Common Antidepressant Medications

A list of antidepressants and their side effects

Depression includes a wide range of normal negative emotions and often manifests physically in symptoms that won’t respond to treatment, including but not limited to weight gain, chronic pain, and digestion disorders. But clinical depression differs significantly from minor or situational depression or mood disorders, even though the symptoms can be the same. How can you tell which you have? The difference is that in mild depression the symptoms ebb and flow and eventually lift, while in major depression they spiral down into a full-blown mental health crisis. Patients often describe the sense that they are on the edge of, or slipping into, a deep, dark hole.

Common symptoms of depression

If you’ve been feeling any of the following symptoms consistently for over a month, you should immediately seek medical advice, preferably from a trained psychiatrist, psychologist, or social worker.

•  Overwhelming, persistent feelings of grief, anxiety, guilt, or despair
•  A sense of numbness or hollowness
•  Feelings of hopelessness
•  A loss of interest or pleasure in activities that you once enjoyed, including sex
•  Dullness
•  Decreased energy
•  Difficulty concentrating or making decisions
•  Disrupted sleep patterns
•  Loss of appetite
•  Suicidal thoughts or attempts and obsessing about death—these are serious warning signs that need to be addressed immediately

If this sounds like you, please don’t worry. You can get better. Depression is a physical and mental condition that responds very well to treatment, both conventional and integrative. The most important thing is to get some help.

Treatment through medication

You may be asked to take medication as part of your treatment plan. If so, then you’ll want to know what some of the options are, so you can help choose what’s best for you. Following is a list of the many antidepressant medications that are used in conventional medicine. It is not a comprehensive list; available medications change rather quickly with new ones being released all the time. This list will familiarize you with some of the medications used for depression and their biochemical family. Some of these medications come with a number of side effects, even when only used short-term. I’ve outlined some of those side effects under headings for the various types of antidepressants.

Relatively little is known about the long-term effects of most drugs used to treat depression since they were never studied for long term use, or their interactions with other drugs. For a more comprehensive discussion about antidepressants, or if you’re curious about natural alternatives to antidepressants, be sure to read our articles on antidepressants and alternative treatments for depression.

Common Antidepressant Medications

Tricyclics

These drugs have been around for a long time and they affect norepinephrine and serotonin. They are as effective as SSRIs in many people, but they do have a much stronger side effect profile. Thus they are usually suggested as a second or third option, rather than a first treatment. Some of the common side effects of tricyclics include dry mouth, constipation, bladder problems, sexual dysfunction, blurred vision, dizziness, drowsiness, and increased heart rate.

MAOIs

Monoamine oxidase inhibitors (MAOIs) are really helpful for some people who have major depression and don’t react to other antidepressants. They can also be used to treat panic disorder and bipolar disorder. People who take MAOIs have many things to remember as they have to avoid taking decongestants and eating many foods that contain high levels of the monoamine tyramine, including fish, chocolate, and fermented foods (such as alcoholic beverages, cheeses, soy sauce, processed meats, and pickles).There are also many vitamins and nutrients that can interact with MAOIs. So if you are on an MAOI remember to read the labels and learn about interactions. One of the most notable interactions of tyramine with MAOIs is they can bring on a sharp increase in blood pressure that can lead to a stroke.

SSRIs

The side effects of serotonin reuptake inhibitors (SSRI) include sexual dysfunction, nausea, nervousness, insomnia, agitation, and decreased sweating with increased body temperature. These side effects may be enhanced when an SSRI is combined with other medications or herbs that affect serotonin (such as St. John’s Wort and SAM-e). There are many people however, who do very well with these treatments. Just remember that we are all different, and we all have different reactions, so it’s important to pay attention. In extreme cases, the combination of medications (for example, an SSRI and an MAOI) may result in a potentially serious or even fatal serotonin syndrome, characterized by fever, confusion, muscle rigidity, and cardiac, liver, or kidney problems.

Newer drugs

There are new classes of antidepressants being developed and being made available for use. Sometimes, these are hard to classify because of their combined biochemical action. One example is serotonin/norepinephrine reuptake inhibitors (SNRI).This class of drugs, like tricyclics, affects both norepinephrine and serotonin levels but comes with less side effects. SNRIs include Effexor (venlafaxine) and Serzone (nefazadone).  

The trade name Serzone was discontinued in 2003 due to some cases of life-threatening liver failure reported in patients treated with Serzone; however, the generic version of Serzone (nefazodone) remains available. The liver issue is probably related to a genetic SNP affecting how drugs are detoxified by the liver. Patients should call their doctor if they have the following symptoms of liver dysfunction: yellowing of the skin or whites of the eyes, unusually dark urine, loss of appetite that lasts for several days, nausea, severe lethargy or abdominal pain.

There are other newer medications that are not chemically related to the other antidepressants, including Remeron(mirtazepine) and Wellbutrin (bupropion). These drugs have similar side effects to SSRIs. They must not used by anyone who has, or might be at risk for, seizure disorders.