Antidepressants by Class
|
MAOIs Monoamine Oxidase Inhibitors |
|
| Generic | Brand |
| Harmaline | --- |
| Iproniazid | --- |
| Isocarboxazid | Marplan |
| Moclobemide | Manerix |
| Nialamide | --- |
| Pargyline | Eutonyl |
| Phenelzine | Nardil |
| Selegiline | Emsam or Eldepryl or Deprynel |
| Toloxatone | --- |
| Tranylcypromine | Parnate |
The MAOIs prevent the breakdown of monoamine neurotransmitters (including serotonin), and therefore increase concentrations of the neurotransmitter in the brain. MAOI therapy is associated with many adverse drug reactions, and patients are at risk of hypertensive crisis triggered by foods with high tyramine-content and certain drugs.
|
TCAs Tricyclic Antidepressants |
|
| Generic | Brand |
| Amitriptyline | Elavil or Endep |
| Amoxapine | Asendin |
| Butriptyline | --- |
| Clomipramine | Anafranil |
| Desipramine | Norpramin |
| Dibenzepin | Noveril |
| Dothiepin | Dosulepin |
| Doxepin | Adapin or Sinequan |
| Imipramine | Tofranil |
| Iprindole | --- , fatal when combined with MDMA (Ecstasy) |
| Lofepramine | Gamanil or Lamont |
| Maprotiline | Ludiomil or Deprilept or Psymion |
| Melitracen | --- |
| Nortriptyline | Pamelor or Aventyl |
| Opipramol | Insidon |
| Protriptyline | Vivactyl |
| Trimipramine | Surmontil |
Tricyclic antidepressants are a class of antidepressant drugs first used in the 1950s. They are named after the drugs' molecular structure, which contains three rings of atoms (compare tetracyclic antidepressant). The exact mechanism of action is not well understood, however it is generally thought that tricylic antidepressants work by inhibiting the re-uptake of the neurotransmitters norepinephrine, dopamine, or serotonin by nerve cells. Tricyclics may also possess an affinity for muscarinic and histamine H1 receptors to varying degrees. Although the pharmacologic effect occurs immediately, often the patient's symptoms do not respond for 2 to 4 weeks.
|
SSRIs Selective Serotonin Reuptake Inhibitors |
|
| Generic | Brand |
| Alaproclate | --- |
| Citalopram | Celexa |
| Escitalopram | Lexapro |
| Etoperidone | --- |
| Fluoxetine | Prozac |
| Fluvoxamine | Luvox |
| Paroxetine | Paxil |
| Sertraline | Zoloft |
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders and some personality disorders. Studies have also found that SSRIs, as a side effect of their action, may cause in many people either a delay of sexual climax or anorgasmia, so they can be used to develop drugs specifically targeted to treat premature ejaculation.
SSRIs increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin available to bind to the postsynaptic receptor. They have varying degrees of selectivity for the other monoamine transporters, having little binding affinity for the noradrenaline and dopamine transporters.
|
SNRIs Serotonin-Norepinephrine Reuptake Inhibitors |
|
| Generic | Brand |
| Duloxetine | Cymbalta |
| Milnacipran | Ixel |
| Nefazodone | Serzone |
| Venlafaxine | Effexor |
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressants used in the treatment of clinical depression and other affective disorders. They are also sometimes used to treat anxiety disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder (ADHD) and chronic neuropathic pain. They act upon two neurotransmitters in the brain that are known to play an important part in mood, namely, serotonin and norepinephrine. This can be contrasted with the more widely-used selective serotonin reuptake inhibitors (SSRIs), which act only on serotonin.
|
RIMAs Reversible Inhibitors of Monoamine Oxidase A |
|
| Generic | Brand |
| Brofaromine | Consonar |
| Moclobemide | Manerix |
Reversible inhibitors of monoamine oxidase type-A (RIMAs) are a family of psychiatric drugs that inhibit monoamine oxidase, temporarily and reversibly. They are mostly used for alleviating depression and dysthymia. These drugs, a subset of monoamine oxidase inhibitors (MAOIs), inhibit only isoenzyme A and are reversible. Isoenzyme B remains free to metabolize tyramine contained in some foods, so they are safer and may not require a special diet.
Because their action is short-lived and selective, they have a better safety profile than the older MAOI drugs (monoamine oxidase inhibitors). A special diet does not need to be so strictly adhered to, although eating excessively large amounts of tyramine-containing foods is not advisable. Combining a RIMA or MAOI with an SSRI is dangerous since it can lead to serotonin syndrome and possible fatality.
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DARIs Dopamine Reuptake Inhibitors (DARI) |
|
| Generic | Brand |
| Amineptine | Survector |
| Phenmetrazine | Preludin, removed from market |
Dopamine Reuptake Inhibitors (DARIs), Dopamine Uptake Inhibitors, and Dopamine Transporter Inhibitors are compounds that inhibit the reuptake of extracellular dopamine back into the presynaptic cell by blocking the cell membrane-spanning dopamine transporter. This usually results in an elevated extracellular dopamine level.
DARIs bind at the transporter molecule and form a non-covalent complex with it. When the DARI-molecule is large enough, which is normally the case, it suppresses the binding of other substances that are transporter substrates, such as endogenous comp A special kind of pseudo-DARI has been developed by scientists. It is a smaller compound, (metabolised/cracked into a small compound after DAT-binding), that binds covalently at the transporter, permanently blocking the binding of larger drugs like cocaine, but allowing small molecules like dopamine to pass through. Amineptine is a potent dopamine reuptake inhibitor, and is now banned in most countries, including the USA. Other drugs which impact the level of dopamine in the brain include bupropion (Wellbutrin, Zyban), venlafaxine (Effexor), duloxetine (Cymbalta), sertraline (Zoloft) (at high doses), MAOIs, cocaine, Benztropine, Nomifensine, Mazindol, amphetamines and a new class of reuptake inhibitors, the GBR series, such as GBR12909 (vanoxerine). In general, the abuse potential of DAR inhibitors depends on how they affect the pattern of dopamine release and reuptake. Compounds that inhibit reuptake and also induce release of dopamine, such as methamphetamine or phenmetrazine, or compounds that inhibit reuptake but have no effect on release, such as cocaine or methylphenidate, tend to be addictive drugs with potential for abuse in humans. On the other hand, compounds that inhibit reuptake but also inhibit release of dopamine, such as bupropion and vanoxerine, have mild stimulant effects and little abuse potential, and can be used to treat stimulant addiction.
|
NRIs or NARIs Norepinephrine Reuptake Inhibitors |
|
| Generic | Brand |
| Atomoxetine | Strattera |
| Maprotiline | Ludiomil or Deprilept or Psymion |
| Reboxetine | Edronax or Vestra |
| Viloxazine | Vivalan |
Norepinephrine reuptake inhibitors (NRIs), also known as noradrenaline reuptake inhibitors (NARIs), are compounds that elevate the extracellular level of the neurotransmitter norepinephrine in the central nervous system by inhibiting its reuptake from the synaptic cleft into the presynaptic neuronal terminal. The drugs inhibit the class of neurotransmitter transporters known as norepinephrine transporters. They have virtually no action at other monoamine transporters.
|
Tetracyclics |
|
| Generic | Brand |
| Maprotiline | Ludiomil or Deprilept or Psymion |
| Mianserin | --- |
| Nefazodone | Serzone |
| Trazodone | Desyrel |
A tetracyclic antidepressant is an antidepressant drug from the tetracyclic drug group. The name tetracyclic is derived from the drug's molecular structure which consists of four ring-like structures in a T-shape (compare tricyclic antidepressant).
Maprotiline/Ludiomil, and Mirtazapine/Remeron in the USA, Zispin in Europe and Avanza in Australia, are the only two drugs from this group widely used for the treatment of clinical depression. The tetracyclic antidepressant Mianserin was previously available internationally, however in most markets it has been phased out in favor of Mirtazapine. The drug Serzone has been taken off the market due to the possibility of liver failure. Trazodone/Desyrel is an older form of this antidepressant class that is well tested and often well tolerated. It usually taken at night and can have a sedative effect. This is helpful for people struggling with depression who also suffer from insomnia or anxiety.
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NaSSAs Noradrenergic and Specific Serotonergic Antidepressants |
|
| Generic | Brand |
| Mirtazapine | Remeron |
Noradrenergic and specific serotonergic antidepressants (NaSSAs) are a relatively new class of antidepressants. They are thought to work by blocking presynaptic alpha-2 adrenergic receptors that normally inhibit the release of the neurotransmitters norepinephrine (noradrenaline) and serotonin. This results in increases in both noradrenergic and specific serotonergic transmission. Examples of NaSSAs include: Mirtazapine (Remeron®, Zispin®, Avanza®, Norset®, Remergil®).
NaSSAs are said to have fewer side effects than tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) while being equally effective. In particular, it is said that the sexual dysfunction that is a relatively common side effect of SSRIs occurs significantly less often during treatment with Mirtazapine.
|
NDRIs Norepinephrine Dopamine Reuptake Inhibitors |
|
| Generic | Brand |
| Bupropion | Wellbutrin |
A Norepinephrine-dopamine reuptake inhibitor is a class of drugs that is both a:
- Dopamine reuptake inhibitor, see DARI
- Norepinephrine reuptake inhibitor, see NRI
A drug related to Bupropion, Radafaxine, is presently in clinical trials. Because this class of drugs increases the availability of norepinephrine it is not recommended for people suffering from trauma symptoms or anxiety.
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SSREs Selective Serotonin Reuptake Enhancers |
|
| Generic | Brand |
| Tianeptine | Stablon |
Selective serotonin reuptake enhancers (SSREs) are antidepressants that enhance the reuptake of serotonin instead of inhibiting it, as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) do.
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SNDRIs Serotonin Norepinephrine Dopamine Reuptake Inhibitors |
|
| Generic | Brand |
| Nomifensine | Merital |
| Tesofensine | NS 2330 |
| Brasofensine | NS-2214 |
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