List of antidepressants

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This is a complete list of clinically approved prescription antidepressants throughout the world, as well as clinically approved prescription drugs used to augment antidepressants, by pharmacological and/or structural classification. Chemical/generic names are listed first, with brand names in parentheses. All drugs listed are approved specifically for major depressive disorder unless noted otherwise.

Selective serotonin reuptake inhibitors (SSRIs)[edit]

Indalpine (Upstene) and zimelidine (Normud, Zelmid) were also formerly used as antidepressants, but were withdrawn from the market.

Serotonin–norepinephrine reuptake inhibitors (SNRIs)[edit]

Serotonin modulators and stimulators (SMS)[edit]

Serotonin antagonists and reuptake inhibitors (SARIs)[edit]

  • Nefazodone (Dutonin, Nefadar, Serzone) – withdrawn/discontinued in most countries
  • Trazodone (Desyrel)

Etoperidone may also have been formerly used as an antidepressant, but has been discontinued.

Norepinephrine reuptake inhibitors (NRIs)[edit]

Although marketed as an antidepressant, a meta-analysis found that reboxetine was ineffective and potentially harmful.[1]

Atomoxetine (Strattera) is also sometimes used as an antidepressant, but is not specifically approved for this purpose.[2][3]

Norepinephrine–dopamine reuptake inhibitors (NDRIs)[edit]

Amineptine (Survector, Maneon) and nomifensine (Merital, Alival) were also formerly marketed, but have since been withdrawn due to toxicity.[5]

Methylphenidate (Ritalin, Concerta) is also sometimes used as an antidepressant, but is not specifically approved for this purpose.[6][7]

Lisdexamfetamine (Vyvanse), an NDRA, was found to be ineffective as an adjunctive antidepressant in phase III clinical trials.[8][2]

Tricyclic antidepressants (TCAs)[edit]

Butriptyline (Evadyne), demexiptiline (Deparon, Tinoran), fluacizine (Phtorazisin), imipraminoxide (Imiprex, Elepsin), iprindole (Prondol, Galatur, Tertran), metapramine (Timaxel), propizepine (Depressin, Vagran), and quinupramine (Kinupril, Kevopril) were also formerly marketed, but have since been discontinued.

Tiazesim (Altinil) and tofenacin (Elamol, Tofacine) are technically not TCAs, but are heterocyclic antidepressants that are very closely related, and similarly to various TCAs, are no longer marketed.

Amineptine (Survector, Maneon) and tianeptine (Stablon, Coaxil) are technically TCAs but are atypical, and are grouped elsewhere.

Tetracyclic antidepressants (TeCAs)[edit]

Mianserin, mirtazapine, and setiptiline are also sometimes described as noradrenergic and specific serotonergic antidepressants (NaSSAs).

Monoamine oxidase inhibitors (MAOIs)[edit]

Irreversible[edit]

Non-selective[edit]

Many others, including benmoxin (Neuralex), iproclozide (Sursum), iproniazid (Marsilid), mebanazine (Actomol), nialamide (Niamid), octamoxin (Ximaol), pheniprazine (Catron), phenoxypropazine (Drazine), pivhydrazine (Tersavid), and safrazine (Safra) were used as antidepressants in the past, but have since been discontinued.

Selective for MAO-B[edit]

Reversible[edit]

Non-selective[edit]

Caroxazone (Surodil, Timostenil) was formerly used as an antidepressant, but has been discontinued.

Selective for MAO-A[edit]

These drugs are sometimes described as reversible inhibitors of MAO-A (RIMAs).

Eprobemide (Befol) and minaprine (Brantur, Cantor) were also formerly used as antidepressants, but have been discontinued.

Mixed[edit]

Non-selective[edit]

  • Bifemelane (Alnert, Celeport) – RIMA, irreversible inhibitor of MAO-B, and weak NRI

Atypical antipsychotics[edit]

  • Amisulpride (Solian) – specifically approved, in low doses, as a monotherapy for dysthymia
  • Lurasidone (Latuda) – specifically approved as a monotherapy for depressive episodes in bipolar disorder
  • Quetiapine (Seroquel) – specifically approved as a monotherapy for depressive episodes in bipolar disorder

Others[edit]

Marketed[edit]

Discontinued/withdrawn[edit]

Over-the-counter[edit]

The following antidepressants are available both with a prescription and over-the-counter:

Adjunctive treatments[edit]

Atypical antipsychotics[edit]

  • Aripiprazole (Abilify) – specifically approved as an adjunct for major depressive disorder
  • Brexpiprazole (Rexulti) – specifically approved as an adjunct for major depressive disorder
  • Lurasidone (Latuda) – specifically approved for depressive episodes in bipolar disorder
  • Olanzapine (Zyprexa) – specifically approved as an adjunct for major depressive disorder
  • Quetiapine (Seroquel) – approved as an adjunct for both major depressive disorder and depressive episodes in bipolar disorder
  • Risperidone (Risperdal) – not specifically approved as an adjunct for major depressive disorder (used off-label)[11]

Others[edit]

  • Buspirone (Buspar) – 5-HT1A receptor partial agonist – not specifically approved for depression (used off-label)
  • Lithium (Eskalith, Lithobid) – mood stabilizer (mechanism of action unknown/unclear) – not specifically approved for depression (used off-label)
  • Thyroxine (T4) – thyroid hormone (thyroid hormone receptor agonist) – not specifically approved for depression (used off-label)
  • Triiodothyronine (T3) – thyroid hormone (thyroid hormone receptor agonist) – not specifically approved for depression (used off-label)

Pindolol (Visken), a beta blocker and to a lesser extent 5-HT1A receptor weak partial agonist or functional antagonist, has sometimes been used off-label as an augmentation therapy for SSRIs, but a 2015 systematic review and meta-analysis found that it was ineffective.[12]

Combination products[edit]

See also[edit]

References[edit]

  1. ^ Eyding D, Lelgemann M, Grouven U, Härter M, Kromp M, Kaiser T, Kerekes MF, Gerken M, Wieseler B (2010). "Reboxetine for acute treatment of major depression: systematic review and meta-analysis of published and unpublished placebo and selective serotonin reuptake inhibitor controlled trials". BMJ. 341: c4737. doi:10.1136/bmj.c4737. PMC 2954275Freely accessible. PMID 20940209. 
  2. ^ a b Corp SA, Gitlin MJ, Altshuler LL (2014). "A review of the use of stimulants and stimulant alternatives in treating bipolar depression and major depressive disorder". J Clin Psychiatry. 75 (9): 1010–8. doi:10.4088/JCP.13r08851. PMID 25295426. 
  3. ^ Dell'Osso B, Palazzo MC, Oldani L, Altamura AC (2011). "The noradrenergic action in antidepressant treatments: pharmacological and clinical aspects". CNS Neurosci Ther. 17 (6): 723–32. doi:10.1111/j.1755-5949.2010.00217.x. PMID 21155988. 
  4. ^ Arias HR, Santamaría A, Ali SF (2009). "Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion". Int. Rev. Neurobiol. International Review of Neurobiology. 88: 223–55. doi:10.1016/S0074-7742(09)88009-4. ISBN 9780123745040. PMID 19897080. 
  5. ^ Rampello, Liborio; Nicoletti, Ferdinando; Nicoletti, Francesco (2000). "Dopamine and Depression". CNS Drugs. 13 (1): 35–45. doi:10.2165/00023210-200013010-00004. ISSN 1172-7047. 
  6. ^ Challman TD, Lipsky JJ (2000). "Methylphenidate: its pharmacology and uses". Mayo Clin. Proc. 75 (7): 711–21. doi:10.4065/75.7.711. PMID 10907387. 
  7. ^ Prommer E (2012). "Methylphenidate: established and expanding roles in symptom management". Am J Hosp Palliat Care. 29 (6): 483–90. doi:10.1177/1049909111427029. PMID 22144657. 
  8. ^ Dale E, Bang-Andersen B, Sánchez C (2015). "Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs". Biochem. Pharmacol. 95 (2): 81–97. doi:10.1016/j.bcp.2015.03.011. PMID 25813654. 
  9. ^ Zhang MW, Harris KM, Ho RC (2016). "Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications". BMC Med Ethics. 17: 4. doi:10.1186/s12910-016-0087-3. PMC 4714497Freely accessible. PMID 26768892. 
  10. ^ Gian F. Placidi; Liliana Dell'Osso; Giuseppe Nistico; Hagop S. Akiskal (6 December 2012). Recurrent Mood Disorders: New Perspectives in Therapy. Springer Science & Business Media. pp. 293–. ISBN 978-3-642-76646-6. 
  11. ^ Thase ME (2016). "Adverse Effects of Second-Generation Antipsychotics as Adjuncts to Antidepressants: Are the Risks Worth the Benefits?". Psychiatr. Clin. North Am. 39 (3): 477–86. doi:10.1016/j.psc.2016.04.008. PMID 27514300. 
  12. ^ Liu Y, Zhou X, Zhu D, Chen J, Qin B, Zhang Y, Wang X, Yang D, Meng H, Luo Q, Xie P (2015). "Is pindolol augmentation effective in depressed patients resistant to selective serotonin reuptake inhibitors? A systematic review and meta-analysis". Hum Psychopharmacol. 30 (3): 132–42. doi:10.1002/hup.2465. PMID 25689398.