The Top 10 Most Effective Antidepressants
Although we all experience periods of sadness and anxiety, depression is more than just feeling down for a few days. Depression can make you miserable for weeks or months at a time. It can affect both children and adults. According to Johns Hopkins Medicine, about 9.5% of Americans over 18 suffer from a depressive disorder yearly.
Always consult your doctor if you are concerned about changes in your mental health. If your symptoms persist, you might need to start taking antidepressants. Even if medication isn’t the only aspect of your mental health treatment, it is helpful to know what to expect if you and your doctor decide that antidepressants are right for you.
Antidepressants work differently for everyone. Each of the dozens of FDA-approved antidepressants has its own mechanism of action. Some of them are similar; others are quite different. You and your doctor can work together to find an antidepressant that works for you while keeping in mind its side effects and potential risks.
An Overview of Antidepressants
There are several classes of antidepressants, each of which works slightly differently. Also, antidepressants can produce different results in different individuals, so finding the proper medication and dosage may take some trial and error. These are the most common antidepressant types.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are the most frequently prescribed type of antidepressant. They are used to treat symptoms of moderate to severe depression. SSRIs work by elevating levels of serotonin in the brain.
Serotonin serves as a chemical messenger between brain neurons. SSRIs prevent brain nerve cells from reabsorbing serotonin, making more serotonin available for the neurons to transmit messages more efficiently. This leads to elevated mood and better functioning of the brain.
The selective nature of SSRIs is based on the fact that they target only serotonin and ignore other neurotransmitters. SSRIs are relatively safe and, compared to other antidepressants, cause few side effects.
Serotonin-noradrenaline Reuptake Inhibitors (SNRIs)
Similar to SSRIs, SNRIs are effective in treating depression. SNRIs work by affecting neurotransmitters in communicating between brain cells.
Like most antidepressants, SNRIs ultimately affect brain chemistry and communication in brain nerve cell circuitry. They help to regulate mood and relieve symptoms of depression. Compared to SSRIs, SNRIs block the brain’s reabsorption of serotonin and norepinephrine neurotransmitters.
Tricyclic and Tetracyclic Antidepressants (TCAs)
Tricyclic and tetracyclic antidepressants were among the first antidepressants developed. Although they are effective, antidepressants with fewer side effects have replaced them. Some people may benefit from cyclic antidepressants. They may relieve depression when other treatments haven’t been successful.
To ease depression, cyclical antidepressants also affect chemical transmitters that allow brain cells to communicate with one another. Like most antidepressants, a cyclic antidepressant modulates brain chemistry and communicates with mood-regulating nerve cell circuitry in the brain to alleviate depression.
In the brain, cyclic antidepressants increase levels of norepinephrine and serotonin by blocking their reabsorption. Since cyclic antidepressants can affect other chemical messengers, they can cause harsher side effects. TCAs also carry the risk of overdose and can have dangerous interactions with other medications, so they are usually prescribed only when other types of antidepressants have been ineffective.
Monoamine Oxidase Inhibitors (MAOIs)
The first type of antidepressant developed, monoamine oxidase inhibitors (MAOIs) are a group of antidepressant medications that work by inhibiting the activity of monoamine oxidase enzymes in the brain. These enzymes break down several neurotransmitters, including serotonin, norepinephrine, and dopamine. By inhibiting the activity of these enzymes, MAOIs increase the levels of these neurotransmitters in the brain, which are thought to help ease symptoms of depression.
Because of their side effects and potential for dangerous interactions with other medications and certain foods, MAOIs are only used as a last resort after other types of antidepressants have been tried and found to be ineffective.
Atypical Antidepressants
As the name suggests, atypical antidepressants are a diverse group of antidepressant medications that do not fit into the traditional categories of antidepressants. These medications may have a different mechanism of action or may affect multiple neurotransmitters in the brain rather than targeting a single neurotransmitter like traditional antidepressants.
Atypical antidepressants can be effective for treating depression, but they may also have their own unique side effects and potential interactions with other medications. They may be considered as an alternative for people for whom traditional antidepressants have not been effective.
Top 10 Antidepressants
Escitalopram (Lexapro)
Escitalopram, or Lexapro, is an SSRI antidepressant medication. It treats adults with major depressive disorder (MDD) and generalized anxiety disorder (GAD). It works by increasing the levels of serotonin in the brain, which can help to reduce symptoms of depression and anxiety.
Common side effects of escitalopram include headache, nausea, insomnia, drowsiness, increased sweating, dry mouth, and diarrhea. Some people may experience more severe side effects, such as changes in weight or appetite or changes in sexual function.
Sertraline (Zoloft)
Sertraline is an SSRI medication. The drug is used to treat a wide range of medical conditions, including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder (SAD).
Sertraline works by elevating serotonin levels in the brain, which can help reduce symptoms of depression, anxiety, and other conditions. It also works by inhibiting serotonin reuptake, allowing more serotonin to be available in the brain. Side effects of sertraline include nausea, restlessness, dry mouth, headaches, and gastrointestinal issues.
Fluoxetine (Prozac)
Fluoxetine is another SSRI antidepressant for the treatment of adults with major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder, bulimia nervosa, and premenstrual dysphoric disorder (PMDD). Fluoxetine increases the amount of serotonin in the brain, reducing symptoms of anxiety, depression, and other mental health disorders.
It also inhibits serotonin reuptake, making more serotonin available to the brain. It is common for people to experience side effects related to Prozac, including headaches, insomnia, drowsiness, excessive sweating, diarrhea, and changes in weight and appetite.
Venlafaxine (Effexor)
Venlafaxine, also known as Effexor, is an SNRI antidepressant medication. Among the conditions that it treats are major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder in adults.
The efficacy of venlafaxine is related to the increases in brain levels of neurotransmitters such as serotonin and norepinephrine. These neurotransmitters regulate mood, and an imbalance of these chemicals can contribute to anxiety and depression. As venlafaxine inhibits the reuptake of these neurotransmitters, their levels in the brain increase, alleviating depression symptoms.
A few of the most common side effects of Venlafaxine are migraines, restlessness, drowsiness, an increase in sweating, and constipation. Several people may experience more severe side effects, including weight gain, appetite fluctuations, and sexual dysfunction.
Paroxetine (Paxil)
Paroxetine is yet another SSRI drug. Similar to medications of the same group, it is used to treat people with major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder, and post-traumatic stress disorder (PTSD). By increasing levels of the neurotransmitter serotonin in the brain, paroxetine reduces anxiety, depression, and other symptoms.
The drug also works by inhibiting the serotonin reuptake in the brain, leading to further elevation of serotonin levels. Common side effects of paroxetine are almost identical to other SSRI antidepressants: nausea, insomnia, drowsiness, and diarrhea.
Bupropion (Wellbutrin)
Bupropion, also known as Wellbutrin, is an atypical antidepressant medication. It is used to treat adults with major depressive disorder (MDD) and seasonal affective disorder (SAD).
Bupropion works differently than other antidepressants such as SSRIs and SNRIs. It primarily affects the neurotransmitters dopamine and norepinephrine but does not directly target serotonin. It is thought to work by inhibiting the reuptake of dopamine and norepinephrine, allowing more of these neurotransmitters to be available in the brain.
Typical side effects of bupropion include dry mouth, insomnia, headache, and nausea.
Duloxetine (Cymbalta)
Duloxetine is an SNRI medication. It is often prescribed for treating adults with major depressive disorder (MDD), generalized anxiety disorder (GAD), diabetic neuropathy, fibromyalgia, and chronic musculoskeletal pain.
Duloxetine works by increasing the neurotransmitters serotonin and norepinephrine levels in the brain and inhibiting the reuptake of these neurotransmitters. Duloxetine can help to ease symptoms of depression, anxiety, and chronic pain.
Common side effects of duloxetine include nausea, tiredness, dry mouth, sleepiness, constipation, increased sweating, and loss of appetite. Some people report experiencing more severe side effects, including weight gain, uncontrollable food cravings, or sexual dysfunction.
Desvenlafaxine (Pristiq)
Desvenlafaxine, also known as Pristiq, is an SNRI antidepressant. It is used to treat major depressive disorder (MDD) in adults. Desvenlafaxine elevates levels of serotonin and norepinephrine in the brain and inhibits further uptake of these neurotransmitters. Among the side effects of desvenlafaxine are nausea, headache, insomnia, constipation, dizziness, dry mouth, and sweating.
Vortioxetine (Trintellix)
Vortioxetine is an atypical antidepressant that affects multiple neurotransmitters in the brain, including serotonin, norepinephrine, and dopamine. It is believed to work by modulating the activity of these neurotransmitters to improve mood. It is a serotonin modulator and stimulator (SMS) antidepressant medication. It is used to treat adults with major depressive disorder (MDD). Side effects of vortioxetine include nausea, diarrhea, constipation, headache, dry mouth, insomnia, and dizziness.
Nortriptyline (Pamelor)
Nortriptyline is a tricyclic antidepressant medication. It is used to treat adults with major depressive disorder (MDD) and a variety of other conditions, such as chronic pain and anxiety disorders. Nortriptyline works by increasing the neurotransmitters norepinephrine and serotonin levels in the brain, alleviating symptoms of depression.
Nortriptyline is considered an older-generation antidepressant. It is not as commonly prescribed as the newer generation antidepressants (SSRIs and SNRIs) because of its potential side effects and risk of toxicity. Common side effects of nortriptyline include dry mouth, constipation, drowsiness, blurred vision, and confusion.
Most antidepressants take several weeks to work. It’s important to continue taking the medication as prescribed, even if you don’t see improvement right away. It’s also essential to have regular follow-up appointments with your healthcare provider to assess your symptoms and evaluate your treatment plan.
Remember that these side effects usually resolve with time and with the help of a healthcare professional, who may adjust the dosage or even switch medications if needed. Antidepressants should not be stopped suddenly as they can cause withdrawal symptoms. Your healthcare provider will guide you in slowly tapering off the drug if you and your provider have decided to discontinue.
When to Seek Immediate Help
It is critical to reach out for help if you’re experiencing symptoms of depression and aren’t sure how to cope with them. Some people find that talking to a mental health professional or a hotline operator can provide a sense of relief and help them work through their feelings.
A hotline can be an excellent resource for people experiencing a crisis or needing immediate help. If you’re struggling to function daily and your depression affects your ability to work, go to school, or engage in other activities, it may be time to reach out for help. In case you’re experiencing suicidal thoughts or hopelessness, seek help immediately.
The National Depression Hotline is a free, confidential helpline that provides support and resources for individuals who are experiencing symptoms of depression. It is available 24 hours a day, seven days a week. The National Depression Hotline provides support, information, and referral services to people experiencing depression and their friends and family members.
The hotline is staffed by trained professionals who can provide information on a wide range of topics related to depression, such as symptoms, treatment options, and resources for support. They can also refer callers to local mental health providers or other resources.
The number for the National Depression Hotline is 866-629-4564. You can also reach the National Depression Hotline online by visiting ndhotline.wpenginepowered.com. If you are experiencing an emergency or crisis, it’s important to seek immediate help.
