Following are examples of the different major types of medical treatment used for depression. This information is easily found on WebMD. The next several post will be an in depth discussion about the mechanism of action of each of these major types of medication. The hope is to allow one to be able to have a better understanding of how each of these medications work and why one may be work better than another. Personally, I do better with reuptake inhibitors, but this may not be the case for everyone. Unless requested by the readers, we will go from the top of this list to the bottom. These post will be followed by an examination of anti-anxiety medications, their mechanism of action, and the combined use of both antidepressants and anti-anxiety medications with focus on the interaction of these two medications.
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- Tricyclic antidepressants (TCAs) were some of the first medications used to treat depression. Examples are amitriptyline (Elavil),desipramine (Norpramin, Pertofrane), doxepin (Adapin, Sinequan),imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline(Vivactil), and trimipramine (Surmontil). Side effects include stomach upset, dizziness, dry mouth, changes in blood pressure, changes in blood sugar levels, and nausea.
- Monoamine oxidase inhibitors (MAOIs) were among the earliesttreatments for depression. The MAOIs block an enzyme, monoamine oxidase. Examples are phenelzine (Nardil),tranylcypromine (Parnate) , isocarboxazid (Marplan), and transdermal selegiline (the EMSAMskin patch). Although MAOIs work well, they're not prescribed very often because of the risk of serious interactions with some other medications and certain foods. Foods that can negatively react with the MAOIs include aged cheese and aged meats.
- Selective serotonin reuptake inhibitors (SSRIs) were launched in the mid to late 1980s. This generation of antidepressants is now the most common class used for depression. Examples include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), fluoxetine (Prozac, Sarafem), and sertraline (Zoloft). Two newer medicines, classified as "serotonin modulators and stimulators" or SMS's (meaning they have some similar properties as SSRIs but also affect other brain receptors) are vilazodone (Viibryd) and vortioxetine (Brintellix) Side effects are generally mild, but can be bothersome in some people. They include nausea, stomach upset, sexual problems, fatigue, dizziness, insomnia, weight change, and headaches.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a newer type of antidepressant. This class includes venlafaxine(Effexor), desvenlafaxine (Pristiq and Khedezla), duloxetine(Cymbalta), and, levomilnacipran (Fetzima). Side effects includeupset stomach, insomnia, sexual problems, anxiety, dizziness, andfatigue.
- Other medications:
- Bupropion (Wellbutrin, Aplenzin) is a unique antidepressant that is thought to affect the brain chemicals norepinephrine and dopamine. Side effects are usually mild, including upset stomach,headache, insomnia, and anxiety. Bupropion may be less likely to cause sexual side effects than other antidepressants.
- Mirtazapine (Remeron) is also a unique antidepressant that is thought to affect mainly serotonin and norepinephrine through different brain receptors than other medicines. It is usually taken at bedtime because it often causes drowsiness. Side effects are usually mild and include sleepiness, weight gain, elevated triglycerides, and dizziness.
- Trazodone (Desyrel) is usually taken with food to reduce chance for stomach upset. Other side effects include drowsiness, dizziness, constipation, dry mouth, and blurry vision.
