Common Medications for Depression

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The information provided below is intended to provide basic information about mental health medications. It is not a complete source for all medications available and should not be used as a guide for making medical decisions.

Antidepressants are medications commonly used to treat depression. Antidepressants can also be used for other health conditions, such as anxiety, pain and insomnia.

The most popular types of antidepressants are called selective serotonin reuptake inhibitors (SSRIs). Examples of SSRIs include:

• Fluoxetine – Nuzak, Lorien (average dosing 20-80mg)

• Citalopram – Cipramil, Cilift (20-40mg)

• Sertraline – Serlife, Zoloft, Setra, Serdep (50-100mg)

• Paroxetine – Paxil (20-60mg)

• Escitalopram – Cipralex, Lexamil, Zytomil (10-20mg)

Other types of antidepressants are serotonin and noradrenaline reuptake inhibitors (SNRIs). SNRIs are similar to SSRIs and include

• Venlafaxine- Efexor, Venlor (75-150mg)

• Duloxetine - Cymbalta, Cymgen, Yelate (60mg)

Bupropion (Wellbutrin) is a third type of antidepressant which works differently than either SSRIs or SNRIs. Bupropion is also used to treat seasonal affective disorder and has also been used to help people stop smoking.

SSRIs, SNRIs, and Bupropion are popular because they do not cause as many side effects as older classes of antidepressants and seem to help a broader group of depressive and anxiety disorders.

Another class of medications listed as Melatonergic specific or other include:

• Trazadone – Molipaxin (150-300mg)

• Agomelatine – Valdoxane (25-50mg)

How do people respond to antidepressants?

According to a research review by the Agency for Healthcare Research and Quality, all antidepressant medications work about as well as each other to improve symptoms of depression and to keep depression symptoms from coming back. For reasons not yet well understood, some people respond better to some antidepressant medications than to others.

Therefore, it is important to know that some people may not feel better with the first medicine they try and may need to try several medicines to find the one that works for them. Others may find that a medicine helped for a while, but then their symptoms come back. Once a person begins taking antidepressants, it is important that they not stop taking them without the help of a doctor, as withdrawal symptoms can be very severe. It may then be unclear whether the resulting symptoms are because of stopping the medication or possibly the condition being treated. Sometimes people taking antidepressants feel better and stop taking the medication too soon, and the depression may return. When it is time to stop the medication, the doctor will help the person slowly and safely decrease the dose. It's important to give the body time to adjust to the change. People don't get addicted to these medications.

What are the possible side effects of antidepressants?

Some antidepressants may cause more side effects than others. A person may need to try several different antidepressant medications before finding the one that improves their symptoms and that causes side effects that they can best manage.

The most common side effects that I see in my practice include:

• Nausea and vomiting

• Weight gain

• Diarrhoea

• Sleepiness

• Sexual problems including loss of libido, or delayed orgasm.

Call your doctor right away if you have any of the following symptoms:

• Thoughts about suicide or dying

• Attempts to commit suicide

• New or worsening depression

• New or worsening anxiety

• Feeling very agitated or restless

• Panic attacks

• Trouble sleeping (insomnia)

• New or worsening irritability

• Acting aggressively, being angry, or violent

• Acting on dangerous impulses

• An extreme increase in activity and talking (mania)

• Other unusual changes in behavior or mood

A serious/severe side effect of the SSRI or SNRI antidepressants is called "serotonin syndrome." A person with serotonin syndrome may be agitated, have hallucinations, have a high temperature, or have unusual blood pressure changes. Serotonin syndrome is usually associated with the older antidepressants called Mono Amine Oxidase Inhibitors (MAOIs), but it can happen with the newer antidepressants as well, if they are mixed with the wrong medications.