Most Common Antidepressants Prescribed and Used

Antidepressants are the most prescribed medications for mental health disorders. This class of medication does not cure depression, but often alleviates symptoms.

Not all antidepressants are effective for every individual. Treatment may involve trying one or more of the different types of antidepressants available. You may require a combination of medications.

This guide highlights some common antidepressants that may work to reduce the symptoms of major depressive disorder.

How Antidepressants Work

There are five main types of antidepressants, and they work in different ways:

1. SSRIs (selective serotonin reuptake inhibitors)
2. SNRIs (serotonin and norepinephrine reuptake inhibitors)
3. TCAs (tricyclic antidepressants)
4. MAOIs (monoamine oxidase inhibitors)
5. Atypical antidepressants

Common antidepressants may work differently, but they all serve to enhance the availability of monoamine neurotransmitters in the brain. Monoamine neurotransmitters are chemical messengers that include dopamine, serotonin, and norepinephrine. These neurotransmitters help govern your emotions, mood, and behavior.

Those suffering from depression have low levels of availability of these neurotransmitters in the brain. Antidepressants can effectively prevent the reuptake of these neurotransmitters, increasing their availability and positively altering the activity of neural circuits in the brain.

What are the Most Common Antidepressants?

Researchers believe that certain neurotransmitters like dopamine, serotonin, and norepinephrine are associated with major depressive disorder. Most antidepressant medications relieve the symptoms of depression by influencing the activity and reuptake of neurotransmitters. The different types of antidepressants affect these chemical messengers in different ways.

These are the major types of antidepressants available in the United States:

• SSRIs: SSRIs (selective serotonin reuptake inhibitors) are considered a first-line treatment for major depressive disorder. Most physicians start by prescribing an SSRI antidepressant. This class of antidepressants typically cause fewer adverse side effects than other types of antidepressants. They are also less likely to induce problems at higher doses than other antidepressants. Common SSRIs include Prozac (fluoxetine), Paxil and Pexeva (paroxetine), Zoloft (sertraline), Celexa (citalopram) and Lexapro (escitalopram).
• SNRIs: SNRIs (serotonin and norepinephrine reuptake inhibitors) include Cymbalta and Drizalma Sprinkle (duloxetine), Effexor XR (venlafaxine), Pristiq (desvenlafaxine) and Fetzima (levomilnacipran).
• TCAs: TCAs (tricyclic antidepressants) include imipramine, Pamelor (nortriptyline), and Norpramin (amitriptyline, doxepin and desipramine). TCAs typically cause more side effects than later-generation antidepressants and are not normally prescribed unless other antidepressants prove ineffective.
• MAOIs: MAOIs (monoamine oxidase inhibitors) include Parnate (tranylcypromine), Nardil (phenelzine) and Marplan (isocarboxazid). MAOIs are sometimes prescribed when other antidepressants are ineffective. MAOIs can interact with foods like pickles, cheeses, and wines. This class of medication may also adversely interact with some decongestants, pain medicines, and herbal supplements. MAOIs cannot be combined with SSRIs.
• Atypical antidepressants: The most prescribed atypical antidepressants include trazodone, Trintellix (vortioxetine), Viibryd (vilazodone) and Wellbutrin SR (bupropion). Unlike most antidepressants, bupropion is not frequently associated with adverse sexual side effects.
• Other medications: Your prescribing physician may recommend combining two types of antidepressants. Alternatively, they may add medications to enhance antidepressant effects. This process is called augmentation. Examples of medications used for antidepressant augmentation include Abilify (aripiprazole), Seroquel (quetiapine) and Lithobid (lithium).

What are The Most Commonly Prescribed Antidepressants?

Some commonly prescribed SSRIs include:

• Prozac (fluoxetine): A 2017 report on antidepressant use shows that Prozac is prescribed to 11% of those being treated for depression. Prozac is one of the only antidepressants approved by the FDA for children and teens.
• Celexa (citalopram): Celexa works as effectively as other SSRIs and induces similar side effects. Taking high doses of this antidepressant is associated with a rare heart rhythm condition. In the above report, 14% of those prescribed antidepressants were taking Celexa.
• Zoloft (sertraline): Zoloft can be highly effective, although it may cause diarrhea. Zoloft is the most common antidepressant, with 16% of participants surveyed in the above study taking Zoloft.
• Paxil (paroxetine): Paxil is liable to trigger sexual side effects and increased sweating.
• Lexapro (escitalopram): Lexapro is also approved by the FDA for use in teens. 8% of participants in the above study reported taking Lexapro.

Some commonly prescribed SNRIs include:

• Ultram (tramadol)
• Strattera (atomoxetine)
• Savella (milnacipran)
• Pristiq (desvenlafaxine)
• Fetzima (levomilnacipran)
• Effexor (venlafaxine)
• Cymbalta (duloxetine)

Effexor (venlafaxine) is as effective as other types of antidepressants for treating depression but is associated with a higher rate of inducing nausea and vomiting, and may also increase heart rate and blood pressure, according to the FDA.

Cymbalta (duloxetine) may also increase blood pressure, and can also trigger liver failure. This medication is inadvisable for those with liver disease or for those who drink lots of alcohol.

Some tricyclics include:

• Vivactil (protriptyline)
• Tofranil (imipramine)
• Surmontil (trimipramine)
• Silenor (doxepin)
• Pamelor (nortriptyline)
• Norpramin (desipramine)
• Elavil (amitriptyline)
• Asendin (amoxapine)

Some commonly prescribed MAOIs include:

• Parnate (tranylcypromine)
• Nardil (phenelzine)
• Marplan (isocarboxazid)
• Emsam (selegiline)

Some commonly prescribed atypical antidepressants include:

• Trintellix (vortioxetine)
• Wellbutrin (bupropion)
• Desyrel (trazodone)

Wellbutrin is one of the most prescribed atypical antidepressants. This medication has a lower risk of gastrointestinal and sexual side effects.

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