Types of Antidepressants

Antidepressants are a group of prescription medicines that treat depression. They may also be used to treat other health conditions. The chemicals in them affect people in different ways. This is why there are several types. You may have to try one or more types before finding one that works. Learn about the different types and talk to your doctor to see which one(s) works for you.

Although prescription antidepressants have the most evidence for their use, there are over-the-counter medications and supplements that are recommended to treat the symptoms of depression. These include 5-HTP and SAMe, among others. These may not be clinically proven to work and may not be FDA approved or regulated. Talk to your doctor before trying any of these types of medicines or supplements.

Path to improved health

Prescription antidepressant medicines are sorted into types. They are based on which chemicals in the brain they affect. Neurotransmitters are the brain chemicals that communicate information throughout your brain and body.

Your doctor may prescribe an antidepressant to treat your depression symptoms. Below are the different types of prescription medicines that regulate the levels of different neurotransmitters in your brain.

Always share with your family doctor if you have a family history of depression or bipolar disease. Antidepressants could make bipolar disorder worse.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs affect a chemical in your brain called serotonin. SSRIs usually are the first kind of antidepressant your doctor will prescribe. These types tend to have fewer side effects.

Types of SSRIs are:

• Citalopram
• Escitalopram
• Fluoxetine
• Fluvoxamine
• Paroxetine
• Sertraline

Common side effects of SSRIs include:

• Dry mouth
• Nausea
• Headaches
• Nervousness
• Restlessness
• Trouble sleeping
• Sexual problems

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

SNRIs affect two chemicals in your brain. They are serotonin and norepinephrine. Your doctor may prescribe them because they don’t interact with your other medicines.

Types of SNRIs are:

• Duloxetine
• Venlafaxine
• Desvenlafaxine

Common side effects of SNRIs include:

• • Nausea (especially in the first 2 weeks)
  • Loss of appetite
  • Anxiety and nervousness
  • Headaches
  • Trouble sleeping
  • Lack of energy
  • Dry mouth
  • Constipation
  • Weight loss
  • Sexual problems
  • Increased heart rate
  • Increased cholesterol levels

Atypical antidepressants

These medicines are called “atypical” because they don’t easily fit into their own category.

Types of atypical antidepressants are:

• Bupropion
• Trazodone
• Mirtazapine

Each drug has different side effects. Like most antidepressants, side effects include nausea, fatigue, and nervousness. Dry mouth, diarrhea, and headaches are common as well.

Trazodone may be used along with an SSRI. This can help with insomnia with depression.

Bupropion may be recommended for people who have certain health issues. The most common is attention-deficit hyperactivity disorder (ADHD). Other issues are nicotine or cocaine dependence. You should not take this kind of medicine if you have a seizure disorder or bulimia. Side effects include agitation, loss of appetite, and trouble sleeping. Bupropion typically has fewer sexual side effects.

Tricyclic antidepressants

Tricyclic antidepressants affect three brain chemicals. They are serotonin, norepinephrine, and dopamine. This is one of the oldest types of antidepressants. The drugs are effective but are used less often because of increased side effects. They take a long time to start working compared to SSRIs and SNRIs. These drugs are not used for older patients, people who have glaucoma, or men who have enlarged prostates.

Types of tricyclic antidepressants are:

• Amitriptyline
• Clomipramine
• Desipramine
• Doxepin
• Imipramine
• Nortriptyline
• Protriptyline
• Trimipramine

Common side effects of tricyclics include:

• Dry mouth
• Blurred vision
• Constipation
• Trouble urinating
• Impaired thinking
• Tiredness
• Worsening of glaucoma

This type of antidepressant also can affect your blood pressure and heart rate.

Monamine oxidase inhibitors (MAOIs)

MAOIs affect an enzyme in your brain called monamine. These drugs typically are used as a last resort if other types haven’t worked.

Types of MAOIs are:

• Isocarboxazid
• Phenelzine
• Selegiline
• Tranylcypromine

MAOIs can have severe side effects. These include:

• Weakness
• Dizziness
• Headaches
• Trembling

They also can have harmful reactions when combined with certain foods or medicines (other antidepressants and cold and flu medicines). The reaction is known as “serotonin syndrome.” These reactions include:

• Hallucinations
• Changes in blood pressure
• Agitation
• Fever

Things to consider

Talk to your doctor about the different types of antidepressants. Be sure they know what other medicines, vitamins, or supplements you take. It is important to follow your doctor’s instructions. You may want to stop taking the medicine(s) once you feel better. However, this can cause your depression to come back. Do not stop taking antidepressants without talking to your doctor. You often need to decrease the dose over time. You cannot get addicted to antidepressants. You may have worse symptoms or withdrawal if you stop taking them at once.

Call your doctor right away or go to the emergency room if you have the following symptoms.

• Attempt to commit suicide
• Have thoughts about suicide or death
• Have thoughts about hurting someone else
• Act angry, violent, or aggressive
• Have sudden onset of mania
• Have panic attacks
• Have severe or ongoing insomnia (trouble sleeping)
• Have new or worsening depression
• Notice heightened symptoms
• Have unusual changes in mood or behavior

Questions to ask your doctor

• What type(s) of antidepressants are best for me?
• How do I know if I should stop taking my medicine(s)?
• What should I do if I accidentally overdose?
• What are the symptoms of withdrawal?

Resources

American Academy of Family Physicians, Clinical Recommendation: Depression

National Institutes of Health, MedlinePlus: Antidepressants

National Institute of Mental Health: Mental Health Medications