Diagnosed with depression? You are not alone. Nearly ten percent of all Americans will suffer an episode of major depression in their lifetime, and is, as of 1990, the fourth leading cause of mental illness according to the World Health Organization. Characterized by symptoms such as poor mood, loss of interest in activities and concentration problems, major depressive disorder can affect eating, sleeping and the general ability to enjoy life.
The terminology when it comes to antidepressant medications can be overwhelming. There are several different classes of medication based on their chemical properties. Some are more commonly prescribed for depression than others are. Most drugs have a patented brand name as well as a bio-equivalent and therapeutic-equivalent generic name; both names are given here for reference. The list of drug names is quite extensive, so only the most popular ones will be discussed.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are considered the first line of pharmaceutical treatment in depression. They work by increasing the level of serotonin in the brain. Serotonin is a neurotransmitter, meaning it helps regulate the signal between neurons and other cells, and is known for its role in happiness. SSRIs generally take four to six weeks before side effects subside and significant results can be seen.
SSRIs are the most commonly prescribed antidepressants in the US, as of 2007. These include Zoloft (sertraline Hcl), Lexapro (escitalopram oxalate) and Prozac (fluoxetine Hcl). Also in the top 10 are Paxil (paroxetine hydrochloride) and Celexa (citalopram hydrobromide).Common side effects include nausea, headache, dry mouth, sexual dysfunction, constipation and insomnia.
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
Like SSRIs, SNRIs prevent serotonin from being reabsorbed by the body, and thus increase the levels of serotonin in the brain. They also work on a second hormone and neurotransmitter, norepinephrine. Related to epinephrine and adrenaline, norepinrephrine can increase energy and concentration performance. Recent studies show that SNRIs may also raise the levels of dopamine, another neurotransmitter that is important for feelings of pleasure.
Compared to SSRIs, SNRIs have a higher rate of side effects, including jitteriness and insomnia. SNRIs include Effexor (venlafaxine hydrochloride), Cymbalta (duloxetine Hcl), Savella (milnacipran HCl) and Pristiq (desvenlafaxine).
Tricyclic Antidepressants (TCAs)
Tricyclics are named for their three-ringed chemical structure. Discovered in the 1950s, they were the first line of antidepressants for several decades before the introduction of SSRIs. While still effective as antidepressants, they are now less commonly prescribed due to an increased risk of side effects and overdose potential compared to newer drugs. Common TCAs include Elavil (amitriptyline), Anafranil (clomipramine Hcl), Tofranil (imipramine), Pamelor (nortryptyline HCl) and Sinequan (doxepin).
Other Classes
Other types of medication sometimes prescribed for depression include mood stabilizers, antipsychotics, tetracyclics and some seizure medications. According to Drug Topics magazine, Wellbutrin (bupropion Hcl) is the fourth most commonly prescribed antidepressant and is in a class of its own, inhibiting both norepinephrine and dopamine.
Mood stabilizers, such as lithium salts, and antipsychotics such as Seroquel (quetiapine fumarate)are mostly used to treat bipolar disorder and schizophrenia, but may be prescribed to treat unipolar depression when other treatments have failed.
Tetrayclic antidepressants like Remeron (mirtazipine) and Desyrel (trazodone hydrochloride) are often prescribed for sleep due to their sedative properties. Monoamine Oxidase Inhibitors (MAOIs) are less common due to their higher interaction rate with over-the-counter medications and certain foods.
Anticonvulsant medications, normally used for epilepsy, such as Lamictal (lamotrigine) and Topamax (topiramate), are sometimes prescribed for their mood stabilizing properties. Herbal remedies are also popular, but many are not approved by the FDA and the medical literature available on them is limited.
Disclaimer: The information provided here is intended for educational and informational purposes only and should not be used to diagnose or treat symptoms of depression. Consult with a qualified medical or mental health professional before beginning, changing or stopping any medications.
Sources:
- "Conquiring Depression: Some Facts and Figures"; World Health Organization. 18 Aug 2006. Retrieved July 11, 2011.
- Robert Sapolsky. (Nov. 10, 2009). “Stanford's Sapolsky On Depression in U.S. (Full Lecture).” Stanford University. Stanford, California. Retrieved July 3, 2011.
- "Top 200 generic drugs by units in 2007." (Feb. 18, 2008). Drug Topics. Retrieved July 3, 2011.
- “Mental Health Medications.” (Revised 2008). US Dept. of Health and Human Services: National Institute of Mental Health. Retrieved July 3, 2011.
Candice Hall - Candice Hall is a freelance writer who enjoys politics, pop-culture, and people that burn, burn, burn like fabulous roman candles.
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