Depression medications work through their effect on our thinking and neural processes. Our thinking processes and related moods are activated by nerve cells in the brain referred to as neurons. The systems of our body and related thinking processes involved in daily routines and related activities, involve specific neurons working and activating other neurons in order for the thinking and actions to actually take place. Networks of neurons are formed in the brain which are then activated by specific actions and processes. Biochemical substances called neurotransmitters are used to communicate with other neurons and networks of neurons to fulfill specific actions. Some of the main neurotransmitters that are used in our daily routines and bodily functions include “norepinephrine” and “serotonin”. These two neurotransmitters have been found to correlate very highly with how a person thinks and feels resulting in a specific mood. Medications used to treat depression currently increase the levels of serotonin or some increase a combination of both serotonin and norepinephrine. Medications that primarily increase the levels of serotonin are referred to as SSRI”s or Selective Serotonin Reuptake Inhibitors. Some of the newer antidepressant medications that activate and increase the level of both norepinephrine and serotonin in our brains are called Serotonin Norepinephrine Reuptake Inhibitors or SNRI’s.

Some depression medications have been around for several decades including the Tricyclic antidepressants and Monoamine Oxidase Inhibitors or MAOI’s. These medications have been found to effect several neurotransmitters in the brain rather than just serotonin and norepinephrine.

Depression Medication: Selective Serotonin Reuptake Inhibitors:

These depression medications have been identified as increasing the level of the neurotransmitter serotonin in the brain. However, because they do not actually only effect the level of serotonin, these medications can’t really be accurately referred to as just serotonin reuptake inhibitors. Although somewhat misleading, the medical naming convention is to refer to them as the SSRI class of medications. These include the brand names of:

Lexapro
Luvox
Paxil
Prozac
Zoloft
Seraphim
Pexeva
Brisdelle
Selfemra
Raniflux.

Other depression medications that have some effect on the brain serotonin metabolism but are not usually referred to as SSRI’s include:

vilazodone (Viibryd)
vortoxetine (Brintellix)
buspirone (BuSpar)
etoperidone (Axiomin, Etonin)
trazodone (Desyrel)

They are included in this section because of their similar side effect profile.

Although the SSRIs seem to be relatively well-tolerated, there are common side effects which include heartburn, drowsiness and difficulty in achieving an orgasm. Also they can sometimes produce transient loss of appetite and may interact poorly with other medications. You should always consult your doctor or pharmacist prior to taking or mixing them with other medications. A more comprehensive listing of SSRI’s side effects will follow on additional pages of this website.

Serotonin Norepinephrine Reuptake Inhibitors (SNRI):

A more recent category of depression medications which have been marketed for their effect on both serotonin and norepinephrine neurotransmitters are categorized as the Serotonin Norepinephrine Reuptake Inhibitors (SNRI’s). These include:

dezvenlafaxine (Pristiq)
duloxetine (Cymbalta)
levomilnacipran (Fetzima)
milnacipran (Ixel, Savella)
tofenacin (Elamol, Tofacine)
venlafaxine (Effexor). Effexor Use and Dosage Effexor Side Effects

Some additional antidepressants that affect primarily serotonin in addition to norepinephrine are not included the marketing category of SSRIs such as;

mirtazapine (Remeron)
setiptline (Tecipul).

Some critics of medication classification conclude that some medicines are classified in a relatively arbitrary manner in order to possibly switch patients from one class to another class if their previous medication does not seem to work effectively.

All of the SNRI’s can possibly cause the same negative side effects listed for the SSRI medications including withdrawal symptoms and possible tardive dysphoria. Venlafaxine (Effexor) and duloxetine (Cymbalta) are in the top five drugs reported to the FDA MedWatch associated with violence, including self injury, suicidal tendency or homicidal ideation.

What are the tricyclic antidepressants?

The tricyclic antidepressants get their name from their chemical structure and are actually some of the older depression medications. While some believe that tricyclics have been effective in combating depression for some people, they are believed to have more troublesome side effects than some of the newer antidepressants. Some of the more problematic side effects include drowsiness, dry mouth and constipation. Some of the more popular tricyclics include:

amitriptyline
nortriptyline
desipramine,

All are now in generic forms and produced by various manufacturers.

Monoamine Oxidase Inhibitors (MAOI’s):

Another classification of medications which are believed to be effective for some types of depression are the MAOI’s. One of the main concerns with MAOI’s however is that they could possibly have potentially life-threatening drug interaction potential. Your physician needs to be intimately involved when taking these medications in assisting you with avoiding foods which may interact poorly resulting in life-threatening consequences. These medications include:

Nardil (phenelzine)
Parnate (tranylcypromine).

Miscellaneous Categories of Antidepressants:

There are a couple of depression medications that really don’t fit easily into specific categories such as

Remeron (mirtazapine)
Serzone (nefazodone)
Wellbutrin (bupropion

By Paul Susic Ph.D. Licensed Psychologist