The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

There are several types of antidepressant drugs that can be used to treat depressive disorders. You may have success with the first medication prescribed, or you may need to try other antidepressants before finding the right one or ones for you. Sometimes the dosage must be increased to be effective. Although some improvements may be seen in the first few weeks, antidepressant medications must be taken regularly for 3-4 weeks (in some cases, as many as eight weeks) before the full therapeutic effect occurs.

Do not stop taking your medication without talking to our doctor. Even if you feel better and think you no longer need the medication, or you may think the medication isn’t helping, do not stop before you speak with your doctor. You need to continue taking the medication until it has a chance to work. Call your doctor if you experience side effects from the medication.

Once you are feeling better, keep taking your medication for as long as your doctor recommends (usually at least six months) to prevent a recurrence of depression. Some medications must be slowly tapered to give your body time to adjust. If stopped abruptly, some drugs may cause withdrawal symptoms. If you have chronic or recurrent depression, you may need to take medication indefinitely.

Prescription Medications

Selective serotonin reuptake inhibitors (SSRIs)

  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Escitalopram (Lexapro)

FDA Public Health Advisory for Antidepressants

The FDA advises that people taking antidepressants should be closely observed. For some, the medications have been linked to worsening symptoms and suicidal thoughts. These adverse effects are most common in young adults. The effects tend to occur at the beginning of treatment or when there is an increase or decrease in the dose.

Although the warning is for all antidepressants, of most concern are the SSRI class such as:

For more information, please visit: http://www.fda.gov/cder/drug/antidepressants/

Tricyclic antidepressants

  • Doxepin (Adapin, Sinequan)
  • Clomipramine (Anafranil)
  • Nortriptyline (Aventyl, Pamelor)
  • Amitriptyline (Elavil)
  • Imipramine (Janimine, Tofranil)
  • Maprotiline (Ludiomil)
  • Desipramine (Norpramin, Pertofrane)
  • Trimipramine (Surmontil)
  • Protriptyline (Vivactil)

Monoamine oxidase inhibitors (MAOIs)

  • Isocarboxid (Marplan)
  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)
  • Selegiline patch (Ensam)

Serotonin/norepinephrine reuptake inhibitors (SNRIs)

  • Venlafaxine (Effexor, Effexor XR)
  • Duloxetine (Cymbalta)

Atypical antidepressants

  • Trazodone (Desyrel)
  • Nefazodone
  • Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL)
  • Mirtazapine (Remeron)

Selective Serotonin Reuptake Inhibitors (SSRIs)

See FDA Public Health Advisory above.

Common names include:

Selective serotonin reuptake inhibitors (SSRIs) affect the concentration in the brain of the neurotransmitter serotonin, which plays a role in depression. The SSRIs are often a preferred class of antidepressants because they are thought to be easier to use, tend to produce fewer side effects, are as effective, and are less likely to be fatal in an overdose compared to other medications available. SSRIs are not addictive.

Improvement is usually seen in 4-6 weeks after beginning treatment. You should not drink alcohol while taking this medication. Do not take an SSRI if you have taken a monoamine oxidase inhibitor (MAOI) in recent weeks.

Possible side effects include:

  • Nausea
  • Diarrhea
  • Insomnia
  • Loss of appetite or weight loss
  • Nervousness
  • Dizziness
  • Sexual dysfunction (ranging from decreased arousal to erectile dysfunction and/or delayed time to orgasm)

Tricyclic Antidepressants

Common names include:

Tricyclic antidepressants are thought to regulate serotonin and norepinephrine in the brain. They have been used effectively for the treatment of depression. Improvement is usually seen in 3-6 weeks after beginning treatment. These drugs are highly toxic if taken in large doses; therefore, they are often not prescribed for suicidal patients. Tricyclic antidepressants are not addictive.

Possible side effects include:

  • Dizziness
  • Dry mouth
  • Constipation
  • Difficulty urinating
  • Weight gain
  • Low blood pressure
  • Sexual dysfunction

Monoamine Oxidase Inhibitors (MAOIs)

Common names include:

Monoamine oxidase inhibitors (MAOIs) are a type of antidepressant that prevent the breakdown of serotonin and norepinephrine. They have been shown to be effective in treating depression. This medication is especially effective for people whose symptoms have not responded to other treatments. Improvement is usually seen in 2-6 weeks after beginning treatment. MAOIs are not widely used today because of dietary restrictions and unpleasant side effects. Ensam (selegiline patch), the lowest dose, is an exception to this.

MAOIs can cause severe adverse reactions when combined with many other types of drugs, including other types of antidepressants. Ask your doctor and pharmacist for complete directions about what drugs to avoid. When taking MAOIs, there are foods you should avoid, as well. These are foods with a high tyramine content, such as:

  • Cheese
  • Alcohol
  • Pickled, marinated, smoked, cured, or fermented foods
  • Organ meats
  • Nuts and peanut butter
  • Fava beans
  • Onions
  • Avocados
  • Canned figs
  • Chocolate
  • Excess amounts of caffeine
  • Foods containing monosodium glutamate (MSG)

The above dietary restrictions do not apply to the 6 mg dose. Ask your doctor, pharmacist, or nutritionist for a complete list of foods you should avoid.

Possible side effects include:

  • Changes in blood pressure, including hypertensive crisis
  • Weight gain
  • Reduced sexual response
  • Insomnia

Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs)

Common names include:

SNRIs affect the level of two neurotransmitters in the brain, serotonin and norepinephrine. Some studies suggest that these drugs are more effective than SSRIs, but these results have been questioned. Improvement is usually seen about 3-6 weeks after starting treatment.

Possible side effects include:

  • Dry mouth
  • Constipation
  • Nausea
  • Decreased appetite
  • Fatigue
  • Drowsiness
  • High blood pressure (when taking venlafaxine)

Atypical Antidepressants

Common names include:

Atypical antidepressants affect the concentration of the neurotransmitter serotonin and can be effective in treating depression. Improvement is usually seen in 4-6 weeks after beginning treatment.

Nefazodone (Serzone) has been associated with reports of life-threatening liver failure. People with pre-existing liver disease should not take it. Patients who are taking nefazodone are advised to immediately report symptoms of liver toxicity, such as jaundice , loss of appetite, malaise, and gastrointestinal symptoms, to their doctor.

Depending on the drug, possible side effects include:

  • Dizziness
  • Weight gain
  • Nervousness
  • Drowsiness
  • Dry mouth
  • Increased appetite
  • Increase risk of seizures (when taking bupropion)

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Know what the results and side effects. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

When to Contact Your Doctor

Contact your doctor if you have any questions about your medication, any side effects that are troublesome, or if you feel that the medication is not working after the allotted time period.