Drugs to Treat Depression

Drugs to Treat Depression

There are several types of depression medications (antidepressants) used to treat depression and conditions that have depression as a component of the disease, such as bipolar disorder. These drugs improve symptoms of depression by increasing the availability of certain brain chemicals called neurotransmitters. It is believed that these brain chemicals can help improve emotions.

Major types of antidepressants include:

• Tricyclic antidepressants (TCAs) are some of the first antidepressants used to treat depression. They primarily affect the levels of two chemical messengers (neurotransmitters), norepinephrine and serotonin, in the brain. Although these drugs are effective in treating depression, they have more side effects, so they usually aren't the first drugs used.
• Monoamine oxidase inhibitors (MAOIs) are another early form of antidepressant. These drugs are most effective in people with depression who do not respond to other treatments. They are also effective for other mental illnesses. Substances in certain foods, like cheese, beverages like wine, and medications can interact with an MAOI, so these people taking this medication must adhere to strict dietary restrictions (see below). For this reason these antidepressants also aren't usually the first drugs used.
• Selective serotonin reuptake inhibitors (SSRIs) are a newer form of antidepressant. These drugs work by altering the amount of a chemical in the brain called serotonin.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another newer form of antidepressant medicine. They treat depression by increasing availability of the brain chemicals serotonin and norepinephrine.

Examples of effective and safe medications commonly prescribed for depression or depression-related problems are listed in the chart below.

Drug Name	Type of medication	Potential Side Effects
Anafranil Adapin Aventyl Elavil Norpramin Pamelor Pertofrane Sinequan Surmontil Tofranil Vivactil	These medicines are tricyclic antidepressants (TCAs) which work by increasing the available amount of serotonin and/or norepinephrine in the brain.	Dry mouth, blurred vision, increased fatigue and sleepiness, weight gain, muscle twitching (tremors), constipation, bladder problems such as urine retention, dizziness, daytime drowsiness, increased heart rate, sexual problems.
Parnate Nardil Marplan	Monoamine oxidase inhibitors (MAOIs) increase the amount of norepinephrine and serotonin in the brain	Must avoid certain foods and medications to avoid dangerous interactions* Serious side effects may include: headache, heart racing, chest pain, neck stiffness, nausea and vomiting. If you experience any of these symptoms, seek medical care immediately.
Celexa Lexapro Luvox Paxil Prozac Zoloft	Selective serotonin reuptake inhibitors, or SSRIs, work by increasing the amount of serotonin, a neurotransmitter found in the brain.	Sexual problems including low sex drive or inability to have an orgasm are common but reversible, dizziness, headaches, nausea right after a dose, insomnia, feeling jittery.
Wellbutrin	Wellbutrin may increase the amounts of the neurotransmitters norepinephrine and dopamine in the brain.	Weight loss, decreased appetite, restlessness, insomnia, anxiety, constipation, dry mouth, diarrhea, dizziness Wellbutrin is much less likely to cause the weight gain or sexual problems seen with other antidepressants.
Effexor Remeron Cymbalta	These drugs increase the levels of the neurotransmitters serotonin and norepinephrine in the brain.	Drowsiness, blurred vision, lightheadedness, strange dreams, constipation, fever/chills, headache, increased or decreased appetite, tremor, dry mouth, nausea. Remeron can be sedating. Cymbalta may increase sweating and blood pressure and also cause fatigue and reduced energy.
Desyrel (trazodone) Ludiomil	These drugs block various neurotransmitter chemicals to some degree.	Desyrel may cause drowsiness, fatigue, tremor, headache, dry mouth, nausea and vomiting. Ludiomil may cause headache, dizziness, dry mouth, fatigue, daytime sleepiness, sweating.

When taking an MAOI, you must avoid taking certain medications (including some over the counter medicines like Sudafed) and eating certain foods such as aged cheese, wine and beer, avocados, bananas, canned meats, yogurt, soy sauce, packaged soups and sour cream.

It is important to note that you should not drink alcoholic beverages while taking antidepressant medicines, since alcohol can seriously interfere with their beneficial effects.

In October 2004, the FDA determined that antidepressant medications may increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider.