What Drugs Are Used to Treat Depression?
When treating depression, several drugs are available. Some of the most commonly used include:
- Selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa), escitalopram oxalate (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine HRI (Paxil), and sertraline (Zoloft).
- Selective serotonin & norepinephrine inhibitors (SNRIs), such as desvenlafaxine (Khedezla), desvenlafaxine succinate (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor).
- Vortioxetine (Trintellix formerly Brintellix) and vilazodone (Viibryd) are newer medicines that both acts as SSRIs and also affect other serotonin receptors.
- Tetracyclic antidepressants that are noradrenergic and specific serotonergic antidepressants (NaSSAs), such as Remeron.
- Older tricyclic antidepressants, such as Elavil, imipramine (Tofranil), nortriptyline (Pamelor), and Sinequan.
- Drugs with unique mechanisms such as bupropion (Wellbutrin).
- Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (EMSAM), and tranylcypromine (Parnate).
- N-methyl-D-aspartate (NMDA) Receptor Antagonist, such as esketamine (Spravato)
- While not technically considered a medication by the FDA, l-methylfolate (Deplin) has proven successful in treating depression. It is categorized as a medical food or nutraceutical, requires a prescription and is the active form of a B-vitamin called folate. L-methylfolate helps regulate the neurotransmitters that control moods.
Your health care provider can determine which drug is right for you. Remember that medications usually take four to eight weeks to become fully effective. And if one medication does not work, there are many others to try.
In some cases, a combination of antidepressants may be necessary. Sometimes an antidepressant combined with a second antidepressant from a different class, or a different type of medication altogether, such as a mood stabilizer (like lithium) or atypical antipsychotic (like aripiprazole [Abilify], brexpiprazole [Rexulti] or quetiapine [Seroquel]) can boost the effect of an antidepressant alone.
Side effects vary, depending on what type of medication you are taking, and may improve once your body adjusts to the medication.
If you decide to stop taking your antidepressants, it is important that you gradually reduce the dose over a period of time recommended by your doctor. Quitting antidepressants abruptly can cause discontinuation symptoms such as headache or dizziness or increase the chance that symptoms will return. It is important to discuss tapering off (or changing) medications with your health care provider first.
What Medications Are Used to Treat Anxiety Disorders?
When treating anxiety disorders, antidepressants, particularly the SSRIs and some SNRIs (serotonin-norepinephrine reuptake inhibitors), have been shown to be effective.
Other anti-anxiety drugs include the benzodiazepines, such as as alprazolam (Xanax), diazepam (Valium), buspirone (Buspar), and lorazepam (Ativan). These drugs do carry a risk of addiction or tolerance (meaning that higher and higher doses become necessary to achieve the same effect), so they are not as desirable for long-term use. Other possible side effects include drowsiness, poor concentration, and irritability. Some anticonvulsant drugs (such as gabapentin [Neurontin] or pregabalin [Lyrica]) and some atypical antipsychotics (such as aripiprazole or quetiapine or Seroquel) are also occasionally used "off label" to treat anxiety symptoms or disorders.