For some people with depression, nonpharmacological interventions such as psychotherapy, lifestyle changes, and natural remedies may be enough to lift the cloud and improve symptoms. But for many other people, these steps aren’t enough, and medication is needed. Numerous depression-fighting medications are available today. If you’re struggling with depression, talk to your primary care doctor or a mental health professional, such as a psychiatrist, to learn whether antidepressant medication may be right for you.
How Many People Take Antidepressants?
Overall, antidepressant use increased from 10.6 percent to nearly 14 percent in the decade between 2009 to 2010 and 2017 to 2018. Women with depression are nearly twice as likely as men to be taking these medications, the NCHS found, with 17.7 percent of women using antidepressants compared with 8.4 percent of men. During the same decade, antidepressant use increased among women but not men.
Are Antidepressants Safe?
If this happens to you or someone you know, immediately contact a doctor or seek emergency help by contacting the Suicide and Crisis Lifeline (988) or, if the risk is imminent, call 911.
SSRIs: The Most Frequently Prescribed Antidepressants
Citalopram (Celexa)Escitalopram (Lexapro)Fluoxetine (Prozac, Sarafem, Symbyax)Fluvoxamine (Luvox, Luvox CR)Paroxetine (Paxil, Paxil CR, Pexeva)Sertraline (Zoloft)Vilazodone (Viibryd)
Nausea and vomitingDry mouthWeight gain or loss due to appetite changesDiarrheaDrowsinessSexual problemsHeadache or dizzinessDrowsiness or insomniaAgitation, restlessness, or nervousness
RELATED: Your 12 Biggest Antidepressant Problems, Solved
SNRIs Work by Blocking Reuptake of Two Brain Chemicals
Commonly used SNRIs include:
Duloxetine (Cymbalta)Venlafaxine (Effexor XR)Levomilnacipran (Fetzima)Desvenlafaxine (Pristiq)
The most common side effects of SNRIs include:
NauseaDry mouthDizzinessHeadacheExcessive sweating
Other possible side effects of SNRIs are:
ConstipationInsomniaLoss of appetiteSexual dysfunctionTiredness
Cyclic Antidepressants: Prone to Causing Side Effects
These drugs are not widely used today because they can cause a range of side effects, some of which may be serious, such as disorientation or confusion, but they are sometimes prescribed when other antidepressants don’t work. Examples of FDA-approved tricyclics are:
Amoxapine (Asendin)Amitriptyline (Elavil)Nortriptyline (Aventyl, Pamelor)Desipramine (Norpramin)Doxepin (Sinequan, Silenor)Imipramine (Tofranil)Protriptyline (Vivactil)
Common side effects of cyclics include:
DrowsinessBlurred visionConstipationDry mouthDrop in blood pressure that can cause lightheadedness when going from a seated position to a standing positionUrine retention
MAOIs: The Oldest Antidepressants
Examples of MAOIs include:
Selegiline (Emsam), a skin patch that may cause fewer side effects than MAOIs taken by mouthIsocarboxazid (Marplan)Phenelzine (Nardil)Tranylcypromine (Parnate)
Although MAOIs can sometimes help people with depression that does not respond to other antidepressants, they are not widely used today because of their potential side effects and interactions with certain foods and beverages as well as other drugs. For example, for people taking MAOIs, ingesting large amounts of the compound tyramine (found in aged cheeses, cured meats, draft beer, sauerkraut, and fermented soy products like miso, tofu, and soy sauce) could cause your blood pressure to rise to a dangerously high level. You may also experience serious reactions if you take an MAOI with various medications, including:
Other prescription antidepressantsPrescription pain relieversCold and allergy drugsHerbal supplements
On rare occasions, MAOIs and other serotonin-containing drugs can cause a potentially life-threatening condition called serotonin syndrome. You may be at risk if you take too much of a serotonin-containing antidepressant or if you combine an MAOI with another prescription antidepressant, certain pain or headache medications, or St. John’s wort (an herbal supplement sometimes used as a home remedy for depression). RELATED: The Signs of Seasonal Affective Disorder
Atypical Antidepressants
Medications that don’t fit into the classes listed above may also treat depression by altering levels of different neurotransmitters in the brain.
Trazodone (Desyrel)Nefazodone (Serzone)Mirtazapine (Remeron)Vortioxetine (Brintellix, Trintellix)
New Breakthrough Drugs for Depression
In 2019, the FDA approved two novel medications for depression:
Esketamine (Spravato), a nasal spray, is a new option for people with depression that hasn’t improved with other antidepressants. It is derived from ketamine, a widely used anesthetic (and party drug), and is only administered at certified treatment centers because of the possibility of abuse and addiction. While traditional antidepressants can take weeks to kick in, esketamine acts quickly, usually within hours.Brexanolone (Zulresso) is the first medication specifically for women with postpartum depression. It is administered as an intravenous infusion in a healthcare setting for two and a half days (60 hours) continuously, and it usually works within a few days. It is chemically similar to a hormone called endogenous allopregnanolone, which decreases in women’s bodies after giving birth and is believed to be associated with postpartum depression.
In August 2022, the FDA granted approval to dextromethorphan-bupropion (Auvelity), an N-methyl D-aspartate receptor antagonist, for major depressive disorder. The drug offers faster relief of depressive symptoms than other antidepressants, often working within a week of consistent use, whereas most other antidepressants take at least six weeks to work. Additional reporting by Pamela Kaufman.
