Medications to relieve symptoms of depression are called antidepressants. They work by altering levels of certain neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain. A neurotransmitter is a brain chemical that enables messages to pass from nerve cell to nerve cell in the central nervous system. Many people with depression have low levels of one or more of these neurotransmitters and antidepressant medications help to boost levels. The most common types of antidepressant medication are:

• Selective serotonin reuptake inhibitors
• Serotonin and norepinephrine reuptake inhibitors
• Tricyclic antidepressants
• Combined reuptake inhibitors and receptor blockers
• Monoamine oxidase inhibitors
• Norepinephrine and dopamine reuptake inhibitors

Your healthcare professional will be able to provide you with information on each medication, which one to take, and possible side effects. Antidepressants sometimes cause mild side effects, some of which may be transient. See your healthcare professional to discuss any side effects you may experience, because stopping your medication abruptly will worsen side effects. Here is a detailed description of the antidepressant medications that you may be prescribed:

1. Selective serotonin reuptake inhibitors

• citalopram (Celexa)
• escitalopram (Lexapro)
• fluoxetine (Prozac, Prozac Weekly™)
• paroxetine (Paxil, Paxil CX®, Pexeva)
• sertraline (Zoloft)

Selective serotonin reuptake inhibitors are the most commonly prescribed medication in the USA for depression, because their side effects are more tolerable and they are safe if taken accidentally in excessive quantities. However, there has been some concern in the press about an increased suicide risk with this medication, but the evidence linking this form of medication to suicide is weak. Common side effects include diarrhea, nausea, insomnia, headache, and feeling jittery. Often these side effects are transient and will resolve within a few days of commencing treatment. One troublesome side effect is sexual problems, whereby people can experience a reduced libido. Antidepressants sometimes cause mild and, usually, temporary side effects in some patients. These side effects are usually not serious. However, any unusual reactions or side effects or reactions that interfere with functioning should be immediately reported to your healthcare professional.

2. Serotonin and norepinephrine reuptake inhibitors

• venlafaxine (Effexor)
• duloxetine (Cymbalta)

Some common side effects of these medications include nausea and loss of appetite, nervousness, headache, and insomnia; dry mouth, constipation and sexual problems can also occur.

3. Tricyclic antidepressants

• amitriptyline (Elavil)
• desipramine (Norpramin)
• doxepin (Sinequan)
• imipramine (Tofranil)
• nortriptyline (Pamelor, Aventyl)
• protriptyline (Vivactil)
• trimipramine (Surmontil)

Common side effects of tricyclic antidepressants drugs include:

• Dry mouth
• Constipation: ensure there is plenty of fiber in the diet
• Bladder problems: emptying the bladder may become difficult
• Sexual problems: such as reduced desire and difficulties with orgasm
• Blurred vision: usually transient
• Dizziness: due to the blood pressure dropping when you stand up
• Drowsiness: instead taking the medicine at bedtime can help with sleep and reduce problems with daytime drowsiness

4. Combined reuptake inhibitors and receptor blockers

• trazodone (Desyrel)
• nefazodone (Serzone)
• maprotiline
• mirtazpine (Remeron)

These medications are similar to selective serotonin reuptake inhibitors in treating depression, and may be used in people who do not tolerate the side effects of selective serotonin reuptake inhibitors. Side effects of these medications include dry mouth, constipation, nausea, sedation, and dizziness. Nefazodone may cause serious liver damage and is no longer available in Europe.

5. Monamine oxidase inhibitors

• phenelzine (Nardil)
• tranylcypromine (Parnate)
• isocarboxazid (Marplan)
• selegiline (Emsam)

Monoamine oxidase inhibitors were the first generation of antidepressants. However, today they are not used as initial treatment for depression because of significant problems with dietary restrictions, side effects, and interactions with other drugs.

6. Norepinephrine and dopamine reuptake inhibitors Bupropion (Wellbutrin SR/XL/XR) has common side effects that include headache and an appetite-supressing effect caused by a stimulant ingredient. It is much less likely to cause sexual dysfunction that selective serotonin reuptake inhibitors. Bupropion drug is not to be used in people with anorexia nervosa or bulimia.

original