Looking for a simple list of common antidepressants.
Antidepressants are drugs used primarily to treat the symptoms of clinical depression. Other uses of antidepressants include treating neuropathic pain and chronic pain disorders (mainly with tricyclic antidepressants), and treating anxiety disorders. The first effective antidepressants, monoamine oxidase inhibitors (MAOIs), were developed in the 1950s. Since then, several classes of antidepressants have joined the market, including tricyclic antidepressants (TCAs), selective serotonin-reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
An antidepressant's effectiveness and tolerability may vary between individuals, and people with depression may be prescribed more than one type of antidepressant before finding one that is right for them.
Discovery of Antidepressants
As with many other scientific discoveries, antidepressants were discovered by accident. MAOIs, the first antidepressants, were discovered in the early 1950s. Iproniazid was the first drug in this class - and was originally developed to treat tuberculosis.
Tricyclic antidepressants (TCAs) were next, starting with imipramine. Although as effective and safer than MAOIs, TCAs still posed high risk in cases of overdose. Although TCAs are still in use, they have largely been superceded by Selective Serotonin-Reuptake Inhibitors or SSRIs. Fluoxetine - better known by its brand-name, Prozac, was the first SSRI ro be marketed.
Drugs from the MAOI, TCA and SSRI classes have all been shown to effectively alleviate depressive symptoms.
Each class of antidepressants works in a different way and has a broadly characteristic range of common side-effects. The most recent antidepressants are generally regarded as being more tolerable and less likely to cause death in case of overdose.
Within a given class of antidepressants, there may be a variety of drugs that work accoridng to the same mechanism, and each drug may be sold by one or mroe brand names, as shown in Table I:
Table I: Antidepressant Classes and Generic and Brand Names
|Class||Abbreviation||Generic Name||Brand Name(s)|
|Dopamine reuptake inhibitors||DRIs||bupropion*||Wellbutrin, Zyban|
|Monoamine oxidase inhibitors||MAOIs||moclobemide||Aurorix, Manerix|
|Norepinephrine/noradrenaline reuptake inhibitors||NRIs, or NERIs/NARIs||bupropion||Wellbutrin, Zyban|
|Opioids||--||buprenorphine||Temgesic, Buprenex, Subutex|
|Selective serotonin reuptake enhancers||SSREs||tianeptine||Stablon, Coaxil, Tatinol|
|Selective serotonin reuptake inhibitors||SSRIs||fluoxetine||Prozac, Sarafem, Fluctin, Fontex, Prodep, Fludep, Lovan|
|sertraline||Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton|
|citalopram||Celexa, Cipramil, Talohexane|
|paroxetine||Paxil, Seroxat, Aropax|
|Serotonin-norepinephrine reuptake inhibitors||SNRIs||duloxetine||Cymbalta|
|Tetracyclic antidepressants||--||maprotiline||Deprilept, Ludiomil, Psymion|
|amoxapine||Asendin, Asendis, Defanyl, Demolox, Moxadil|
|trazodone||Desyrel, Trittico, Thombran, Trialodine|
|dothiepin (dosulepin)||Prothiaden, Dothapax|
* Bupropion is a relatively weak inhibitor of the neuronal uptake of norepinephrine, serotonin and dopamine.
How Antidepressants Work
Antidepressants are primarily classed according to how the drugs work in the body. For example, SSRIs prevent neurons from taking up serotonin that is released between at the junction between two neurons (thus the term "reuptake inhibitor"). The overall effect is that the level of serotonin in the brain's synapses increases. In contrast, MAOIs prevent the breakdown of neurotransmitters by enzymes that normally break them down, and TCAs prevent reuptake of various neurotransmitters, including serotonin, norepinephrine and dopamine.
Although much is known about these drugs on the checmical level, some questions remain unanswered. For example, while it takes only a few days for blood levels of these drugs to rise, the consequent changes in modd may require up to a month or more to occur - and the cause for the disparity remains unclear.
Switching and Augmenting Antidepressants
According to the American Psychiatric Association 2000 Practice Guideline for the Treatment of Patients with Major Depressive Disorder, where no response occurs after 6-8 weeks' treatment with an antidepressant, switching to another antidepressant in the same class, then to a different class of antidepressant, is recommended. In some cases, the American Psychiatric Association advises augmenting an antidepressant with a different drug, such as lithium, thyroid supplementation, atypical antipsychotics, and dopamine agonists.