Depression Medication: Types of Antidepressants

Clinical depression is treated with a wide range of different medications. Zoloft, Prozac, SSRIs, TCAs, MAOIs – the different terms can confuse and bewilder anyone that's not an MD. Antidepressant drugs generally fall into three broad categories, each of which is described below.

Common Brand Names

You may have seen advertisements for depression medications online or in magazines. Each of these work in different ways, described below. Some common brand names of depression medications include:
  • Adapin®
  • Endep®
  • Luvox®
  • Nardil®
  • Norpramin®
  • Pamelor®
  • Parnate®
  • Paxil®
  • Prozac®
  • Sinequan®
  • Zoloft®.
SSRIs (Selective Serotonin Reuptake Inhibitors)
How they work An SSRI works by stabilizing levels of serotonin, an important neurotransmitter. Low levels of serotonin have been linked to depression and other mood disorders.
Commonly prescribed drugs Zoloft, Prozac, Luvox, Paxil
Advantages Antidepressant drugs such as Zoloft and Prozac have relatively few side effects compared to other medications. An SSRI is generally the first choice of most physicians.
Disadvantages Can be transferred in breast milk: results can take up to 12 weeks: can cause mild side effects, such as headaches. 


TCA (Tricyclic Antidepressants)
How they work An earlier family of antidepressant drugs, TCAs increase the brain's levels of norepinephrine, a neurotransmitter.
Commonly prescribed drugs Adapin, Endep, Norpramin, Pamelor, Sinequan
Advantages More side effects than SSRIs, but some patients respond better to TCA medication.
Disadvantages May cause sensitivity to heat, making it harder for the body to adjust to temperature changes. Must be discontinued slowly, or withdrawal symptoms may occur.


MAOI (Monoamine Oxidase Inhibitors)
How they work MAOIs increase the levels of epinephrine, norepinephrine and serotonin in the brain.
Commonly prescribed drugs Nardil, Parnate
Advantages May be used if other antidepressant medications fail to treat the depression.
Disadvantages A strict dietary regimen must be followed. Failure to do so can result in a hypertensive crisis, which can be fatal. Many other medications react badly with MAOIs.


MAOI Transdermal (Skin) Patch

How they work Delivers selegiline (an MAOI) through the skin to the bloodstream then has the same effect as oral MAOIs.
Commonly prescribed drugs Emsam (selegiline) is the only transdermal antidepressant available.
Advantages The skin patch delivers antidepressant medication continuously over 24 hours. With the lowest dose (6 mg), no dietary restrictions are required.
Disadvantages With higher doses (9 mg and 12 mg), patients must follow a tyramine-free diet regimen or risk a hypertensive crisis. Numerous medications should not be used with transdermal selegiline.

The categories listed above are by no means exhaustive. That is, your doctor could prescribe a drug that does not appear in any of the general categories mentioned. New drug treatments for depression are constantly being developed and tested in pharmacology and research labs around the world. In the US, drugs must receive FDA approval before entering the consumer market.

Most medications must be taken for a period of time before any improvement is seen.Your doctor will choose the drug that's best for you. When starting a medication, your doctor may adjust the drug dosage depending on your reaction. This is not unusual. Most medications must be taken for a period of time before results are seen, so it's important to report any problems or side effects to the prescribing physician. Because some of these drugs have serious interaction effects — that is, if you take them with other medications, the result could be very damaging to you — never take antidepressants with any other medications or supplements without first consulting your physician. And never take any medication that was prescribed for someone else.

Resources

Depression Clinic staff. (n.d.). Antidepressants. Retrieved September 21, 2001, from the Depression Clinic Web site: www.depressionclinic.com/
mentalhealth/depression/medication/default.htm.

National Institute of Mental Health. (updated 2002). Depression. [NIH Publication No. 02-3561].

U.S. Food and Drug Administration staff. (2006). FDA approves Emsam (selegiline) as first drug patch for depression. FDA News.