TCAs) are most commonly prescribed by a mental health professional, a specialist in the diagnosis and treatment of mental health conditions, such as depression. There are many different types of mental health professionals out there. Some types, usually doctors, are authorized to prescribe medications, including TCAs. Other mental health professionals work with providers who can write prescriptions. The most common types of mental health professionals include:

• Psychiatrists are doctors who specialize in mental health disorders. Psychiatrists can prescribe medication.
• Psychologists are professionals trained in psychology. Psychologists may use one-on-one counseling sessions and/or group therapy sessions. They often have doctoral degrees but don't have medical degrees. They cannot prescribe medication unless they have a special license. Some psychologists work with providers who can prescribe medication.
• Psychiatric or mental health nurses are nurses with special training in mental health disorders. Nurses who may have a master's or doctoral degree in mental health nursing include: advanced nurse practitioners (APRNs), certified nurse practitioners (CNPs), and specialized clinical nurses (CNSs). In some states, some nurses may prescribe medication.
• Certified clinical social workers have at least a master's degree in social work with special training in mental health. They can't prescribe medication but can work with providers who can. Providers who are licensed clinical social workers usually have LCSW or LICSW after their name.
• Certified professional counsellors (LPC) may also be referred to as clinicians or therapists. States have various names for these licenses, such as LMFT (licensed marriage and family therapist). These professionals generally have a master's degree in a field related to mental health. They cannot prescribe medication but can work with providers who can.

If you are suffering from depression, it is important to get treatment. Talk to your primary doctor if you need help finding a mental health provider who can treat your depression.

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