Here is a list of the antidepressant medications 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 antidepressant medications
|
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 drugs
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.
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