Antidepressants help relieve the symptoms of depression and anxiety. Common examples include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta).
They work by correcting chemical imbalances of neurotransmitters in the brain. Experts believe these are responsible for changes in mood and behavior.
This article will cover the different types of antidepressants, how they work, their side effects, other uses, and alternative options.
Doctors tend to divide antidepressants into different types. These include:
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are a
Examples of SSRIs include:
- citalopram (Celexa)
- escitalopram (Lexapro)
- fluoxetine (Prozac, Sarafem)
- fluvoxamine (Luvox)
- paroxetine (Paxil)
- sertraline (Zoloft)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
SNRIs are a newer class of antidepressant compared with SSRIs. However, they work in a similar way.
Doctors may prescribe SNRIs for:
- attention deficit hyperactivity disorder (ADHD)
- obsessive-compulsive disorder (OCD)
- anxiety disorders
- menopausal symptoms
- chronic neuropathic pain
Examples of SNRIs include:
- duloxetine (Cymbalta)
- venlafaxine (Effexor XR)
- desvenlafaxine (Pristiq)
Tricyclic antidepressants (TCAs)
Doctors may recommend TCAs for depression, fibromyalgia, some types of anxiety, and chronic pain.
- clomipramine (Anafranil)
- desipramine (Norpramin)
- doxepin (Sinequan)
- imipramine (Tofranil)
- nortriptyline (Pamelor)
- protriptyline (Vivactil)
- trimipramine (Surmontil)
Monoamine oxidase inhibitors (MAOIs)
Due to their adverse side effects and drug-drug interactions, doctors
- phenelzine (Nardil)
- tranylcypromine (Parnate)
- isocarboxazid (Marplan)
- selegiline (Emsam, Eldepryl)
Noradrenaline and specific serotoninergic antidepressants (NaSSAs)
Doctors use NaSSAs to treat anxiety disorders and depression.
Examples include mianserin (Tolvon) and mirtazapine (Remeron, Avanza, Zispin).
It is important to note that
SSRIs and SNRIs
SSRIs and SNRIs can lead to:
- nausea and anxiety for the first couple of weeks, according to 2010 research
- sexual dysfunction
SNRIs can also cause an increase in blood pressure. A person with a serious heart condition should not take the SNRI venlafaxine.
TCAs may have the following side effects:
MAOIs can interact with other drugs. For example, if a person combined an MAOI with an SSRI, it could lead to serotonin syndrome. Serotonin syndrome is a serious condition in which a person has too much serotonin in their body.
MAOIs can also lead to:
- dry mouth
- sexual dysfunction
MAOIs prevent the breakdown of tyramine. If a person consumes foods that contain tyramine, such as sausages, fish, and overripe fruit, it
These antidepressants can lead to side effects similar to SSRIs and SNRIs. They can also cause drowsiness and weight gain. However, they are less likely to cause sexual dysfunction, according to 2010 research.
Rarer side effects
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Rarer side effects of antidepressants include:
- Suicidal thoughts: Some
studieshave found that young adults and children may be at a higher risk of suicidal thoughts when they first start taking antidepressants. If side effects are very unpleasant, or if they include thinking about suicide, the person should speak with a doctor straight away.
- Withdrawal symptoms: Some people who take SSRIs and SNRIs experience some withdrawal symptoms when they stop taking the medication. Withdrawal symptoms can last for
1–2 weeks, and can include:
- nightmares or vivid dreams
- electric shock-like sensations in the body
- flu-like symptoms
- abdominal pain
Doctors recommend antidepressants to treat:
- depression and major depressive disorder
- generalized anxiety disorder
- panic attacks
- chronic pain
- post-traumatic stress disorder (PTSD)
- social anxiety disorder
Antidepressants tend to be effective. However, everyone responds to medication differently.
According to the Institute for Quality and Efficiency in Health Care,
The research notes that the more severe the depression, the greater the benefits of antidepressants may be.
There are many types of antidepressants. They all work differently and have different benefits, risks, and side effects.
A person should speak with a doctor about their individual circumstances. The doctor will help them find the best treatment option for them.
For some people, the risks associated with stopping the medication are higher than those associated with continuing taking it.
If a person is pregnant and wishes to continue or begin taking antidepressants, they should speak with a doctor.
Tiny amounts of some antidepressants can enter breast milk. However, the
People may wish to try the following:
People with depression may wish to undergo therapy. Types of therapy that can help to treat depression include:
- cognitive behavioral therapy (CBT)
- interpersonal therapy
- problem-solving therapy
Learn more about available mental health resources.
St. John’s wort
Hypericum, made from the herb St. John’s wort, may help some people with depression. It is available over the counter as a supplement.
However, there are some possible risks associated with taking hypericum:
- If combined with certain antidepressants, it can lead to a potentially life threatening increase in serotonin.
- It can worsen symptoms of bipolar disorder and schizophrenia.
- It might reduce the efficacy of some prescription medications, including antidepressants, birth control pills, some heart medications, warfarin, and some therapies for HIV and cancer.
It is important for a person to tell a doctor or pharmacist if they plan on taking St. John’s wort.
People who experience seasonal affective disorder may benefit from light therapy.
This involves sitting in front of a light box first thing in the morning for
Diet and exercise
The CDC notes that regular physical activity can reduce a person’s risk of depression. People may wish to try three exercise sessions per week for
Learn more about exercise as a treatment option for depression.
People may also benefit from eating a balanced, nutritious diet consisting of fresh and whole foods. They may wish to avoid refined and processed foods.
While different antidepressants work in different ways, they all affect neurotransmitters. Neurotransmitters are chemicals brain cells use to communicate with each other.
According to a
- SSRIs: These reduce the amount of serotonin the brain absorbs. This makes it easier for the brain cells to send and receive messages, leading to more stable moods.
- SNRIs: These raise the levels of serotonin and norepinephrine in the brain. These neurotransmitters play a key role in stabilizing mood.
- TCAs: These regulate the amount of serotonin and norepinephrine the brain absorbs. This helps to reduce feelings of anxiety and depression.
- MAOIs: These target the brain enzyme monoamine oxidase, which helps to break down neurotransmitters such as serotonin. This can lead to more stabilized moods and less anxiety.
According to the United Kingdom’s National Health Service (NHS), people may begin to feel the benefits of the antidepressants after 1–2 weeks if the person has not missed a dose.
Some people may stop taking them because they believe the medications are not working. However, it is important to keep taking the medication exactly as their doctor has prescribed.
If a person has not felt any benefit after 4 weeks, they should speak with a doctor.
According to the NHS, doctors will typically suggest a person takes antidepressants for at least 6 months.
People should take their antidepressants exactly as their doctor has prescribed.
Antidepressants can help relieve symptoms of conditions such as depression and anxiety disorders. They work by correcting the balance of neurotransmitters in the brain.
Examples of antidepressants include SSRIs, SNRIs, TCAs, and NaSSAs. MAOIs may also be an option, though doctors prescribe these less often due to the risk of adverse side effects.
It can take several weeks for antidepressants to start working, and people may experience side effects.
Alternatives to antidepressants include therapy, diet and exercise, and St. John’s wort. However, depression is a serious condition that may need medical treatment. Anyone who experiences the symptoms of depression should speak with a doctor.