Management of depression requires administration of the right antidepressant drugs. They are several types of antidepressants that the clinician can opt for to manage his or her patient based on the client’s condition.
Categories of Antidepressants
Basically antidepressants are classified into the following categories:
Tricyclic antidepressant (TCA)
These types of antidepressants mode of action are inhibition of reuptake of norepinephrine and serotonin by the brain. The following drugs falls under this category:
- Clomipramine – The common brands in the markets are Placil and Anafranil
- Trimipramine – One of the brands available is Surmonil
- Doxepin – Sinequin is a brand of this antidepressant.
- Protyptyline – Vivactil
- Imipramine – Available as Tofranil and Tolerade amidst other new brands.
- Desipramine – One of the brands of this is Norpramin
- Nortriptyline – Brands in the market are Pamelor, Allegron and Aventyl
- Dothiepin – Dothep, Prothiaden
- Amitryptyline – Some of the registred brands are Laroxyl, Endep and Elavil
Selective Serotonin Reuptake Inhibitors (SSRIs)
These antidepressants inhibit reuptake of serotonin in the brain. The therapeutic drugs that are members of this group are:
- Sertaline – Zoloft is the common brand found in most of the pharmacies. Other are Seralin, Xydep, Eleva, Ralset, Setrona, Sertra , Tralen amidst other brands.
- Fluvoxamine – There are Luvox, Voxam, Faverin and Movox brands in the market.
- Fluoxetine – Brands includes Zactin, Lovan and Prozac
- Citalopram – Brands available are Celac, Citadril, Lopacit, Talam and others.
- Paroxetine – Available as Extine, Pharmacor, Paxil, Exctine, Aropax.
- Escitalopram – Some of the brands are Loxalate, Esipram, Lexapro and Escicor
Monoamine Oxidase Inhibitors (MOI)
These antidepressants are not commonly used due to their adverse reactions and interactions with other drugs and foods. The following are the antidepressants that are classified in this category:
- Tranylcypromine – One of the available brands is Parnate
- Isocarboxacid – The common brand is Marplan.
- Phenalazine – Nardil is a brand of this generic.
- Sellegine – Emsam is one of the brands in the market.
SNRIs (serotonin and noradrenaline reuptake inhibitors)
Also known as atypical antidepressants. These are a category of antidepressants used in the management of severe depression. They are also to manage mood disorders. Below are the SNRIs available in the market:
- Duloxetine – Currently, the brands that are mostly used more so in the US are Cymbalta, and Yentreve
- Venlafaxine – Available brand in the market is Effexor
- Levomilnacipran – The brand that is available in most of the pharmacies is Fetzima
- Milnacipran – Brands available are Ixel, Dalcipran, Savella amidst others.
- Desvenlafaxine – Pristiq
- Sibutramine – Brands of this generic are Meridia and Reductil
Reversible Inhibitor of Monoamine Oxidase (RIMA)
These types antidepressants inhibit the breakdown of the main three neurotransmitters: serotonin, dopamine and norepinephrine . Moclobemide is the one of the drugs that falls under this category. The brands that are commonly administered are Clobemix, Amira and Aurorix.
Agomelatine( Valdoxan) falls under this category.
Noradrenergic and Specific Serotonergic antidepressant (NASSA)
This antidepressant work by blocking adrenegic auto receptors. They optimize noradrenergic and serotonergic neurotransmission across the central nervous system.The following are the drugs falling in this category of antidepressant:
Desvenlafaxine – Pristiq
Duloxetine – One of the brands available is Cymbalta.
Venlafaxine – Efexor-XR
These antidepressant helps to reduce depression symptoms and improves on the patients’ moods. Mianserin falls under this category and trade with these brands: Also, there are tetracyclic analogues of mianserin. Mirtazapine is classified in this category and available as Remeron, Axit, Avanza and Mirta
Based on the patient’s history, drug benefits, safety margin and efficacy margin, a psychiatrist or the clinician has a wide option of the types of antidepressants that will provide the best clinical intervention for his or her patient.