Effexor, generic name venlafaxine, is prescribed to treat depression. It works as a selective serotonin and norepinephrine reuptake inhibitor. This means it increases the amounts of the neurotransmitters serotonin and norepinephrine in the brain. This medication may take 6 to 8 weeks of dosing before results are observed. Other classes of antidepressants including selective serotonin reuptake inhibitors and tricyclic antidepressants can be tried if Effexor is not working or if the side effects are not tolerable. Patients considering switching medications, need to consult their physician.
Prozac
Prozac, generic name fluoxetine hydrochloride, works as a selective serotonin reuptake inhibitor. It comes in doses of 10, 20 and 40 mg. The initial dose is 20 mg per day and can be increased up to a maximum of 80 mg per day. A life-threatening condition that can develop as a result of increasing serotonin levels in the brain is called "serotonin syndrome." Symptoms include a racing heart, agitation, hallucinations, nausea and vomiting, diarrhea and over-active reflexes. If patients experience these symptoms, they need to contact a health care provider immediately.
Elavil
Amitriptyline, brand name Elavil, is a tricyclic antidepressant, named so for its three-ringed chemical structure. Tricyclic antidepressants work on several receptors in the brain, which may increase side effects. These include headaches, nightmares, confusion, nausea, dry mouth and changes in appetite. Other side effects such as crushing chest pain, rapid, pounding or irregular heartbeat or weakness or numbness of an arm or a leg may signal a serious condition, and patients should contact a physician immediately if they have any of these symptoms. A study by Yvonne-B. Schueler and Markus Koesters, et al., published in the journal Acta Psychiatrica Scandinavica suggests that venlafaxine was not different than tricyclic antidepressants in either response rate or the rate of discontinuation due to adverse events.
Wellbutrin
Wellbutrin, generic name bupripion, works by weakly inhibiting the reuptake of norepinephrine and dopamine. However, the mechanism of this antidepressant is not fully understood. Wellbutrin is not related chemically to either the selective serotonin reuptake inhibitors or the tricyclic antidepressants. Bupropion has been associated with seizures; the risk for seizure increases with dose. Other side effects may include agitation, insomnia and anxiety. Neuropsychiatric side effects can include confusion, trouble concentrating, delusions, hallucinations or paranoia and psychosis. Patients should consult a physician if they experience side effects.
References
- PubMed Health: Venlafaxine
- Eli Lilly: Prescribing Information, Prozac
- MedlinePlus: Amitriptyline
- "Acta Psychiatrica Scandinavica"; A Systematic Review of Duloxetine and Venlafaxine in Major Depression, Including Unpublished Data; September 2010
- GlaxoSmithKline: Prescribing Information, Wellbutrin
