Depression Medications

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!