Antidepressants: Selecting one that's right for you
Daunted by the choice in antidepressants? With persistence, you and your doctor should find one that works so you can enjoy life more fully again.
Antidepressant medications are often the first treatment choice for adults with moderate or severe depression, sometimes along with psychotherapy. Although antidepressants may not cure depression, they can help you achieve remission — the disappearance or nearly complete reduction of depression symptoms.
With scores of antidepressants available, finding the right medication for your situation can be challenging, though. Explore the decision-making process that may help you and your doctor find the best antidepressant for your situation.
Finding the right antidepressant for you
Finding the right antidepressant for your situation might take time. Each antidepressant has its own pros and cons, and until you try one, you won't know exactly how it'll affect you or how well it'll work. You may need to try several antidepressants before finding the one, or the combination, that works best for you.
In general, most antidepressants work pretty well for most people. So which antidepressant you and your doctor choose depends largely on:
Anticipated side effects
Your ability to tolerate these side effects and stick with the treatment
Cost and health insurance coverage
Previous experiences you or family members have had with antidepressants
Whether you're pregnant or breast-feeding
Your age
Your other medical and psychiatric conditions
Blood test may help in choosing antidepressants
A blood test may help make the antidepressant decision somewhat easier. The test, called the cytochrome P450, helps pinpoint genetic factors that influence your response to certain antidepressants (as well as some other medications). The test doesn't predict which antidepressant will work best for you. But it does help suggest which ones may not work, and which ones may have the greatest side effects specifically for you.
Approach to antidepressant treatment
Antidepressants are generally prescribed in a step-by-step treatment approach. When you're beginning treatment for the first time, doctors typically start by prescribing a type of antidepressant that's thought to be very effective and has the fewest side effects. If this doesn't work, your doctor may prescribe different types of antidepressants or combinations of two or more antidepressants and other medications. Don't give up until you find an antidepressant that's suitable for you — you have a good chance of finding one that works and doesn't have intolerable side effects.
First choices in antidepressants
Many doctors start by prescribing antidepressants known as SSRIs — selective serotonin reuptake inhibitors. This is because the side effects of these kinds of antidepressants are generally more tolerable than those of other types of antidepressants, and they also generally work well.
Generic Name: clomipramine (kloe MI pra meen)
Brand Names: Anafranil What is Anafranil (clomipramine)? Clomipramine is a tricyclic antidepressant. It affects chemicals in the brain that may become unbalanced.
Clomipramine is used to treat symptoms of obsessive-compulsive disorder (OCD) such as recurrent thoughts or feelings and repetitive actions.
Generic Name: citalopram (oral) (si TAL o pram)
Brand Names: Celexa What is Celexa?
Celexa is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It works by restoring the balance of serotonin, a natural occuring substance found in the brain, which helps to improve certain mood problems. Celexa is used to treat depression.
Generic Name: duloxetine (du LOX e teen)
Brand Names: Cymbalta What is Cymbalta? Cymbalta is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Cymbalta affects chemicals in the brain that may become unbalanced and cause depression.
Cymbalta is used to treat major depressive disorder and general anxiety disorder. It is also used to treat a chronic pain disorder called fibromyalgia, and to treat pain caused by nerve damage in people with diabetes (diabetic neuropathy).
Desyrel
Generic Name: trazodone (TRAZ oh done)
Brand Names: Desyrel What is Desyrel (trazodone)?
Trazodone is an antidepressant medication. It affects chemicals in the brain that may become unbalanced and cause depression
Trazodone is used to treat depression.
Generic Name: venlafaxine (oral) (VEN la fax een)
Brand Names: Effexor, Effexor XR What is Effexor?
Effexor is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Effexor works by restoring the balance of certain natural substances in the brain, which helps to improve certain mood problems.
Effexor is used to treat major depressive disorder, anxiety, and panic disorder.
Generic Name: amitriptyline (a mee TRIP ti leen)
Brand Names: Vanatripb
What is Elavil?
Elavil is in a group of drugs called tricyclic antidepressants. Elavil affects chemicals in the brain that may become unbalanced.
Elavil is used to treat symptoms of depression.
Generic Name: fluoxetine (floo OX e teen)
Brand names: Prozac, Prozac Weekly, Rapiflux, Sarafem, Selfemra What is fluoxetine?,br.
Fluoxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Fluoxetine affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms.
Fluoxetine is used to treat major depressive disorder, bulimia nervosa (an eating disorder) obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD).
Generic Name: ziprasidone (zi PRAY si done)
Brand Names: Geodon What is Geodon?
Geodon is an antipsychotic medication. It works by changing the effects of chemicals in the brain.
Geodon is used to treat schizophrenia and the manic symptoms of bipolar disorder (manic depression).
Generic Name: escitalopram (EE si TAL o pram)
Brand Names: Lexapro What is Lexapro?
Lexapro is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It affects chemicals in the brain that may become unbalanced and cause depression or anxiety.
Lexapro is used to treat anxiety and major depressive disorder.
Loxapine
Generic: Loxitane )
Loxapine ( Loxitane ) is an anti psychotic drug of intermediate-potency. Used in the treatment of disorganized and psychotic thinking. Also used to help treat false perceptions ( e.g. hallucinations or delusions ).
Generic Name: fluvoxamine (floo VOX a meen)
Brand Names: Luvox, Luvox CR What is Luvox (fluvoxamine)? Fluvoxamine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Fluvoxamine affects chemicals in the brain that may become unbalanced and cause obsessive-compulsive symptoms.
Fluvoxamine is used to treat social anxiety disorder (social phobia), or obsessive-compulsive disorders involving recurring thoughts or actions.
Generic Name: paroxetine (pa ROX a teen)
Brand Names: Paxil, Paxil CR, Pexeva What is Paxil? Paxil is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRI). It works by restoring the balance of serotonin,a natural substance in the brain, which helps to improve certain mood problems.
Paxil is used to treat depression, obsessive-compulsive disorder, anxiety disorders, post-traumatic stress disorder, and premenstrual dysphoric disorder.
Generic Name: fluoxetine (floo OX e teen)
Brand Names: Prozac, Prozac Weekly, Rapiflux, Sarafem What is Prozac? Prozac is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Prozac affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms.
Prozac is used to treat major depressive disorder, bulimia nervosa (an eating disorder) obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD).
Generic Name: mirtazapine (mir TAH zah peen)
Brand Names: Remeron, Remeron SolTab What is Remeron? Remeron is a tetracyclic antidepressant. It affects chemicals in the brain that may become unbalanced and cause depression. It is thought to increase the activity of norepinephrine and serotonin which help elevate mood.
Remeron is used to treat major depressive disorder.
Generic Name: bupropion (oral) (byoo PRO pee on)
Brand Names: Budeprion, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban What is Wellbutrin?
Wellbutrin is an antidepressant medication. It works in the brain to treat depression.
Wellbutrin is used to treat major depressive disorder and seasonal affective disorder. At least one brand of bupropion (Zyban) is used to help people stop smoking by reducing cravings and other withdrawal effects.
Zoloft
Generic Name: sertraline (SER tra leen)
Brand Names: Zoloft
Zoloft is well tolerated and effective for the treatment of depression and certain anxiety conditions.
Zoloft is FDA approved to treat depression, certain types of social anxiety conditions, posttraumatic stress disorder (PTSD), panic disorder, obsessive-compulsive disorder (OCD), and premenstrual dysphoric disorder (PMDD) in adults over age 18. It is also approved for OCD in children and adolescents age 6-17 years.
Zyprexa
Generic Name: olanzapine (oh LANZ a peen)
Brand Names: Zyprexa, Zyprexa Zydis What is Zyprexa? Zyprexa is an atypical antipsychotic medication. Exactly how it works is not known. It is thought to work by changing the actions of certain chemicals in the brain.
Zyprexa is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression).
