Depression Medications

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Depression Medications

Several different classes of medications are used to treat depression. An explanation of each class along with examples of medications from each class is as follows:

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
    • Work to improve mood by increasing the amount of serotonin available in the brain
    • Have relatively few side effects, the most common being GI upset, sexual dysfunction, and decreased energy level
    • Are preferred in children and adolescents
    • Examples include Prozac (Fluoxetine), Celexa (Citalopram), Lexapro (Escitalopram), Paxil (Paroxetine), and Zoloft (Sertraline) among others
  • Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs)
    • Work to improve mood by increasing the amount of both serotonin and norepinephrine available in the brain
    • May also effectively treat pain and fatigue, unlike SSRIs
    • May be first or second line agents in treating depression, especially if SSRIs fail
    • Have a similar side effect profile to SSRIs, except that they may also cause high blood pressure
    • Examples include Effexor (Venlafaxine), Pristiq (Desvenlafaxine), and Cymbalta (Duloxetine)
  • Atypical Antidepressants
    • Effective both alone and in combination therapy with other antidepressants for hard to treat depression
    • Low toxicity in overdose
    • Examples include Wellbutrin (Buproprion), Remeron (Mirtazapine), Desyrel (Trazodone), and Nefazodon
  • Tricyclic Antidepressants (TCAs)
    • TCAs work in a similar manner to SSRIs and SNRIs, except that they are less selective and thus more dangerous
    • TCAs are effective in treating depression as well as other disorders such as anxiety, ADHD, and chronic pain syndromes
    • When prescribed, TCAs must be closely monitored by a specially trained medical professional and discontinued at the first sign of harmful side effects
    • Examples include Elavil (Amytriptyline) and Anafranil (Clomipramine) among several others
  • Monoamine Oxidase Inhibitors (MAOIs)
    • MAOIs are now much less commonly used than other antidepressants because of their high incidence of side effects
    • Nonetheless, they are effective in a wide variety of mood disorders
    • Please discuss the many side effects of MAOIs with your physician before beginning treatment with one of these medications
  • St. John’s Wort (Hypericum perforatum)
    • First line treatment for certain types of depression in Europe and other areas outside the US
    • May be effective for mild and possibly moderate depressive symptoms but is not effective for major depressive disorder
    • Not regulated by the FDA and thus its effectiveness has not been proven; additionally, may have dangerous interactions with other drugs
    • Can cause GI upset as well
    • Please consult your physician before beginning this herbal remedy!