What baseline test is recommended before starting a TCA?

Before starting a tricyclic antidepressant (TCA), obtaining an electrocardiogram (ECG) to assess heart rhythm is recommended. This is particularly important because TCAs can have significant cardiovascular side effects, including the potential for arrhythmias, especially in patients with pre-existing heart conditions or risk factors. The ECG helps to establish a baseline assessment of the heart's electrical activity, allowing healthcare providers to monitor any changes that may occur during treatment.

The necessity for this baseline test arises from the pharmacological profile of TCAs, which can lead to increased heart rate or conduction abnormalities. Identifying any pre-existing issues can inform clinical decisions, such as dosage adjustments or the need for additional monitoring. This proactive approach enhances patient safety during the treatment process with TCAs.

Other tests and assessments hold their importance but do not specifically address the cardiovascular risks associated with TCAs in the same direct manner as an ECG does.