Depression Medications (Antidepressants)

Medically Reviewed by Zilpah Sheikh, MD on June 16, 2024
Written by Frances Gatta
11 min read

Depression medications are prescribed to treat depression. A doctor may prescribe them to you, alone or with talk therapy, after you get a diagnosis that you have moderate to severe depression.

Depression medications are FDA-approved for other mental health conditions as well, including:

  • Obsessive-compulsive disorder
  • Social phobia
  • Panic disorder
  • Generalized anxiety disorder (GAD)
  • Posttraumatic stress disorder (PTSD)

A doctor may also prescribe depression medications for health conditions other than those approved by the FDA. They may prescribe tricyclic antidepressants for pain, insomnia, and migraine, for instance.

Depression medications come in different types or classes, including:

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are the most commonly prescribed antidepressants. Your doctor will likely prescribe it to you first.

SSRIs come with mild side effects that usually go away as you continue to take them. These side effects include: 

  • Diarrhea
  • Agitation
  • Headache
  • Nausea
  • Vomiting
  • Insomnia
  • Drowsiness
  • Reduced sex drive

Even when you take them in higher doses, you’re less likely to have serious side effects compared to other depression medications.

SSRI medicines include:

  • Citalopram (Celexa)
  • Escitalopram  (Lexapro)
  • Fluvoxamine (Luvox)
  • Fluoxetine (Prozac)
  • Paroxetine  (Paxil, Pexeva)
  • Sertraline (Zoloft)

Serotonin/norepinephrine reuptake inhibitors (SNRIs)

SNRIs are another commonly prescribed antidepressant that you may receive first before your doctor considers including other options in your treatment plan.

They may cause mild side effects, such as:

  • Nausea
  • Sweating
  • Dry mouth
  • Dizziness
  • Headache

These side effects go away in the first weeks of taking them. You can reduce the chance of nausea by taking food with your medicine.

Examples of SNRIs include:

  • Desvenlafaxine (Pristiq)
  • Duloxetine (Cymbalta, Drizalma Sprinkle, Irenka)
  • Levomilnacipran (Fetzima)
  • Milnacipran (Savella)
  • Venlafaxine (Effexor)

Atypical antidepressants

Atypical antidepressants are a group of different medicines that don't belong to other classes of antidepressants. Side effects vary, but you may have: 

  • Dry mouth
  • Dizziness
  • Lightheadedness
  • Nausea
  • Weight gain

Atypical depressants include:

  • Bupropion (Wellbutrin SR, Wellbutrin XL)
  • Mirtazapine (Remeron)

Serotonin modulators

Serotonin modulators are just as safe and work just as well as SSRIs and SNRIs. Your doctor may recommend them instead of SSRIs and SNRIs if they believe they are your best first treatment.

Some of the side effects you might have when taking serotonin modulators are:

  • Nausea
  • Dizziness
  • Bleeding
  • Sexual problems such as low sex drive

Depression medications that fall under serotonin modulators include:

  • Nefazodone (Merative)
  • Trazodone (Desyrel, Desyrel Dividose, Oleptro)
  • Vilazodone (Viibryd)
  • Vortioxetine (Trintellix)

Tricyclic antidepressants (TCAs)

Doctors don’t recommend TCAs often because they are tied to more serious side effects, and it’s easy to overdose on them.

They might only recommend them if your depression symptoms don’t improve after taking SSRIs, SNRIs, and serotonin modulators or if you have severe depression.

TCAs are tied to side effects, including:

  • Constipation
  • Confusion
  • Blurred vision
  • Fast heartbeat
  • Problems peeing
  • Increased appetite
  • Weight gain
  • Dizziness

TCAs include:

  • Amitriptyline (Elavil)
  • Amoxapine (Asendin)
  • Clomipramine (Anafranil)
  • Desipramine (Norpramin)
  • Doxepin (Silenor)
  • Imipramine (Tofranil)
  • Trimipramine (Surmontil)

N-methyl-D-aspartate (NMDA) antagonists

Esketamine (Spravato) and dextromethorphan/bupropion are the only FDA-approved NMDA antagonist medications for depression.

A doctor will usually prescribe esketamine only if your symptoms don’t get better with other antidepressant medicines.

These NMDA antagonist medicines are rapid-acting. Unlike other antidepressants that take weeks before you start feeling better, esketamine works within 4 hours, and dextromethorphan/bupropion starts working within a week.

You take esketamine through a nasal spray and dextromethorphan/bupropion by mouth. Your doctor will recommend these medicines with other antidepressants.

Common side effects of esketamine include: 

  • Blurred vision
  • Confusion
  • Dizziness
  • Anxiety
  • Pounding in the ear
  • Headache
  • Drowsiness
  • Lightheadedness

Dextromethorphan/bupropion side effects include:

  • Dizziness
  • Nausea
  • Dry mouth
  • Decreased appetite
  • Anxiety

Monoamine oxidase inhibitors (MAOIs)

MAOIs are the oldest type of antidepressant. Doctors mainly prescribe them when other depression medications don’t improve your symptoms as well as they should. 

You may need to make serious changes to your diet when taking them to reduce your risk of developing health problems such as a serious and quick rise in blood pressure when taking them.

You can’t have MAOIs with many commonly eaten foods such as:

  • Cheese
  • Cured meats such as sausages and pepperoni
  • Sauces such as soy sauce and fish sauce
  • Smoked or processed meats such as hot dogs, bacon, and corned beef
  • Pickled or fermented foods, such as kimchi, caviar, tofu, and pickles
  • Soybeans
  • Overripe fruits such as bananas and avocados
  • Dried fruits such as raisins and prunes
  • Alcoholic drinks

Also, your doctor might tell you to eat only fresh foods. They won’t recommend these medicines with other antidepressants either.

MAOI medications approved for depression include:

  • Moclobemide (Manerix)
  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)

MAOIs may cause side effects, such as:

  • Dry mouth
  • Nausea
  • Diarrhea
  • Constipation
  • Drowsiness 
  • Insomnia
  • Dizziness
  • Lightheadedness

Postpartum depression medication

Postpartum depression starts after you have a baby. A doctor may recommend antidepressants, including:

  • SSRIs such as sertraline (Zoloft) and fluoxetine (Prozac)
  • SNRIs, including duloxetine (Cymbalta)
  • Atypical antidepressants, such as Bupropion (Wellbutrin)
  • TCAs such as amitriptyline (Elavil) and imipramine (Tofranil)

Zuranolone (Zurzuvae) belongs to a new medication class called neurosteroid antidepressants. The FDA approved it for treating postpartum depression in 2023.

You take this medicine by mouth. You may start noticing your symptoms getting better within 3 days of taking it.

Side effects you may have when taking zuranolone include:

  • Drowsiness
  • Sleepiness
  • Dizziness
  • Diarrhea
  • Fatigue
  • Common cold
  • Urinary tract infections (UTIs) 

Another FDA-approved neurosteroid antidepressant medicine for postpartum medication is brexanolone.

A doctor will give you this medicine through your veins for 60 hours, and you’ll have to stay in the hospital for a few days while taking it.

Side effects of brexanolone include:

  • Dizziness 
  • Lightheadedness
  • Drowsiness
  • Fainting
  • Feeling relaxed and calm
  • Feeling like everything is spinning

Though only small amounts of depression medication enter breastmilk that your baby might take, ask your doctor about the risks of taking postpartum depression medication for yourself and your baby.

Also, tell them about any side effects you might be having while taking postpartum depression medication. 

Depression and anxiety medication

A doctor may prescribe depression medications for anxiety. They may recommend these medicines alone or with talk therapy.

Some depression medications FDA-approved for managing anxiety symptoms include:

  • SSRIs including escitalopram (Lexapro) and paroxetine (Paxil, Paxil CR)
  • SNRIs such as duloxetine (Cymbalta)
  • Atypical antidepressants, such as vilazodone (Viibryd) and mirtazapine (Remeron)

Though the FDA doesn’t approve them for anxiety, a doctor may prescribe other depression medications off-label for anxiety. These medicines include:

  • Citalopram (Celexa)
  • Desvenlafaxine (Pristiq)
  • Vilazodone (Viibryd)
  • Mirtazapine (Remeron)

Depression resistant medication

About 30% of people with depression have symptoms that don’t improve, even with the first and second depression medications a doctor recommends.

In that case, they may recommend depression-resistant medications such as:

  • TCAs
  • NMDA antagonists
  • MAOIs

Major depressive disorder medications

The FDA has approved many major depressive disorder medications. These medicines may fall into any of these classes:

  • SSRIs
  • SNRIs
  • Serotonin modulators
  • Atypical antidepressants
  • TCAs
  • NMDA antagonists
  • MAOIs

Talk to your doctor about the different types and their side effects to choose the best option.

Scientists are still figuring out how and why antidepressants work.

What they have learned so far is that depression medications work to improve mood, emotion, and behavior by targeting certain brain chemical messengers.

They believe these depression medications increase chemicals in the brain, including:

  • Serotonin, which regulates mood, sleep, appetite, and how you feel pain
  • Dopamine, which is involved in mood, alertness, and how your body responds to stress
  • Norepinephrine, which is involved in pleasure, motivation, and reward

Depression medications work differently for each person, and it can take a while, about 6-12 weeks, for most types of depression medications to see if they are helping or not.

How effective are depression medications?

Depression medications work well in improving symptoms of moderate to severe or chronic depression and ensuring they don’t come back, but they may not be helpful for mild depression.

Your doctor will likely prescribe depression medications that are unlikely to cause serious side effects and health problems first. These medicines include:

  • TCAs
  • SSRIs
  • SNRIs

If they don’t work as well as they should, they may recommend other ones, such as:

  • Serotonin modulators
  • Atypical antidepressants
  • NMDA antagonists
  • MAOIs

Most antidepressants start working within a week or two, but it might take longer for you to notice changes in your symptoms.

Your doctor may recommend you take these medicines for a year or two so your depression symptoms don’t come back.

Take your medication as your doctor prescribes and take them as long as they are recommended, even when you start feeling better.

The following are some of the depression medications (antidepressants) available in the U.S.:

More than 50% of people with depression will have side effects when taking depression medications.

You might notice these side effects in the first few weeks of treatment, but they will pass as you continue taking your medicine.

Some of the common depression medication side effects include:

  • Dry mouth
  • Headaches
  • Dizziness
  • Restlessness
  • Sexual problems
  • Diarrhea
  • Nausea
  • Sleep problems
  • Difficulty peeing
  • Constipation

Depression medication and weight loss

Some people notice weight loss when they’re taking depression medications. Atypical antidepressant bupropion is commonly reported to cause weight loss as a side effect, for example.

But people have weight gain more often. Apart from being a depression medication side effect, weight gain may also happen as a symptom of depression.

Suicide risk

The FDA requires that antidepressants carry black box warnings, the strongest warnings for prescription drugs. This warning highlights the risk of suicide when taking depression medications.

Suicide risk is higher in people under 25 when they start or change their treatment dose. SSRIs and SNRIs, in particular, have been tied to a risk of suicide.

If you or someone you know is having suicidal thoughts or showing suicidal behavior, call or text 988 or chat at 988lifeline.org. You can also text MHA to 741741, call 911, or go to the nearest emergency room.

Health complications that can happen when you’re taking antidepressants include:

  • Having suicidal thoughts or behavior
  • Antidepressant discontinuation syndrome, which are symptoms that happen to 20% of people when they suddenly stop taking or reduce how often they take antidepressants. They include flu-like symptoms, insomnia, nausea, imbalance, sensory problems, and hyperarousal
  • Serotonin syndrome, which happens when you have too much serotonin in your body.
  • Overdose
  • Stomach bleeding, which is most likely to happen when you take SSRI medications and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac

Talk to your doctor about these potential health problems and get immediate medical help if you have any.

You can start having withdrawal-like symptoms when you stop taking depression medications suddenly and without your doctor recommending you do so. These symptoms aren’t happening because you’re addicted to your medication, though.

Depression medication withdrawal symptoms may happen within a day or two of not taking your medications, and they include:

  • Insomnia
  • Headaches
  • Dizziness
  • Tiredness
  • Irritability
  • Feeling anxious
  • Flu-like symptoms, such as chills
  • Nausea
  • Sensations of electric shock

Your depression symptoms may also get worse if you suddenly stop taking your medicines.

The right antidepressant for you will depend on:

  • How severe your depression symptoms are
  • How likely you are to have serious side effects when taking depression medications

Your doctor will likely recommend SSRIs, SNRIs, serotonin modulators, or other first-treatment options for depression.

You might only start seeing your symptoms improve after a few weeks of taking them.

But if you’ve been taking the recommended antidepressants for over 6 weeks and haven’t noticed any difference in your symptoms, talk to your doctor about other medications that may help. Also, talk to your doctor if you’re having serious or disturbing side effects when taking antidepressants. They may recommend changing your dose, taking another antidepressant or medicine with your current one, or starting a different antidepressant.

Depression medications work well for treating moderate, severe, or chronic depression. With so many FDA-approved options, you can work with your doctor to choose the right one based on your symptoms and risk of serious side effects. Take your medications for as long as your doctor recommends. If you feel you need to change your dose, try a different depression medication, or stop taking antidepressants altogether, talk to your doctor first.

What is the most popular drug for depression?

Selective serotonin reuptake inhibitors (SSRIs) are the most popular drugs to treat depression.

How do antidepressants make you feel?

Antidepressants work by reducing depression symptoms such as exhaustion, low mood, loss of interest, restlessness, anxiety, and problems sleeping. They also help prevent you from having suicidal thoughts or behaviors.

How do I know if I need an antidepressant?

Your doctor might recommend an antidepressant for you if they’ve diagnosed you with moderate, chronic, or severe depression.