Depression globally impacts 121 million people and causes work, home life and relationships to suffer. Depression, which affects 10-20% of people throughout life, increases health care costs by increase the severity of many diseases. Depression impairs quality of life, impairs physical and mental functioning and increases disability. Medicine is a popular modality to treat depression. Medications altar the chemicals - also known as neurotransmitters - in the brain, and can have a profound impact on depression. This article will help you understand the different medication classes used to treat depression.
Step 1 The most popular class of medication is the Selective serotonin reuptake inhibitors (SSRIs). Drugs in this class include: paroxetine (****), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), and fluvoxamine (Luvox). They are associated with minimal side effects and are safer then older classes of antidepressants.
Step 2 Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a newer class of medication to treat depression. Drugs in this class include: venlafaxine (Effexor), duloxetine (Cymbalta) and Desvenlafaxine (Pristiq). This class has similar safety to SSRIs, but occasionally they may be associated with an increase in blood pressure. They can be used as the first drug to treat depression as well as in those who do not respond to SSRIs
Step 3 Tricyclic antidepressants (TCA), including amitriptyline (Elavil) and nortriptyline (Pamelor), are an older drug that have fallen out of favor with the development of the newer types of antidepressants. TCAs have numerous side effects and can be lethal in overdose.
Step 4 Monoamine oxidase inhibitors are another older class of antidepressants. They are not used often today because of better tolerated agents. They have the potential for serious interactions with both food and other medications - including over the counter medications. The restrictions associated with these medication are significant and typically they are only prescribed by a prescriber who is well versed in monitoring these medications.
Step 5 Other antidepressants include: bupropion (Wellbutrin), nefazodone (Serzone), mirtazapine (Remeron) and trazodone (Desyrel). This group also shows low toxicity in overdose and may have an advantage over the SSRIs by causing less sexual dysfunction and GI distress. Trazodone and mirtazapine are associated with sedation. Bupropion may increase the risk of seizures. This class is often used when SSRIs and SNRIs do not.
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