Antidepressants

What are antidepressants?

Antidepressants are drugs that are used to treat the symptoms of depression and anxiety. They are also used in the treatment of obsessive compulsive disorder, panic disorders, and bulimia (anti-suppressant).

The body produces chemicals in the brain called neurotransmitters, among them are serotonin, norepinephrine and dopamine. When the body produces low levels of these chemicals, a chemical imbalance occurs in the brain. Antidepressants alter the level and flow of neurotransmitters across the neural synapses, reducing the symptoms of depression.

Antidepressants are not classified as uppers or stimulants. There are different classes of antidepressants, the most common being Selective Serotonin Reuptake Inhibitors (SSRI's) and Tricyclics. Antidepressants are classified by their action on the brain.

See Antidepressants by Drug Types below for the classes of antidepressants drugs common in Australia, Canada, the United Kingdom and The United States, along with their generic drug names and their equivalent brand / trade Name.

Why do people take antidepressants?

Doctors prescribe antidepressants to relieve symptoms of depression, obsessive compulsive disorder, anxiety, and bulimia.

Antidepressants by Drug Types
Drug name >>> brand / trade names. Please note name of drugs may differ by country

  • Selective Serotonin Reuptake Inhibitors - SSRI
    • Citalopram >> Celexa, Cipramil
    • Escitalopram oxalate >> Lexapro, Cipralex
    • Fluoxetine >> Prozac, Sarafem
    • Fluvoxamine >> Faverin, Luvox
    • Paroxetine >> Paxil, Seroxat, Paxil CR
    • Sertraline >> Lustral, Zoloft
  • Serotonin Norepinephrine Reuptake Inhibitors - SNRI
    • Venlafaxine >> Efexor, Effexor
    • Milnacipran
    • Desvenlafaxine >> PRISTIQ®
    • Duloxetine >> Cymbalta®
  • Tricyclic Antidepressants - TCA’s
    • Amitriptyline >> Tryptizol, Elavil
    • Amoxapine >> Asendis, Asendin
    • Clomipramine >> Anafranil
    • Desipramine >> Norpramin
    • Dothepin>> Prothiaden, Pertofran
    • Doxepin >> Sinequan, Adapin
    • Imipramine >> Tofranil
    • Lofepramine >> Gamanil
    • Nortriptyline >> Aventyl, Allegron, Pamelor
    • Protriptyline >> Concordin, Vivactil
    • Trimipramine >> Surmontil
  • Dual Action Antidepressants
    • Bupropion >> Wellbutrin, Wellbutrin SR, XL, Zyban
    • Mirtazappine >> Remeron® is not approved for use in pediatric patients.1
    • Trazodone >> Molipaxin, Desyrel
  • Tricyclics Related Antidepressants - Others
    • Maprotiline >> Ludiomil “Tetracyclic”
    • Viloxazine Hydrochloride >> Vivalan “Bicyclic”
  • Norepinephrine Dopamine Reuptake Inhibitor - NDRI
      (Dopamine-norepinephrine reuptake inhibitors)

    • Bupropion >> Wellbutrin, Zyban
  • Selective Noradrenaline Reuptake Inhibitor - SNaRI
    • Reboxetine >> Edronax, Vestra (Currently unavailable in the United States or Canada)
  • Serotonin Antagonist and Reuptake Inhibitors - SARI
    • Trazodone >> Desyrel
    • Nefazodone >> Serzone (USA), Dutonin (UK)
  • Norepinephrine Antagonist Serotonin Antagonists - NASA
    • Mirtazapine >> Remeron, Zispin, Norset, Avanza and Remergil
    • Mianserin
  • Monoamine Oxidase Inhibitors - MAOIs
    • Isocarboxazid >> Marplan
    • Phenelzine >> Nardil
    • Tranylcypromine >>Parnate
  • Reversible Monoamine Oxidase Inhibitors - RIMAs
    • Brofaromine
    • Moclobemide >> Mannerix
  • Serotonin Precursors
    • L Tryptophan >> Tryptan

Antidepressants are also known as

Amtrak, rainbows, blue devils, reds, yellows, yellow jackets ...

How are antidepressants taken?

Antidepressants are taken orally (pill, capsule, liquid) or injected .

What are the possible effects of antidepressants use?

Effects related with antidepressant use vary widely by drug type. Check specific drug type for further information.

The following is but a short list of potential effects. For example, if you take a SSRI with an MAOI, this could result in a potentially serious or even fatal “serotonin syndrome”

  • Dry mouth
  • Constipation
  • Diarrhea
  • Bladder problems
  • Sexual problems
  • Blurred vision
  • Headaches
  • Nausea
  • Nervousness, agitation, sweating
  • Insomnia
  • Increased heart rate
  • Arrhythmia, irregular heart beat
  • Increased risk of GI bleeding
  • Weight gain
  • Anorexia
  • Sedation
  • Decreased seizure threshold
  • Changes in blood pressure
  • Increased risk of suicide(1)

  • Serotonin Syndrome
    Serotonin syndrome is caused by high levels of serotonin.  It is characterized by fever, confusion, muscle rigidity or spasms, and cardiac, liver, or kidney problems.

    It can also cause agitation, restlessness, diarrhea, increased heart rate, hallucinations, increased body temperature, loss of coordination, nausea, overactive reflexes, rapid changes in blood pressure, vomiting, dilated pupils, heavy sweating, fever, shivering, tremor, seizures.

Chronic / long term use of antidepressants may cause

Research has yet to discover what the potential effects of long term antidepressant use are.

What are the risks associated with pregnancy and antidepressants use?

Risks related with pregnancy and antidepressant use vary widely by drug type. Check specific drug type for further information. If antidepressants are needed, the dose is often decreased when near term to decrease the risk of withdrawal symptoms in newborn.

MAOI types of antidepressants should not be used as they are proven to be teratogenic, meaning that they have the potential to harm the foetus, which can cause birth defects.

Symptoms of antidepressants overdose

  • Agitation
  • Restlessness
  • Blurred vision, dilated pupils
  • Flushed red skin
  • Dry mouth
  • Nausea, vomiting
  • Slowed labored breathing
  • Irregular heartbeat
  • Change in normal body temperature
  • Low blood pressure
  • Uncoordination
  • Muscle rigidity
  • Convulsions
  • Shock
  • Coma

Withdrawal symptoms

When discontinuing an antidepressant, tapering off use into gradual withdrawal is generally advisable. Do not quit “Cold Turkey”. Withdrawal symptoms include:

  • Drug-induced psychosis
  • Upset stomach, flu like symptoms
  • Dizzy spells
  • Anxiety
  • Depression
  • Suicidal
  • Interrupted sleep pattern, nightmares, insomnia
  • Confusion, disorientation
  • Aggression, violence
  • Loss of conscious behavior
  • Headaches
  • Irritability
  • Nausea

Did you know ?

Not all antidepressant medicines prescribed for children are FDA approved for use in children. Talk to your healthcare provider for more information.2

Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults when the medicine is first started.2

Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have (or have a family history of) bipolar illness also called manic-depressive illness) or suicidal thoughts or actions.2

 

References

Forest University Baptist Medical Center “Antidepressants Overdose” Best Health - Health Encyclopedia - Poison Reference http://www.wfubmc.edu/besthealth/ency/article/002511.htm  [May 25, 2003]

Gant, Charles , M.D., Ph.D. “Using Antidepressants vs. Finding the Underlying Medical Causes of Depression” Healthy Place.com Depression Community http://www.healthyplace.com/Communities/Depression/treatment/alternative/antidepressants_vs_causes.asp  [May 25, 2003]

Karasu, T. Byram, M.D. et al. “Part A: Treatment Recommendations for Patients with Major Depressive Disorder” from Practice Guideline for the Treatment of Patients With Major Depression. Revised April 2002. Amercian Psychiatric Asociation - Clinical Resources http://www.psych.org/clin_res/Depression2e.book-7.cfm  [May 25, 2003]

Lintner, Brenda, Dr. “Medical Methods of Treatment” The SANE Mental Health Series http://www.sane.org.uk/public_html/About_Mental_Illness/Medical_Treatments.htm  [May 26, 2003]

National Institute of Mental Health. National Institute of Health. U.S. Department of Health and Human Services. “NIMH Medications” NIH Publication No. 02-3929 Revised April 2002, Reprinted September 2002. Medications. 4th edition. http://www.nimh.nih.gov/publicat/medicate.cfm#ptdep7 [March 20, 2003]

“Quick Guide to Antidepressants” (2001) Saneline : About Mental Illness http://www.sane.org.uk/About_Mental_Illness/Medical_Treatments.htm  [May 26, 2003]

The Royal College of Psychiatrists “Factsheets - Antidepressants” (2002) The Royal College of Psychiatrists’ Website http://www.rcpsych.ac.uk/info/factsheets/pfacanti.htm  [March 15, 2003]

(1) Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of REMERON® (mirtazapine) Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. REMERON® is not approved for use in pediatric patients. (See WARNINGS: Clinical Worsening and Suicide Risk, PRECAUTIONS: INFORMATION FOR PATIENTS, and PRECAUTIONS: Pediatric Use)  http://www.rxlist.com/remeron-drug.htm [October 04, 2009]

(2) “Revisions to Medication Guide : Medication Guide Antidepressant Medicines, Depression and other Serious Mental Illnesses, and Suicidal Thoughts or Actions”  http://www.fda.gov/downloads/Drugs/DrugSafety/InformationbyDrugClass/ucm100211.pdf  [October 04, 2009]