Antidepressants

What is the definition of antidepressants?

People with anxiety, depression, PTSD, and some eating disorders take antidepressants to help them feel better. They can also help people who are in pain all the time and have trouble sleeping.

Depression is the main reason people take antidepressants. It’s a mental illness that’s not just depression. It can change your energy, mood, drive, and way of thinking for a long time. Because of this, you might lose interest in things you used to enjoy. In addition, it might be hard to remember things, sleep, and eat well.

These medicines might help with symptoms like feeling tired or having mood swings. But they don’t deal with the real problem. So, doctors often suggest that people talk to a therapist, which is also known as “talk therapy.”

In the United States, antidepressants are among the most often prescribed medications.

What are the different types of antidepressants?

There are five common types of antidepressants. Here is a quick overview:

Type	Common examples
SSRIs	Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft)
SNRIs	Desvenlafaxine (Pristiq), Duloxetine (Cymbalta), Venlafaxine (Effexor)
Atypical antidepressants	Bupropion (Wellbutrin XL), Bupropion/dextromethorphan (Auvelity), Esketamine (Spravato), Mirtazapine (Remeron), Trazodone (Desyrel)
Tricyclic antidepressants (TCAs)	Amitriptyline, Desipramine (Norpramin), Doxepin, Nortriptyline (Pamelor)
MAOIs	Isocarboxazid (Marplan), Phenelzine (Nardil), Selegiline patches (Emsam), Tranylcypromine (Parnate)

1. Selective serotonin reuptake inhibitors (SSRIs)

These make your brain produce more serotonin, which makes you feel better. SSRIs are the most popular type of drug. It is thought that these drugs work by increasing the brain’s serotonin levels. Serotonin is a hormone that helps control mood. They do help treat depression, but it usually takes two weeks for them to start working and four to eight weeks to feel their full effects.

• Citalopram (Celexa)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)

2. Serotonin-norepinephrine reuptake inhibitors (SNRIs)

There is more serotonin and norepinephrine in the body, which help with mood, stress, and staying awake. Norepinephrine makes you more alert and helps you concentrate. Much like SSRIs, these drugs may take two weeks to begin to work and four to eight weeks to fully kick in.

• Desvenlafaxine (Pristiq)
• Duloxetine (Cymbalta)
• Venlafaxine (Effexor)

3. Atypical antidepressants

It’s not completely clear how some of these types of antidepressants work. SSRIs and SNRIs don’t work as well as bupropion and mirtazapine. And both are thought to be the best ways to treat sadness. Trazodone, on the other hand, can help people who are depressed and have trouble sleeping. If you have tried at least two other antidepressants and they haven’t helped, esketamine may be an option.

• Bupropion (Wellbutrin XL)
• Bupropion/dextromethorphan (Auvelity)
• Esketamine (Spravato)
• Mirtazapine (Remeron)
• Trazodone (Desyrel)

4. Tricyclic antidepressants (TCAs)

It is thought that TCAs treat sadness by making the brain make more serotonin and norepinephrine. Based on some studies, they may work better for some people who are really depressed. They are more likely to have side effects, though. Since they don’t work as well as some of the other antidepressants on this list, most people don’t choose them first.

• Amitriptyline
• Desipramine (Norpramin)
• Doxepin
• Nortriptyline (Pamelor)

5. Monoamine oxidase inhibitors (MAOIs)

A protein known as monoamine oxidase (MAO) is what allows MAOIs to do their job. It is the job of MAO to break down dopamine, serotonin, and norepinephrine. By blocking this protein, MAOIs help the brain make more of these chemicals that talk to each other.

Most people with depression are not told to take MAOIs because they can cause major side effects, require special diets, and interact with many other medications. On the other hand, research has shown that they can help people with sadness that doesn’t get better with other antidepressants.

• Isocarboxazid (Marplan)
• Phenelzine (Nardil)
• Selegiline patches (Emsam)
• Tranylcypromine (Parnate)

Antidepressants and the risk of suicide

Even though most antidepressants are safe, the U.S. Food and Drug Administration (FDA) requires all of them to have black box warnings, which are the strongest warnings for prescription drugs. Children, teens, and young adults under 25 may have more suicidal thoughts or act more suicidally when they take antidepressants, especially in the first few weeks or when the dose is changed.

People who take antidepressants should be closely watched to see if their depression gets worse or if they act in strange ways. If you or someone you know is taking an antidepressant and is having suicide thoughts, you should call your doctor right away or get emergency help.

Keep in mind that antidepressants are more likely to lower the chance of suicide over time because they make people feel better.

Is there a best medicine for depression?

Different kinds of antidepressants have been compared in studies over the years. The American Psychiatric Association looked at all the research that was done and decided that no antidepressant was better at treating depression than the others. Instead, antidepressants are usually suggested based on things like their side effects and whether you’ve had a good experience with a certain drug in the past.

Either an SSRI or an SNRI will be the first drug most people take. Most of the time, these medicines work better than other antidepressants. They can also treat other conditions, like anxiety, that people sometimes have along with sadness.

But in the end, the best drug is the one that helps you the most while also hurting you the least. Finding the right treatment for depression is a journey that is different for everyone.

Frequently Asked Questions

Which type of antidepressant is most often given to people?

The type of antidepressant that is most often prescribed is an SSRI. This is because they work and have mild side effects that most people can handle. Since many SSRIs are sold as generic drugs, they are also often less expensive. For the same reasons, SNRIs and bupropion are also popular picks.

In terms of side effects, which drug is the best?

There isn’t a clear answer to this question. All antidepressants can make you feel bad in some way. And different people deal with them in different ways. Most people generally tolerate SSRIs and SNRIs well. They are also very likely to be safe in the long term, according to strong evidence. Drugs that have been around longer, like TCAs and MAOIs, tend to have more side effects.

Which antidepressant works the most quickly?

The drug that works the fastest is Spravato. In just a few hours, it may start to help. But some very bad things can happen when you take Spravato, and you can only do it at your doctor’s office. Also, the FDA has only approved it for people with depression that doesn’t respond to other treatments. It means that most people can’t use it.

Another antidepressant that works faster is Auvelity. In as little as one week, it can start to help with depression symptoms. So, unlike Spravato, there are no limits on how it can be used.

Some types of antidepressants don’t work for a few weeks. When you first start taking your medicine, you can usually expect to feel some effects between 4 and 6 weeks. Tell your doctor that it doesn’t seem to be working if you don’t feel any better after 8 weeks.

How do I determine which depression medication is appropriate for me?

It can be hard to choose a depression drug because there are so many to choose from. Your doctor will help you choose the one that is most likely to work based on things like:

1. Your exact symptoms
2. Effects that could happen
3. What might happen if you take it with other medicines
4. One or more conditions you have

You should also tell your doctor about your plans. One example is that some antidepressants are safe to use while you are pregnant. Your provider can help you figure out the safest way to start a family.

How long does it take for an antidepressant to work?

Your symptoms may get better after four to eight weeks of taking the medicine. Before your mood gets better, you may notice changes in your sleep, energy, hunger, or ability to concentrate. The wait is because the medicine needs time to change the way your brain connects to itself.

Make sure you do what your doctor tells you and take the medicine for as long as they say to. You might not get the full benefits if you stop too soon. And it might have effects you don’t want.