Major depressive disorder is a mood disorder characterized by depressed mood or loss of interest in activities accompanied by insomnia or sleeping too much, fatigue, changes in appetite or weight, feeling hopeless or worthless, difficulties with concentration or decisiveness, feeling guilty, feeling restless or slowed down or thoughts about suicide or death. Depression is a serious condition that warrants treatment. According to a study by Martin Keller in the May 18, 2000, issue of the New England Journal of Medicine, the most effective treatment for depression is a combination of antidepressant medication and psychotherapy. The following describes the various types of antidepressants.
Selective Serotonin Reuptake Inhibitors
Selective serotonin reuptake inhibitors, or SSRIs, are a type of antidepressant that affects serotonin, a biochemical called a neurotransmitter that transmits signals between neurons in the brain. SSRIs increase serotonin levels. Side effects of SSRIs include insomnia, sexual dysfunction, headache, and gastrointestinal difficulties (such as nausea, diarrhea and constipation). The best known SSRI is Prozac (fluoxetine is its generic name). Other SSRIs include Zoloft (sertraline), Lexapro (escitalopram), Paxil (paroxetine),Celexa (citalopram), and Luvox (fluvoxamine),
Serotonin-Norepinephrine Reuptake Inhibitors
Serotonin-norepinephrine reuptake inhibitors, or SNRIs, are a newer type of antidepressant. SNRIs affect the neurotransmitters serotonin and norepinephrine, thus, increasing the levels of these neurotransmitters in the brain. SNRIs have similar but milder side effects when compared to those of the SSRIs. Some SNRIs include Effexor (venlafaxine), Cymbalta (duloxetine), Pristiq (desvenlafaxine) and Ixel (milnacipran).
Tricyclic Antidepressants
Tricyclic antidepressants, or TCAs, were introduced in the 1950s and are the oldest type of antidepressant medications. TCAs seem to affect the neurotransmitters norepinephrine and serotonin. These medications are effective in treating depression but have undesirable side effects, including increased heart rate, constipation, dry mouth, fatigue and weight gain. They are often lethal when taken in excessive doses. Some TCAs include Elavil (amitriptyline), Tofranil (imipramine), Anafranil (clomipramine), Doxepin (sinequan), and Surmontil (trimipramine).
Monoamine Oxidase Inhibitors
Monoamine oxidase inhibitors, or MAOIs, are used less often because of potentially lethal drug and food interactions. Taking certain drugs, such as cold medicines, and eating food and drinking beverages with tyramine (such as cheese, red wine and beer) can cause very high blood pressure and even death. Some MAOIs include Marplan (isocarboxazid), Nardil (phenelzine) and Parnate (tranylcypromine).
Other Antidepressants
Wellbutrin and Remeron are two other antidepressants that have been recently introduced. Wellbutrin (bupropion) affects the neurotransmitters norepinephrine and dopamine. It is known for being effective in treating depression without causing sexual dysfunction. Wellbutrin is also called Zyban when it is prescribed to help people stop smoking. Remeron (mirtazepine) is another newer antidepressant. The major downside to Remeron is its side effects of increased hunger, weight gain and drowsiness.
References
- "The New England Journal of Medicine"; A Comparison of Nefazodone, the Cognitive Behavioral-Analysis System of Psychotherapy and their Combination for the Treatment of Chronic Depression;. Martin Keller, James McCullough, Daniel Klein, Bruce Arnow, David Dunner, Allan Gelenberg, John Markowitz, Charles Nemeroff, James Russell, Michael Thase, Madhukar Trivedi and John Zajecka; May 18, 2000
- "PDR Drug Guide for Mental Health Professionals, 3rd Edition"; Thomson Reuters; 2007.
