List of antidepressants

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This is a list of antidepressants by drug group. Generic drug names are listed first with trade names in brackets.

Antidepressant drugs may be augmented in the treatment of depression or other mood disorders by non-antidepressant drugs (such as lithium carbonate) which have been shown to boost the antidepressant effect of a main antidepressant treatment.

Contents

[edit] Selective serotonin reuptake inhibitors (SSRIs)

  • Citalopram (Celexa): usual dosing is 20 mg initially; maintenance 40 mg per day; maximum dose is now been limited to 40 mg per day.
  • Escitalopram (Lexapro, Cipralex): usual dosing is 10 mg and shown to be as effective as 20 mg in most cases. Maximum dose 20 mg. Also helps with anxiety.
  • Paroxetine (Paxil, Seroxat): Also used to treat panic disorder, OCD, social anxiety disorder, generalized anxiety disorder and PTSD. Usual dose 25 mg per day; may be increased to 40 mg per day. Available in controlled release 12.5 to 37.5 mg per day; controlled release dose maximum 50 mg per day. Less cycling in patients who are bipolar.
  • Fluoxetine (Prozac): Also used to treat OCD, bulimia, and panic disorder. Long half-life; less withdrawal when medication is stopped. Dosing is 20 mg to a maximum of 80 mg.
  • Fluvoxamine (Luvox): Although primarily used in the treatment of OCD, a doctor may prescribe it for depression. Initial dose is 50 mg, increasing by 50 mg every 4–7 days. If daily dose is greater than 100 mg give in equally divided doses or give larger dose at bedtime not to exceed 300 mg per day.
  • Sertraline (Zoloft, Lustral): Also used to treat panic disorder, OCD, PTSD, social anxiety disorder, premenstrual dysphoric disorder. Dosing is 50–200 mg per day and should be titrated upward.

Be aware of drug interactions. Dextromethorphan (found in many brands of over-the-counter cough syrup) as well as the opioids tramadol (Tramal, Ultram), and pethidine/meperidine are contraindicated with all SSRIs as they are serotonin reuptake inhibitors (SRIs) themselves and the combination could cause the potentially fatal serotonin syndrome. Many SSRIs inhibit the metabolism of dextromethorphan as well, further adding to the risk.

Drug interactions may also occur when concurrently taking phenytoin (Dilantin) and warfarin (Coumadin) (phenytoin and warfarin levels are increased).

Always check with pharmacy regarding potential drug interactions.

[edit] Serotonin-norepinephrine reuptake inhibitors (SNRIs)

  • Desvenlafaxine (Pristiq): Similar to Venlafaxine.
  • Duloxetine (Cymbalta): Dosing 40 mg two X daily or 60 mg once daily.
  • Milnacipran (Ixel, Savella): Serotonin/norepinhephrine reuptake inhibitor. Manufactured in France by Pierre Fabre.
  • Venlafaxine (Effexor): Also used to treat generalized anxiety disorder, panic disorder and social anxiety disorder. Dose should be titrated upward starting at 37.5 mg X one week. Maximum dose 375 mg in XR form. Blood pressure should be monitored as this medication can increase it.

Agents such as Tramadol (Tramal, Ultram) and Sibutramine (Meridia, Reductil) are also SNRIs and may be included in this class.

[edit] Serotonin antagonist and reuptake inhibitors (SARIs)

[edit] Norepinephrine reuptake inhibitors (NRIs)

[edit] Norepinephrine-dopamine reuptake inhibitors (NDRIs)

[edit] Norepinephrine-dopamine releasing agents (NDRAs)

[edit] Tricyclic antidepressants (TCAs)

Tricyclics can cause arrhythmias and ECG changes and are very lethal in overdose.

These medications should be used with extreme caution in the elderly.

[edit] Tetracyclic antidepressants (TeCAs)

[edit] Monoamine oxidase inhibitors (MAOIs)

Serious and potentially fatal adverse reactions may occur with concurrent use of other antidepressants including SSRIs, SNRIs, TCAs, nefazodone (Serzone), and trazodone (Desyrel), as well as other medications such as amphetamine (Adderall, Dexedrine), methylphenidate (Ritalin, Concerta), carbamazepine (Tegretol), cyclobenzaprine (Flexeril), and many others.

Also similar potentially fatal reactions can occur with recreational drugs such as methamphetamine and MDMA (Ecstasy), the AIDS drug ritonavir (Norvir), and high amounts of certain food products containing tyramine such as cheese, meat, and beer.

Moclobemide is a reversible inhibitor of monoamine oxidase A (RIMA), which in practice means that it is somewhat less problematic with dietary restrictions and drug interactions.

[edit] Miscellaneous

[edit] 5-HT1A Receptor Agonists

[edit] 5-HT2 Receptor Agonists

[edit] 5-HT2 Receptor Antagonists

[edit] 5-HT7 Receptor Antagonists

[edit] D2 Receptor Partial Agonists

[edit] D2 Receptor Antagonists

[edit] D3 Receptor Antagonists

[edit] D4 Receptor Antagonists

[edit] α-adrenergic Receptor Antagonists

[edit] mACh Receptor Antagonists

[edit] Serotonin Reuptake Inhibitors (SRIs)

[edit] Norepinephrine Reuptake Inhibitors (NRIs)

[edit] Selective Serotonin Reuptake Enhancers (SSREs)

[edit] Sigma Receptor Agonists

[edit] Mood Stabilizers

[edit] References

  1. ^ Niels H Jensen, Ramona M Rodriguiz et al. (2008). "N-Desalkylquetiapine, a Potent Norepinephrine Reuptake Inhibitor and Partial 5-HT1A Agonist, as a Putative Mediator of Quetiapine's Antidepressant Activity". Neuropsychopharmacology 33: 2303–2312. doi:10.1038/sj.npp.1301646. 
 This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (October 2009)
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