About Depression: Feelings of depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. But true clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period of time.
These are the SSRIs currently approved by the FDA to treat depression:
- Prozac (fluoxetine)
- Zoloft (sertraline)
- Lexapro (escitalopram)
- Paxil (paroxetine)
- Celexa (citalopram)
- Viibryd (vilazodone)
Side effects of SSRIs may include :
- Sexual dysfunction
- Gastrointestinal symptoms, such as nausea and diarrhea
- Dry mouth
- Insomnia, drowsiness
- Nervousness or jitters
- Dizziness, blurred vision
SNRIs: Work by Blocking Two Brain Chemicals
Commonly used SNRIs include:
- Effexor XR (venlafaxine)
- Pristiq, Khedezla (desvenlafaxine)
- Cymbalta (duloxetine)
- Fetzima (levomilnacipran)
Common side effects may include:
- Dry mouth
- Excessive sweating
Possible side effects can be:
- Sexual dysfunction
- Loss of appetite
SNRIs are not considered addictive, but stopping treatment abruptly or skipping several doses can lead to withdrawal-like symptoms. (5)
Another popular type of antidepressant that targets norepinephrine is Wellbutrin (bupropion). This medication affects the neurotransmitter dopamine in addition to norepinephrine, so it’s considered a norepinephrine-dopamine reuptake inhibitor, or NDRI.
Wellbutrin has similar side effects to those of SSRIs and SNRIs, but it’s less likely to cause sexual dysfunction and may increase your risk of seizures.
Tricyclics: They’re Prone to Side Effects
Tricyclic antidepressants (tricyclics, or TCAs) are older drugs that work by blocking the reabsorption of serotonin and norepinephrine through a different mechanism than SNRIs.
These drugs are seldom used today because they can cause a wide range of side effects, some of which may be serious.
But they are sometimes prescribed when other antidepressants are ineffective, according to NAMI.
Examples of tricyclics include:
- Elavil (amitriptyline)
- Norpramin (desipramine)
- Sinequan (doxepin)
- Tofranil (imipramine)
- Pamelor (nortriptyline)
- Aventyl (nortriptyline)
- Vivactil (protriptyline)
Some serious potential side effects of tricyclics include (6):
- Blurred vision
- Irregular heartbeat
- Confusion in elderly people
MAOIs: The Oldest of the Antidepressants
The oldest class of antidepressants, monoamine oxidase inhibitors (MAOIs) work by blocking the enzyme monoamine oxidase, which breaks down various neurotransmitters — including serotonin and norepinephrine — in the brain.
Examples of MAOIs include:
- Nardil (phenelzine)
- Marplan (isocarboxazid)
- Parnate (tranylcypromine sulfate)
- Emsam (selegiline), a more recently developed skin patch that causes fewer side effects than other MAOIs
Although MAOIs can sometimes be effective for people who do not respond to other medications, they are rarely used today because of their potential side effects and interactions with other drugs.
For example, if you consume a large of amount of the compound tyramine (found in cheese, pickles, and red wine) while taking an MAOI, you could develop hypertensive crisis — a severe spike in blood pressure that can lead to stroke.
You may also experience serious reactions if you take an MAOI with various medications, including:
- Prescription pain relievers
- Cold and allergy drugs
- Herbal supplements
On rare occasions, MAOIs can cause a potentially life-threatening condition called serotonin syndrome. You may be at risk if you combine an MAOI with another prescription antidepressant, certain pain or headache medications, or St. John’s wort (an herbal supplement used as a home remedy for depression).
Other Medications Used to Treat Depression
Various other medications that don’t fit into the classes listed above are also available to treat depression.
These drugs include:
- Trazodone — also used to treat insomnia
- Serzone (nefazodone)
- Remeron (mirtazapine)
- Abilify (aripiprazole) — prescribed as an add-on treatment for adults to supplement an antidepressant
- Seroquel (quetiapine) — an antipsychotic
- Trintellix (vortioxetine)