January 20, 2019
Medications

The ABCs of Antidepressants

by Wellness Letter  

Here's a look at the nine classes of drugs used to treat depression, from monoamine oxidase inhibitors (MAOIs) and tricyclics to selective serotonin reuptake inhibitors (SSRIs) and serotonin modulators.

Selective serotonin reuptake inhibitors (SSRIs): citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft). Block the reabsorption of the neurotransmitter serotonin. Increase the availability of serotonin to carry messages between nerve cells.

Serotonin antagonist and reuptake inhibitors (SARIs): nefazodone (Serzone), trazodone. Prevent the reuptake of serotonin and block serotonin receptors.

Serotonin and norepinephrine reuptake inhibitors (SNRIs): duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq). Block the reabsorption of serotonin and norepinephrine, increasing the availability of these neurotransmitters in the brain.

Norepinephrine and dopamine reuptake inhibitors (NDRIs): bupropion (Wellbutrin).Block the reabsorption of norepinephrine and dopamine, increasing their availability in the brain.

Tricyclics: amitriptylene (Elavil), nortriptyline (Aventyl), doxepin (Sinequan), desipramine (Norpramin), nortriptyline (Pamelor), trimipramine (Surmontil), imipramine (Tofranil), protriptyline (Vivactil). Block the reabsorption of the neurotransmitters serotonin, norepinephrine, and to a lesser extent, dopamine, increasing their availability in the brain.

Tetracyclics: maprotiline (Ludiomil), mirtazapine (Remeron). Block the reabsorption of serotonin and norepinephrine, increasing the availability of these neurotransmitters.

Monoamine oxidase inhibitors (MAOIs): selegiline (Emsam), isocarboxazid (Marplan),phenelzine (Nardil), tranylcypromine (Parnate). Block the action of an enzyme that inactivates serotonin, norepinephrine, and dopamine, thereby increasing levels of these neurotransmitters.

Atypical antipsychotic/selective serotonin reuptake inhibitors: olanzapine/fluoxetine (Symbyax). Increase the availability of the neurotransmitters serotonin, norepinephrine, and dopamine.

Serotonin modulators: vortioxetine (Trintellix), vilazodone (Viibryd). Block the reabsorption of the neurotransmitter serotonin (via a different mechanism than SSRIs), increasing the availability of serotonin to carry messages between nerve cells.

This article first appeared in the UC Berkeley Wellness Letter.