Top 12 Most Popular & Effective Antidepressants: A Psychiatrists List
Although the antidepressant that works best is a very individual experience and choice, some medications are more popular among both prescribers and patients. One of the first lists of these antidepressants was compiled in 2009 by a group of psychiatrists. Their top 12 most popular and effective antidepressants were:
However, as new antidepressant formulas are released, prescribed, and found to have side effects or be widely effective, this list is likely to change. For now, though, it appears that SSRI and SNRI type antidepressants are the most effective forms of medicating most types of depression.
If depression, regardless of underlying cause, is not properly treated as soon as possible, it could lead to substance abuse. People who struggle with all kinds of mental health conditions, like bipolar disorder, anxiety, and depression, may also struggle with substance abuse, as a method of self-medicating their symptoms. Withdrawal symptoms associated with addiction to or dependence on drugs and alcohol, along with the brain chemistry changes caused by drugs and alcohol, can actually make symptoms of depression worse over time.
How Do Antidepressants Work
There are five major classes of antidepressants, and they all work in different ways:
- Selective serotonin reuptake inhibitors
- Serotonin and norepinephrine reuptake inhibitors
- Atypical antidepressants
- Tricyclic antidepressants
- Monoamine oxidase inhibitors
But the one thing all of these antidepressants have in common is that they increase the availability of monoamine neurotransmitters in the brain.
In people with depression, the availability of these monoamine neurotransmitters in the brain is characteristically low. Antidepressants work by preventing the reuptake of one or more of these neurotransmitters, thereby increasing their availability.
Ssris: The Most Frequently Prescribed Antidepressants
Selective serotonin reuptake inhibitors, or SSRIs, are the most commonly prescribed antidepressant class.
These are the SSRIs currently approved by the FDA to treat depression:
Although MAOIs can sometimes help people who do not respond to other antidepressants, they are not widely used today because of their potential side effects and interactions with certain foods and beverages as well as other drugs.
For example, for people taking MAOIs, ingesting large amounts of the compound tyramine could cause dangerously high blood pressure.
You may also experience serious reactions if you take an MAOI with various medications, including:
- Other prescription antidepressants
- Cold and allergydrugs
- Herbal supplements
On rare occasions, MAOIs and other serotonin-containing drugs can cause a potentially life-threatening condition called serotonin syndrome. You may be at risk if you take too much of a serotonin-containing antidepressant, or if you combine an MAOI with another prescription antidepressant, certain pain or headache medications, or St. Johns wort .
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Isoniazid Iproniazid And Imipramine
In 1951, Irving Selikoff and Edward H. Robitzek , working out of Sea View Hospital on Staten Island, began clinical trials on two new anti-tuberculosis agents developed by Hoffman-LaRoche, isoniazid and iproniazid. Only patients with a poor prognosis were initially treated nevertheless, their condition improved dramatically. Selikoff and Robitzek noted “a subtle general stimulation … the patients exhibited renewed vigor and indeed this occasionally served to introduce disciplinary problems.” The promise of a cure for tuberculosis in the Sea View Hospital trials was excitedly discussed in the mainstream press.
In 1952, learning of the stimulating side effects of isoniazid, the Cincinnati psychiatrist Max Lurie tried it on his patients. In the following year, he and Harry Salzer reported that isoniazid improved depression in two-thirds of their patients and coined the term antidepressant to refer to its action. A similar incident took place in Paris, where Jean Delay, head of psychiatry at Sainte-Anne Hospital, heard of this effect from his pulmonology colleagues at Cochin Hospital. In 1952 , Delay, with the resident Jean-Francois Buisson , reported the positive effect of isoniazid on depressed patients. The mode of antidepressant action of isoniazid is still unclear. It is speculated that its effect is due to the inhibition of diamine oxidase, coupled with a weak inhibition of monoamine oxidase A.
Women Who Are Pregnant Or Who May Become Pregnant
The research on the use of psychiatric medications during pregnancy is limited. The risks are different depending on which medication is taken, and at what point during the pregnancy the medication is taken. Decisions on treatments for all conditions during pregnancy should be based on each woman’s needs and circumstances, and based on a careful weighing of the likely benefits and risks of all available options, including psychotherapy , medication, or a combination of the two. While no medication is considered perfectly safe for all women at all stages of pregnancy, this must be balanced for each woman against the fact that untreated serious mental disorders themselves can pose a risk to a pregnant woman and her developing fetus. Medications should be selected based on available scientific research, and they should be taken at the lowest possible dose. Pregnant women should have a medical professional who will watch them closely throughout their pregnancy and after delivery.
Most women should avoid certain medications during pregnancy. For example:
Antidepressants, especially SSRIs, are considered to be safe during pregnancy. However, antidepressant medications do cross the placental barrier and may reach the fetus. Birth defects or other problems are possible, but they are very rare. The effects of antidepressants on childhood development remain under study.
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Should You Treat Your Depression With Medications
You might be asking your healthcare provider this question if you have been feeling low and your friends and family have mentioned this to you. Your provider might have mentioned medication if your mood interferes with work, family or socializing for more than two weeks. Some people with depression might even have legal troubles linked to outbursts.
What Are Mood Stabilizers
Mood stabilizers are used primarily to treat bipolar disorder, mood swings associated with other mental disorders, and in some cases, to augment the effect of other medications used to treat depression. Lithium, which is aneffective mood stabilizer, is approved for the treatment of mania and the maintenance treatment of bipolar disorder. A number of cohort studies describe anti-suicide benefits of lithium for individuals on long-term maintenance. Mood stabilizers work by decreasing abnormal activity in the brain and are also sometimes used to treat:
- Schizoaffective Disorder
- Hair loss
These medications may also:
- Cause damage to the liver or pancreas, so people taking it should see their doctors regularly
- Increase testosterone levels in teenage girls and lead to a condition called polycystic ovarian syndrome
Medications for common adult health problems, such as diabetes, high blood pressure, anxiety, and depression may interact badly with anticonvulsants. In this case, a doctor can offer other medication options.
For more information about the risks and side effects for each medication, please see .
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Medications For Depression: Which Is Best
There are many medications that can be used to treat mood disorders. But finding the right one can be a lengthy process, and the choice can be more complicated than you might imagine. Just because a particular drug worked for a friend doesn’t mean it will work for you. Psychiatrists and doctors who prescribe antidepressants choose a particular drug and dosage based on many factors, including the following:
To learn more strategies for battling depression, check out Understanding Depression, a Special Health Report from Harvard Medical School.
Serotonin Antagonists And Reuptake Inhibitors
Serotonin antagonist and reuptake inhibitors while mainly used as antidepressants, are also anxiolytics and hypnotics. They act by antagonizingserotonin receptors such as 5-HT2A and inhibiting the reuptake of serotonin, norepinephrine, and/or dopamine. Additionally, most also act as Î±1-adrenergic receptorantagonists. The majority of the currently marketed SARIs belong to the phenylpiperazine class of compounds. They include trazodone and nefazodone.
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Depression And Your Children
Like adults, children and teens can also feel depressed. You should watch your children for signs of depression. Talk to your children if you notice changes in their behavior. Talk to your childs healthcare provider if you are still concerned.
Prozac is the only medicine that is approved by FDA for use in children with depression. Prozac and Lexapro are the only FDA-approved medicines for teens with depression. Talk to your healthcare provider about important warnings for children and teens who take medicine for depression.
Selective Serotonin Reuptake Inhibitors Side Effects
Selective serotonin reuptake inhibitors and serotonin/norepinephrine reuptake inhibitors are two classes of antidepressants associated with abnormal thinking, agitation, anxiety, dizziness, headache, insomnia, sexual dysfunction, sedation, tremor, sweating, weight loss, diarrhea, constipation, dry mouth, rash, and nausea. Rarely, SSRIs have been associated with hyponatremia , hypoglycemia , and seizures.
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How Is Depression Diagnosed
If your mood has been low for a while and you are having difficulty coping with day to day activities, talk to your doctor or a trusted professional. Your doctor will ask you questions about your symptoms and your medical history and may ask you to complete a questionnaire that may help to diagnose depression or refer you to a psychiatrist.
You can also call the National Suicide Prevention Hotline at 1-800-273-8255, 24 hours a day, 7 days a week, or have an online chat . All information is confidential and free.
What Does Antidepressant Medications Do
Antidepressant medications increase the activity of chemicals called neurotransmitters in the brain. Increasing the activity of the neurotransmitters serotonin, norepinephrine and dopamine seems to help lessen the symptoms of depression and anxiety. However, the brain is a very complex organ and the reasons why these drugs work are not yet fully understood.
We do know that these drugs help to relieve symptoms of depression and anxiety in up to 70 per cent of people who try them. This rate is even higher when people who dont get relief with one type of antidepressant try a second type.
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Are There Differences Among Antidepressants
Antidepressants differ in their effects on neurotransmitters, established uses, adverse effects and drug interactions. All antidepressants that are used for depression are effective there is no evidence that one antidepressant is more effective than another. However, patients may respond to or tolerate one antidepressant, and not respond to or tolerate another antidepressant.
Sign Up For A Pregnancy Registry
Pregnancy Exposure Registries are research studies that collect information from women who take prescription medicines or vaccines during pregnancy.
Pregnancy registries can help women and their doctors learn more about how depression medicines affect women during pregnancy.
The FDA does not run pregnancy studies, but it keeps a list of registries. Check to see if there is a registry for your depression medicine or other medicines at: www.fda.gov/pregnancyregistries
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Drug Choice And Administration Of Antidepressants
Choice of drug may be guided by past response to a specific antidepressant. Otherwise, selective serotonin reuptake inhibitors are often the initial drugs of choice. Although the different SSRIs are equally effective for typical cases, certain properties of the drugs make them more or less appropriate for certain patients .
If one SSRI is ineffective, another SSRI can be substituted, or an antidepressant from a different class may be used instead. Tranylcypromine 20 to 30 mg orally twice a day is often effective for depression refractory to sequential trials of other antidepressants it should be given by a physician experienced in use of monoamine oxidase inhibitors . Psychologic support of patients and loved ones is particularly important in refractory cases.
Insomnia, a common adverse effect of SSRIs, is treated by reducing the dose, giving the dose in the morning, or adding a low dose of trazodone or another sedating antidepressant at bedtime. Initial nausea and loose stools usually resolve, but throbbing headaches do not always go away, necessitating a change in drug class. An SSRI should be stopped if it causes agitation. When decreased libido, impotence, or anorgasmia occur during SSRI therapy, dose reduction or a change to a serotonin modulator or a norepinephrine-dopamine reuptake inhibitor may help.
Continued therapy with an antidepressant for 6 to 12 months is usually needed to prevent relapse.
Side Effects Of Antidepressants
All drugs, including antidepressants, have some risk of side effects, even if you use them as directed. For most people, these side effects are usually temporary and manageable. But some may be serious.
If you have a side effect that bothers you, or you experience something unusual, talk to your health care provider about what to do. You can also report side effects to Health Canada toll-free at 1-866-234-2345 or online at MedEffect.
Family members should closely watch patients for any new or worsened mood or behaviour problems, such as unexpected hostility, agitation or anxiety. This is especially important in the first few weeks after a patient starts an antidepressant.
As a patient, it is also very important to follow up regularly with your health care provider and keep talking about how you are feeling.
More information on the potential side effects of a drug is available in its official Canadian “product monograph,” which contains important prescribing and safety information for health professionals and patients. Product monographs are available by searching Health Canada’s Drug Product Database.
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What Home Remedies Can Help Treat Depression
Depressive disorders can make a person feel negative about life. Negative thinking fades as treatment begins to take effect. The following are common remedies to fight depression:
- Drink sufficient water and eat a healthy diet. Foods that include folate and vitamin Dsupplements help fight depression.
- Proper rest helps with mood elevation.
- Make a habit to express feelings to close ones during depression.
- Do not indulge in any stress-related tasks make small daily goals to cope with depressive mood.
- Failing to reach expectations should not be considered a failure it should be seen positively.
- Try to socialize more frequently.
- Motivate yourself by exercising, going for a movie or spending quality time with loved ones.
- Limit access to things that could hurt you or others .
What Should You Consider When Deciding Whether Or Not To Take Antidepressants
Whether antidepressants are an option will depend on things like the severity of the symptoms. Other aspects can also play a role in the decision:
- Are you going to psychotherapy or are you planning to?
- Have you taken antidepressants before and did they help?
- How bad do you think the potential side effects are compared to the possible benefits?
The question of side effects can also be key when choosing which drug to take: Some people might be more keen to avoid digestion problems. Others might prefer to avoid dizziness, decreased sex drive or erection problems.
It only makes sense to use antidepressants if the is correct. Specialists believe that some people are prescribed antidepressants unnecessarily. The fact that a lot more people take antidepressants nowadays suggests that this is true. They are sometimes already prescribed for milder symptoms, even though it’s not clear whether they help in mild .
But it’s still important to make sure that severe is diagnosed and treated properly. Antidepressants can be helpful here, and for some people may be the only way that they can get back into a daily routine or start going to psychotherapy.
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What Are Side Effects Of Antidepressants
Antidepressants that belong to the same class of antidepressant produce similar side effects. Antidepressants may cause withdrawal symptoms if abruptly discontinued. Withdrawal symptoms include nausea, vomiting, dizziness, headache, irritability, sleep disturbance, nightmares, psychosis, and seizures. All antidepressants have a warning about use in children and adolescents. Antidepressants increased the risk of suicidal thinking, and suicidal behavior in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of antidepressant in a child or adolescent must balance this risk of suicide with the clinical need for the drug. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts or unusual changes in behavior.
How Are Antidepressant Medications Selected
The type of drug prescribed will depend on your symptoms, the presence of other medical conditions, other medicines you are currently taking, the cost of the prescribed treatments, and potential side effects. If you have had depression before, your provider may prescribe the same medicine that worked for you in the past. If you have a family history of depression, medicines that have been effective in treating your family member may also be considered.
Usually you will start taking the medicine at a low dose. The dose will be gradually increased until it has reached the therapeutic dose, or until you start to see an improvement .
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Most Common Tricyclic Antidepressants
Tricyclic : This class of antidepressants is considered one of the oldest. These drugs are noted for their three ring atomic structure. Many of the tricyclics are less common these days simply because SSRIs are considered safer with better tolerability. This class of drugs acts on serotonin and norepinephrine to elicit an antidepressant response.
- Amitriptyline : This is a very commonly used tricyclic antidepressant and one of the most utilized throughout history. It was introduced to markets in 1961 and was heavily prescribed until the introduction of newer SSRIs.
- Nortriptyline : This is another common TCA drug that is closely related to the more commonly prescribed Amitriptyline. It is used for major depression as well as some types of pain, and to prevent childhood bedwetting.
- Doxepin : This is a common TCA drug that comes in both pill form and as a skin cream. It is used to treat depression as well as various skin conditions such as hives. Although it is less common than SSRIs, it is a common tricyclic antidepressant option.
- Desipramine : At one point this was another very common TCA medication. These days people have discovered the fact that it could have genotoxic effects and is associated with increased risk of breast cancer.