Authored by Dr. Sharon Stills, NMD
Here is a list of the antidepressants in current use in conventional medicine. The listing is not comprehensive, but is meant to identify the major depression medications and the biochemical family to which each belongs.
Some of the side effects of antidepressants are also described below, under headings for the various types of antidepressants. Note that these side effects occur even in short-term use. Relatively little is known about the long-term effects of most drugs for depression or their interactions with other drugs.
For more information about antidepressants, or if you’re interested in natural alternatives to antidepressants, be sure to read our full article on antidepressants and alternative treatments for depression.
Common antidepressants
| Chemical name | Antidepressant family | Brand name |
|---|---|---|
| amitriptyline | tricyclic | Elavil |
| amoxapine | tricyclic | Asendin |
| bupropion | aminoketone | Wellbutrin |
| citalopram | SSRI | Celexa |
| clomipramine | tricyclic | Anafranil |
| desipramine | tricyclic/SNRI | Norpramin, Pertofrane |
| doxepin | tricyclic | Adapine, Sinequan |
| duloxetine | SNRI | Cymbalta |
| escitalopram | SSRI | Lexapro |
| fluvoxamine | SSRI | Luvox |
| fluoxetine | SSRI | Prozac |
| imipramine | tricyclic | Tofranil |
| isocarboxazid | MAOI | Marplan |
| maprotiline | NRI | Ludiomil |
| mirtazapine | “NaSSA” | Remeron |
| nefazodone | SNRI | Serzone |
| nortriptyline | tricyclic | Aventyl, Pamelor |
| paroxetine | SSRI | Paxil |
| phenelzine | MAOI | Nardil |
| protriptyline | tricyclic | Vivactil |
| sertraline | SSRI | Zoloft |
| tranylcypromine | MAOI | Parnate |
| trazodone | serotonin modulator | Desyrel |
| trimipramine | tricyclic | Surmontil |
| venlafaxine | SNRI | Effexor |
Tricyclics
These older drugs affect norepinephrine and serotonin. They are as effective as SSRI’s in many people, but have stronger side effects and so are used as a second or third level of treatment. Common side effects of tricyclics include dry mouth, constipation, bladder problems, sexual dysfunction, blurred vision, dizziness, drowsiness, and increased heart rate.
MAOI’s
Monoamine oxidase inhibitors are effective for some people with major depression who do not respond to other antidepressants. They are also used to treat panic disorder and bipolar depression. The limited population for whom MAOI’s are indicated need to avoid taking decongestants and consuming certain foods that contain high levels of the monoamine tyramine, including fish, chocolate, and fermented foods such as alcoholic beverages, cheeses, soy sauce, processed meats, and pickles. The interaction of tyramine with MAOI’s can bring on a sharp increase in blood pressure that can lead to a stroke.
SSRI’s
Side effects of SSRI’s (serotonin reuptake inhibitors) include sexual dysfunction, nausea, nervousness and insomnia, agitation, decreased sweating with increased body temperature.
Any of these side effects may be amplified when an SSRI is combined with other medications or herbs that affect serotonin (such as St. John’s Wort and SAM-e). In the most extreme cases, such a combination of medications (e.g., an SSRI and an MAOI) may result in a potentially serious or even fatal serotonin syndrome, characterized by fever, confusion, muscle rigidity, and cardiac, liver, or kidney problems.
Newer antidepressants
New classes of antidepressants are steadily being developed and brought to market. Classifying them is not always straightforward due to their combined pharmacokinetic action. One of these newer classes, the SNRI’s (serotonin/norepinephrine reuptake inhibitors), like the tricyclics, affects both norepinephrine and serotonin but has fewer side effects. SNRI’s include Effexor (venlafaxine) and Serzone (nefazadone).
Cases of life-threatening hepatic failure have been reported in patients treated with Serzone, and this tradename was actually discontinued in 2003; however, the generic version of Serzone, nefazodone, remains available. Patients should call the doctor if the following symptoms of liver dysfunction occur: yellowing of the skin or whites of the eyes, unusually dark urine, loss of appetite that lasts for several days, nausea, or abdominal pain.
Other newer medications chemically unrelated to the other antidepressants but with similar side effects to SSRI’s include Remeron (mirtazepine) and Wellbutrin (bupropion). These must not used by people with, or at risk for, seizure disorders.
Click here to return to our article on antidepressants and alternative treatments for depression.
