Selective Serotonin Reuptake Inhibitors (SSRIs)

• Citalopram
• Fluvoxamine
• Paroxetine
• Fluoxetine
• Sertraline
• Escitalopram

SSRIs help with serotonin, a brain chemical that plays a role in depression. These may be the first choice if you need to try medicine.

Don't drink alcohol while taking an SSRI. Don't take SSRIs if you've taken a monoamine oxidase inhibitor (MAOI) in recent weeks.

Some problems are:

• Risk of severe changes in your mood and behavior. This may also include self-harm or trying to take your own life:
  • Children and young adults (mainly under age 25)
  • The risk is greatest in the first few weeks of starting these
• Nausea
• Stomach irritation
• Diarrhea
• Insomnia
• Less hunger than normal or weight loss
• More hunger than normal or weight gain
• Nervousness
• Lightheadedness
• Problems with sex—can be with arousal, erectile dysfunction (ED), and delayed time to or lack of orgasm
• Serotonin syndrome—happens when there is too much serotonin, which can be serious

Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs)

• Venlafaxine
• Duloxetine
• Desvenlafaxine

SNRIs help with serotonin and norepinephrine. They work as well as SSRIs.

Some problems are:

• Dry mouth
• Constipation
• Nausea
• Fatigue
• Drowsiness
• Excessive sweating
• Higher heart rate
• High blood pressure—venlafaxine
• Lightheadedness
• Low blood pressure
• Diarrhea
• More hunger than normal or weight gain
• Nervousness
• Problems with sex—can be with arousal, ED, and delayed time to or lack of orgasm
• Serotonin syndrome—happens when there is too much serotonin, which can be serious
• Risk of severe changes in your mood and behavior. This may also include self-harm or trying to take your own life:
  • Young adults may be at a higher risk.
  • The risk is greatest in the first few weeks of starting these.

Tricyclic Antidepressants

• Doxepin
• Clomipramine
• Nortriptyline
• Amitriptyline
• Imipramine
• Maprotiline
• Desipramine
• Trimipramine
• Protriptyline

These work on more than 1 chemical in your brain. But they are toxic if taken in large doses. They're not used for people who think about taking their own life. Tricyclics don't cause addiction.

Some problems are:

• Lightheadedness
• Dry mouth
• Constipation
• Problems passing urine
• Low blood pressure
• Irregular or rapid heartbeat
• Drowsiness
• Nausea
• Diarrhea
• More hunger than normal or weight gain
• Nervousness
• Vision problems
• Problems with sex—can be with arousal, ED, and delayed time to or lack of orgasm
• Serotonin syndrome—happens when there is too much serotonin, which can be serious
• Risk of severe changes in your mood and behavior. This may also include self-harm or trying to take your own life:
  • Young adults may be at a higher risk.
  • The risk is greatest in the first few weeks of starting these.

Monoamine Oxidase Inhibitors (MAOIs)

Common names include:

• Isocarboxazid
• Phenelzine
• Tranylcypromine
• Selegiline patch

MAOIs will keep brain chemicals from being broken down. These may help people who haven't had success with other types of medicine.

If you take MAOI, you will need to make changes in how you eat to keep a certain substance called tyramine from building up in your body. Not doing so can cause a hypertensive crisis, which can lead to death.

You will have to avoid:

• Alcohol
• Certain types of cheeses
• Overripe or spoiled fruits
• Chicken and beef liver
• Dried meats
• Certain kinds of beans
• Monosodium glutamate (MSG)

Some other problems are:

• Lightheadedness, sleepiness, blurred vision, problems thinking clearly
• Headache
• Constipation
• Insomnia
• Skin irritation—selegiline patch
• Problems with sex—can be with arousal, ED, and delayed time to or lack of orgasm
• Serotonin syndrome—happens when there is too much serotonin, which can be serious
• Risk of severe changes in your mood and behavior. This may also include self-harm or trying to take your own life:
  • Young adults may be at a higher risk.
  • The risk is greatest in the first few weeks of starting these.
• High blood pressure—rare

MAOIs can cause problems when mixed with many other types of drugs, even other antidepressants. Ask your doctor about what you will need to avoid.

Other Antidepressants

• Trazodone
• Nefazodone
• Bupropion
• Mirtazapine

There are many other types that work in different ways. These change the levels of brain chemicals that keep your moods level.

Nefazodone has been associated with reports of life-threatening liver failure. People with liver disease shouldn't take it. Those who are taking nefazodone are advised to report liver problems right away. These may be jaundice, loss of hunger, feeling ill, and problems with your gastrointestinal system.

Some problems are:

• Lightheadedness
• Dry mouth
• Constipation
• Problems passing urine
• Low blood pressure
• Sedation
• Nausea
• Diarrhea
• More hunger than normal or weight gain
• Less hunger than normal or weight loss
• Nervousness
• Vision problems
• Problems with sex—can be with arousal, ED, and delayed time to or lack of orgasm
• Serotonin syndrome—happens when there is too much serotonin, which can be serious
• Risk of severe changes in your mood and behavior. This may also include self-harm or trying to take your own life:
  • Young adults may be at a higher risk.
  • The risk is greatest in the first few weeks of starting these.