Other Antidepressants for Depression
All of these antidepressants are tablets taken by mouth (orally).
These antidepressants are newer (second-generation) antidepressants and tend to have fewer side effects than older (first-generation) antidepressants such tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs). Serotonin reuptake inhibitors (SSRIs) also are second-generation antidepressants.
How It Works
Bupropion, duloxetine, mirtazapine, trazodone, and venlafaxine balance certain brain chemicals (neurotransmitters) that are important to your mood. When these brain chemicals are balanced, it helps the symptoms of depression.
Why It Is Used
Your doctor may suggest these medicines when other antidepressants don't work or have bothersome side effects. For example:
You take these medicines alone or with another medicine.
Make sure your doctor knows all your medical history, all health problems you have, and all medicines you are taking before you use these medicines.
These medicines have not been approved for use in people younger than age 18.
How Well It Works
These antidepressants work to treat depression.
Bupropion, duloxetine, mirtazapine, trazodone, and venlafaxine help adults and have been approved by the U.S. Food and Drug Administration (FDA) for treating depression.
Bupropion, duloxetine, mirtazapine, trazodone, and venlafaxine have different side effects than selective serotonin reuptake inhibitors (SSRIs), cyclic antidepressants, or monoamine oxidase inhibitors (MAOIs).
Trazodone has numerous side effects, and in rare cases, some can be severe.
The most common side effects of each of these medicines are listed below.
Bupropion possible side effects
In rare cases, bupropion can cause other adverse effects such as allergic reactions, dry mouth, headaches, heart palpitations, and seizures.
Desvenlafaxine possible side effects
Duloxetine possible side effects
More serious side effects are rare but can include liver problems (particularly in people who drink a lot of alcohol), increased blood pressure, mania or hypomania, seizures, and mydriasis (pupil dilation), which can cause problems for people with narrow-angle glaucoma.
Mirtazapine possible side effects
Other more serious side effects are rare but can include agranulocytosis (insufficient white blood cell count), allergic reactions, and liver or pancreas problems.
Trazodone possible side effects
Side effects may also include priapism, a painful condition in which the penis stays erect. If this happens, call your doctor at once.
Venlafaxine possible side effects
When you stop using venlafaxine, side effects can include dizziness, nausea, headache, abnormal touch sensation or tingling (paresthesia), vomiting, irritability, and nightmares.
Venlafaxine makes bleeding more likely in the upper gastrointestinal tract (stomach and esophagus). Taking venlafaxine with NSAIDs (such as Aleve or Advil) makes bleeding even more likely. Taking medicines that control acid in the stomach may help.1
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Antidepressant medicines work in different ways. No antidepressant works better than another, but different ones work better or worse for different people. The side effects of antidepressant medicines are different and may lead you to chose one instead of another. Tell your doctor about side effects.
You may have to try different medicines or take more than one to help your symptoms. Most people find a medicine that works within a few tries. Other people take longer to find the right one and may need to take the antidepressant and another type of medicine.
Take your antidepressant as your doctor says. Don't quit taking your medicines without talking to your doctor. If you quit suddenly, it can cause dizziness, anxiety, fatigue, and headache. If you and your doctor decide you can quit using medicine, gradually reduce the dose over several weeks.
You may start to feel better within 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor.
Like with other antidepressants, these medicines should not be used along with monoamine oxidase inhibitors (MAOIs) because serious, sometimes fatal, reactions can occur. To avoid serious reactions, wait at least 14 days after ending an MAOI treatment before beginning treatment with any one of these medicines.
Taking medicines for depression during pregnancy may make birth defects more likely. If you are pregnant or thinking of becoming pregnant, talk to your doctor. Medicines may need to be continued if your depression is severe. You and your doctor must weight the risks of taking these medicines against the risks of not treating depression.
These medicines must be used very carefully in those who have bipolar disorder, because they may trigger a manic episode. If you have bipolar disorder, your doctor may prescribe them along with a mood stabilizer.
eMedicineHealth Medical Reference from Healthwise
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