Unlike ordinary sadness, depression is a serious and often debilitating mental health disorder. While prevalent before the pandemic, the condition has become even more widespread in recent years, affecting as many as 1 in 3 U.S. adults according to some research studies.
If undiagnosed and untreated, depression can greatly interfere with daily life. Fortunately, medication and therapy can help manage symptoms. Here’s more on commonly prescribed antidepressants and what to consider when exploring your options.
Causes and risk factors
There isn’t one single cause of depression. Several factors can trigger the condition, including the following.
Early childhood trauma
Experiences of trauma early in life can affect how your brain reacts to fear and stress, in some cases resulting in depression.
Life events
External circumstances including relationship changes, financial stress, or an unstable living situation can also factor into depression.
Genetics
Like many mental health disorders, depression often runs in families.
Health history
Depression has been linked to other conditions, including sleep disorders, chronic pain, anxiety, and attention-deficit hyperactivity disorder (ADHD). Having a heart attack or stroke can also increase your risk of depression.
For women, changes in estrogen and progesterone levels throughout a menstrual cycle or during postpartum or menopause may contribute to the condition.
Substance use
A history of substance misuse is considered a risk factor for depression, and alcohol use in particular can worsen symptoms of depression. Treatment for a substance use disorder may be part of a treatment plan for some individuals with depression.
Symptoms of depression
A depressive disorder is diagnosed when a person experiences symptoms of a depressive episode for longer than two weeks. These are some of the most common symptoms:
Loss of interest or pleasure in activities
Changes in appetite or weight
Difficulty concentrating
Disrupted sleep
Agitation
Fatigue
Feelings of low self-worth, guilt, or hopelessness
Suicidal thoughts
Commonly prescribed antidepressant medications
Symptoms of depression can be managed with treatment, which may include medication, psychotherapy, and lifestyle adjustments like prioritizing physical activity.
There are many options for medication to treat depression. Your provider will make recommendations based on your specific symptoms. Below are some of the most commonly prescribed medication classes.
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant. These medications increase a person’s levels of serotonin — a chemical in the brain that affects mood — to alleviate symptoms of depression.
SSRIs used to treat depression include:
Sertraline (Zoloft®)
Paroxetine (Paxil®)
Fluoxetine (Prozac®)
Citalopram (Celexa®)
Escitalopram (Lexapro®)
It typically takes several weeks to a month to experience an SSRI’s benefits. Even if you don't feel like the medication is working, continue to take it as prescribed so that you can achieve a therapeutic level. If you still have concerns several weeks into treatment, speak with your doctor.
Always consult your doctor before stopping an SSRI. In most cases, you will gradually taper to lower doses of the medication before you stop taking it completely. This helps to prevent withdrawal symptoms.
SSRIs have been linked to the following side effects, though they are mild in the majority of cases. Speak with your doctor about any concerns.
Nausea
Dry mouth
Diarrhea
Dizziness
Drowsiness
Sexual dysfunction
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs) increase levels of serotonin — like SSRIs — but they also increase norepinephrine, another brain chemical that affects mood.
SNRIs used to treat depression include:
Venlafaxine (Effexor®)
Desvenlafaxine (Pristiq®)
Duloxetine (Cymbalta®)
Levomilnacipran (Fetzima®)
These medications also have the potential for mild side effects, including the following. Speak with your doctor about any concerns.
Nausea
Dry mouth
Dizziness
Headache
Sweating
Tricyclic antidepressants (TCAs)
Tricyclic antidepressants also increase the amount of serotonin and norepinephrine in your brain. An older medication class, they are less prescribed than newer medications as they have a greater potential for side effects.
TCAs used to treat depression include:
Nortriptyline (Pamelor®)
Amitriptyline (Elavil®)
Imipramine (Tofranil®)
Doxepin (Silenor®)
Side effects linked to TCAs include:
Dry mouth
Blurred vision
Increased fatigue and sleepiness
Weight gain
Tremors
Constipation
Dizziness
Increased heart rate
Monoamine oxidase inhibitors (MAOIs)
Another older and less frequently prescribed class of antidepressants, monoamine oxidase inhibitors (MAOIs) increase the amount of dopamine, norepinephrine, and serotonin in your brain. They have a greater potential for medication interactions than other antidepressants.
MAOIs used to treat depression include:
Phenelzine (Nardil®)
Tranylcypromine (Parnate®)
Isocarboxazid (Marplan®)
Potential side effects of these medications include:
Drowsiness
Dry mouth
Dizziness
Headache
Nausea
Insomnia
Diarrhea or constipation
Weight gain
Low blood pressure
Tremors
Sweating
Sexual dysfunction
Other antidepressants
Some commonly prescribed antidepressants, like the following, don’t fit into the above categories.
Bupropion (Wellbutrin®) belongs to a class of medications called norepinephrine and dopamine reuptake inhibitors (NDRIs). It increases your levels of norepinephrine and dopamine to reduce symptoms of depression.
Nefazodone (Serzone®) and trazodone (Desyrel®, Oleptro®) are 5-HT2 receptor antagonists, which use a different mechanism than SSRIs to increase serotonin levels.
Mirtazapine (Remeron®) is a noradrenergic antagonist. It increases norepinephrine levels.
What to consider when taking an antidepressant
Finding the right antidepressant for your symptoms of depression may take time and trial and error. There are some steps you can take to improve your chances of success with the medication your doctor prescribes.
Always take your medication as prescribed. If you have concerns about a medication, consult your doctor before you stop taking it. Keep in mind that the initial side effects of some medications often improve with time.
Avoid use of alcohol and other substances, which can worsen symptoms of depression over the long term and make the condition more difficult to treat.
If you don’t experience an improvement in symptoms after taking your medication for an extended period of time, speak with your doctor about other options. It may be necessary to add a second antidepressant or another medication to your treatment plan.
Combining medication with therapy is the most impactful treatment option for some people with depression. Finding the right therapist can also take time. If you have insurance coverage of therapy sessions, check your insurance company’s provider network as a starting point. You can also look through reputable online databases like Psychology Today or the American Psychological Association (APA)’s psychologist locator. Some therapists offer sliding scale fees to make sessions more affordable.
A flexible and reliable pharmacy partner
Maintaining good mental health is easier with a reliable pharmacy on your side. Our pharmacists can answer any questions you may have about your medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.
To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
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