Types of Antidepressants: Know Your Options
Antidepressants are a common treatment method for depression. They help reduce the symptoms of depression and may even help a person overcome this condition.
Typically, it may take a few different types of antidepressants until you find the right one. This is absolutely normal and should be expected. If the first round doesn’t work, know that there are other types of antidepressants out there.
What to Consider About the Different Types of Antidepressants
Your doctor knows you and your situation best. As such, they will often be able to prescribe what they believe will be the best fit. Frequently, this may be a test and measure stage, again, until the right dosage or right medication is found. When determining what type is best for you, your doctor may consider the following:
1. Your Symptoms: depression can manifest in a variety of ways. Thus, your symptoms may vary from the next person. Certain types of antidepressants are more suitable for certain symptoms.
2. Side Effects or Drug Interactions: your doctor will consider if each medication will interact with any others that you may be taking. They will also inform you of any possible side effects and determine, based on your situation, whether you are more at risk. A side effect may also be found to be a reason to switch certain medications.
3. Pregnancy or Breastfeeding: certain medications aren’t recommended during pregnancy and the pros and cons will be weighed by your healthcare provider.
4. Health Conditions: if you have specific health conditions or disorders, certain medications may exacerbate these. Again, your doctor will be able to advise you.
5. Coverage: depending on your insurance, a certain medication type may also be recommended.
So, what are some common types of antidepressants? How do they work?
Reuptake inhibitors inhibit the reuptake of certain chemicals within the brain, specifically serotonin, norepinephrine or dopamine. The following three are the most common reuptake inhibitors prescribed to treat depression:
SSRIs, or selective serotonin reuptake inhibitors, are a commonly prescribed antidepressant. Generally, these are often recommended first due to their lower side effects. They also don’t only treat depression; they are also used to help in anxiety disorders, obsessive compulsive disorder, panic disorders, phobias, PTSD and more.
Generally, SSRIs work by enhancing serotonin levels in the brain. They do this by blocking the reuptake of serotonin by nerve cells. This means more serotonin is present. It helps combat depression since many depressive disorders are characterized by low serotonin levels. Typically, these medications need to be taken for at least four weeks to determine if they are working or not.
Side effects may include agitation, dizziness, blurred vision, low libido and anxiousness. SSRIs that are available on the market include Cipramil, Prozac, Priligy and Cipralex.
SNRIs, or serotonin and norepinephrine reuptake inhibitors, are often prescribed to help with symptoms including sadness and irritability. They are also sometimes used to help with chronic pain and anxiety. While SSRIs block only the reuptake of serotonin, SNRIs block the reuptake of serotonin and norepinephrine. Common medications that are SNRIs include Pristiq, Cymbalta, Fetzima and Effexor XR.
However, these also come with their own set of potential side effects, such as nausea, dry mouth, excess sweating, headaches, dizziness, fatigue, insomnia, constipation, low libido and loss of appetite.
NDRIs, or Norepinephrine-Dopamine Reuptake Inhibitors, block the reuptake of norepinephrine and dopamine, which leaves higher levels of these two chemicals within the brain. In addition to being used to help treat depression, this antidepressant may also be prescribed to help with ADHD or narcolepsy. Common types of NDRIs include Focalin, Ritalin and Wellbutrin.
Again, there are various side effects attached to these drugs, such as anxiety, hyperventilation, nervousness, irritability, shaking, sleeping difficulties and restlessness.
Tetracyclics are not as commonly prescribed as reuptake inhibitors. However, in the past, they were widely believed to help with feelings of worthlessness, trouble sleeping, low energy and suicidal thoughts. The prescription of tetracyclines greatly diminished due to the development of newer drugs with lesser side effects. The side effects of tetracyclines include drowsiness, weight gain, blurred vision and dry mouth. Further, suddenly stopping these medications resulted in withdrawal symptoms.
Similar to tetracyclines, tricyclics, such as Tofranil and Pamelor, are typically no longer recommended or prescribed. They usually are only prescribed if other medications have failed to help and tend to have similar side effects to tetracyclines.
MAOIs, or monoamine oxidase inhibitors, like Parnate, Nardil or Marplan, inhibit monoamine oxidase. In turn, this allows more neurotransmitters to remain in the brain, potentially re-balancing the brain chemicals.
However, these types of medications are, again, not prescribed as often due to their side effects and the strict diet that must be followed. MAOIs may cause fatigue, nervousness, muscle aches, insomnia, low libido, diarrhea, lightheadedness, dry mouth, weight gain and more. Further, certain foods, like some cheeses and wines, must be completely avoided while taking this type of medication.
Determining the right antidepressant comes down to what your doctor believes is best for you. Again, it may take a few tries to get it right. Be prepared for that and to not give up until you and your doctor determine the right medication for you and your health.
- Mayo Clinic (Antidepressants: Selecting one that's right for you)
- NHS (Selective serotonin reuptake inhibitors (SSRIs))
- Mayo Clinic (Serotonin and norepinephrine reuptake inhibitors (SNRIs))
- verywell mind (How Reuptake Inhibitor Drugs Work in Different Ways)
- Healthline (Depression Medications and Side Effects)
- American Addiction Centers (Tetracyclics)
- Healthline (What Are MAO Inhibitors?)