Antidepressants Matching

Fluoxetine (Prozac, Weekly, Serafem)

Prozac is most energizing. 1st of class

Weekly has very long half life

Serafem is marketed for PMDD

SSRI

Sertraline (Zoloft)

Known for GI upset, take with meals for optimal absorption

SSRI

Fluvoxamine (Luvox)

Great for OCD (higher dose than normal range) & social anxiety disorder, no indication for depression

SSRI

Paroxetine (Paxil, Brisdelle)

Paxil is most sedating & causes most weight gain

Brisdelle is used for hot flashes

SSRI

Citalopram

Can prolong QT interval

SSRI

Escitalopram

“Cleaner” - less drug-drug interactions

SSRI

Vilazodone (Viibryd)

Newer, works differently - agonizes some serotonin receptors

SSRI

Vortioxetine (Trintellix)

Newest, doesn’t cause weight gain, safe in elderly - off label for geriatric depression

SSRI

Venlafaxine HCL (Effexor)

Used for depression, GAD, OCD

lower dose: more like SSRI, more serotonin, less norepi

higher dose: less serotonin, more norepi

SNRI

Desvenlafaxine (Pristiq)

ONLY ER form - no crush/cut/chew. used for depression

cautions: renal disease, hepatic disease, seizure disorder, cardiovascular/cerebrovascular dx.

side effects: hyperhidrosis, orthostatic hypotension in elderly, abnormal bleeding, narrow angle glaucoma, hyperlipidemia, hyponatremia, pneumonia

SNRI

Duloxetine (Cymbalta)

used for depression, diabetic neuropathic pain, GAD, low back pain, fibromyalgia

contraindicated: liver disease

side effects: insomnia, headache, dizziness

SNRI

Levomilnacipran (Fetzima)

only ER form. used for depression

contraindications: narrow-angle glaucoma, ESRD

side effects: abnormal bleeding, glaucoma, seizures, hyponatremia, hyperhidrosis

SNRI

Tricyclics

Amitriptyline, Nortriptyline, Protriptyline

Tricyclics

Imipramine, Desipramine, Trimipramine, Clomipramine

Tricyclics

Doxepin

Tricyclics

Amoxapine

Tricyclics

Phenelzine (Nardil)

MAOI

Tranylcypromine (Parnate)

MAOI

Selegine (EMSAM)

transdermal patch, if on lowest dose don’t need to follow dietary restrictions

MAOI

Isocarboxazid (Marplan)

MAOI

Trazodone (Desyrel)

NOT an effective antidepressant as a monotherapy

used for depression, insomnia

side effects, sedation, priapism, dizziness, agranulocytosis (sore throat, malaise, unusual bleeding/bruising)

Heterocyclics

Nefazodone (Serzone)

not available in US

black box warning for liver failure

Heterocyclics

Mirtazepine (Remeron)

used for depression

side effects: sedation, weight gain, dry mouth. lower the dose = more appetite stimulating & sedating

Heterocyclics

Bupropion (Wellbutrin, Zyban)

inhibits norepi & dopamine

used for depression, zyban = smoking cessation, ADHD

side effects: agitation, dizziness, dry mouth, sweating, tremor, increased psychosis, headache, potential seizure = wellbutrin

contraindicated: eating disorder = can decrease appetite

Heterocyclics