What are Antidepressants?
Antidepressants are medications used to treat all kinds of depression, from mild depression to major depression with anxiety to depression associated with bipolar disorder or cyclothymic disorder. This category of medications is broad, because there are so many underlying causes of depression, and different medications will work for different people, depending on their needs. Depending on the type of antidepressant prescribed, the medication could take a few weeks to begin lifting depression. It is important for people taking antidepressants to stay in contact with their prescribing physician or psychiatrist in order to keep track of the medication’s effectiveness.
5 Types of Antidepressants
There are five basic categories of antidepressant medications.
- Selective serotonin reuptake inhibitors (SSRIs) : Most prescribing physicians or psychiatrists will begin by prescribing this type of antidepressant. For most people, SSRIs effectively moderate mood, with fewer side effects than other medications. These medications work by blocking some reuptake of serotonin, so mood is elevated. Paxil, Prozac, Celexa, Lexapro, and Zoloft are all commonly prescribed SSRI antidepressants.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): These medications work by blocking both serotonin and norepinephrine from being absorbed by neurons, so the effects of these neurotransmitters linger in the brain longer, allowing changed communication between neurons and elevated mood. These antidepressants include Cymbalta, Effexor, Fetzima, and Pristiq.
- Tricyclic antidepressants (TCAs): These antidepressants tend to be a little more powerful than SSRIs or SNRIs, and they also cause more side effects. They were some of the earliest antidepressants but have fallen out of favor over time. Tricyclic antidepressants are not prescribed often; usually, they are prescribed in the instance that other antidepressants like SSRIs have not been effective. These medications increase levels of serotonin and norepinephrine in the brain by both blocking reuptake and changing output of the neurotransmitters. Medications in this category include Elavil, Tofranil, and Pamelor.
- Monoamine oxidase inhibitors (MAOIs): These are rarely prescribed, unless all other categories of antidepressants have failed to work. This was one of the first classes of antidepressants on the market, and they work by preventing monoamine oxidase from removing neurotransmitters from the brain, especially norepinephrine, serotonin, and dopamine. There are serious side effects associated with MAOIs, and the medication interacts with several types of foods, including some cheeses, pickles, and wine in ways that can be dangerous or deadly. Additionally, MAOIs interact with many other medications, including birth control pills, over-the-counter decongestants, and some herbal supplements. People who take MAOIs must follow a restricted diet and carefully examine any other medications they take. MAOI medications include Marplan, Nardil, and Parnate.
- Other antidepressants: Wellbutrin is an NDRI (norepinephrine and dopamine reuptake inhibitor); Oleptro and Remeron are sedating antidepressants; and some medications may be combined with antidepressants to increase the effectiveness of the antidepressant.
Although SSRIs and SNRIs are the first go-to prescriptions to treat depression, the above list shows that several categories of antidepressants exist because treatment for mental health conditions is so individual. Some understanding of the most effective prescription treatments for depression can be gathered by comparing some lists of popular antidepressants.
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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:
- Remeron (mirtazapine)
- Lexapro (escitalopram)
- Effexor (venlafaxine)
- Zoloft (sertraline)
- Celexa (citalopram)
- Wellbutrin (bupropion)
- Paxil (paroxetine)
- Savella (milnacipran)
- Prozac (fluoxetine)
- Cymbalta (duloxetine)
- Luvox (fluvoxamine)
- Vestra (reboxetine)
Top 10 Most Popular Antidepressants by Prescription and Sales
In 2013 and 2014, there were slightly different prescription and sales patterns for antidepressants in the United States. Here are the most popular and prescribed antidepressant medications from that time period:
Top 7 Most Consistently Popular Antidepressants
Between these two lists, the following antidepressants remain popular, widely prescribed, well liked, well tolerated, and induce few side effects. These are, in alphabetical order:
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.
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Help Is Needed to Overcome Depression
People who struggle with both depression and substance abuse have co-occurring disorders. It is important to find effective treatment for both of these conditions at the same time. Experts agree that co-occurring disorders must be treated simultaneously for recovery on both fronts to occur.
As more medical research is conducted into the prevalence of co-occurring disorders, more rehabilitation programs are incorporating this capability into their treatment plans, and they are better prepared to help people struggling with simultaneous substance abuse and mental health issues. With professional help, individuals can learn to manage both their substance abuse and their depression so they can embrace healthier, happier lives.