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Antidepressants are a group of prescription medicines that treat depression. They may also be used to treat other health conditions. The chemicals in them affect people in different ways. This is why there are several types. You may have to try one or more types before finding one that works. Learn about the different types and talk to your healthcare provider to see which one(s) works for you.

Path to improved health

Prescription antidepressant medicines are sorted into types. They are based on which chemicals in the brain they affect. Neurotransmitters are the brain chemicals that communicate information throughout your brain and body.

Your healthcare provider may prescribe an antidepressant to treat your depression symptoms. Below are the different types of prescription medicines that regulate the levels of different neurotransmitters in your brain.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs affect a chemical in the brain called serotonin. SSRIs are usually the first kind of antidepressant medicine your healthcare provider will prescribe. These medicines tend to have fewer side effects. Types of SSRIs are:

• citalopram
• escitalopram
• fluoxetine
• fluvoxamine
• paroxetine
• sertraline

Common side effects of SSRIs include:

• dry mouth
• nausea
• headache
• nervousness
• restlessness
• trouble sleeping
• sexual problems

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

SNRIs affect two chemicals – serotonin and norepinephrine – in the brain. These medicines are sometimes chosen because they don’t interfere with certain other medicines.

• desvenlafaxine
• duloxetine
• venlafaxine

Common side effects of SNRIs include:

• nausea (especially in the first two weeks)
• loss of appetite
• anxiety and nervousness
• headaches
• trouble sleeping
• lack of energy
• dry mouth,
• constipation
• weight loss
• sexual problems,
• increased heart rate
• increased cholesterol levels

Atypical antidepressants

These medicines are called “atypical” because they don’t easily fit into their own category.

Types of atypical antidepressants are:

• bupropion
• mirtazapine
• trazodone

 Each drug has different side effects. Like most antidepressants, side effects include nausea, fatigue, nervousness. Dry mouth and headaches are common as well.

Trazodone may be used along with an SSRI. This can help with insomnia with depression.

Bupropion is sometimes recommended for people who have certain health issues. The most common is attention-deficit hyperactivity disorder (ADHD), Other issues are nicotine or cocaine dependence You should not take this kind of medicine if you have a seizure disorder or bulimia. Side effects include agitation, loss of appetite, and trouble sleeping. Bupropion typically has less risk of sexual side effects.

Tricyclic antidepressants

Tricyclic antidepressants affect three brain chemicals.  They are serotonin, norepinephrine, and dopamine. This is one of the oldest types of antidepressants. The drugs are effective, but they are used less often because of increased side effects. They are not used for older patients, people who have glaucoma, or men who have enlarged prostates.

Types of tricyclic antidepressants are:

• amitriptyline
• clomipramine
• desipramine
• doxepin
• imipramine
• nortriptyline
• trimipramine

Common side effects of tricyclics include:

• dry mouth
• blurred vision
• constipation
• trouble urinating
• impaired thinking
• tiredness
• worsening of glaucoma

These antidepressants can also affect a person’s blood pressure and heart rate.

Monoamine oxidase inhibitors (MAOIs)

MAOIs affect an enzyme in the brain called monoamine. These drugs are typically used as a last resort, when other types of antidepressants haven’t worked. 

Types of MAOIs are:

• phenelzine
• selegiline
• tranylcypromine

MAOIs can have severe side effects. These include:

• weakness
• dizziness
• Headaches
• trembling

They also can have harmful reactions when combined with certain foods or medicines (other antidepressants and cold and flu medicines). The reaction is known as “serotonin syndrome.” These reactions include:

• hallucinations
• changes in blood pressure
• agitation
• fever

Things to consider

Talk to your healthcare provider about the different types of antidepressants. Be sure they know what other medicines, vitamins, or supplements you take. It is important to follow your healthcare provider’s instructions. You may want to stop taking the medicine(s) once you feel better. However, this can cause your depression to come back. Do not stop taking antidepressants without talking to your healthcare provider. You often need to decrease the dose over time. You cannot get addicted to antidepressants. You may have worse symptoms or withdrawal if you stop taking them at once.

Contact your healthcare provider right away or go to the emergency room if you have the following symptoms.

• Attempt to commit suicide.
• Have thoughts about suicide or death.
• Have thoughts about hurting someone else.
• Act angry, violent, or aggressive.
• Have sudden onset of mania.
• Have panic attacks.
• Have severe or ongoing insomnia (trouble sleeping).
• Have new or worsening depression.
• Notice heightened symptoms.
• Have unusual changes in mood or behavior.