List of antidepressants

This is a complete list of clinically approved prescription antidepressants throughout the world, as well as clinically approved prescription drugs used to augment antidepressants, by pharmacological and/or structural classification. Chemical/generic names are listed first, with brand names in parentheses. All drugs listed are approved specifically for major depressive disorder unless noted otherwise.

Selective serotonin reuptake inhibitors (SSRIs)

Serotonin–norepinephrine reuptake inhibitors (SNRIs)

Serotonin modulator and stimulators (SMSs)

Serotonin antagonist and reuptake inhibitors (SARIs)

  • Nefazodone (Dutonin, Nefadar, Serzone) – withdrawn/discontinued in most countries
  • Trazodone (Desyrel)

Norepinephrine reuptake inhibitors (NRIs)

Although marketed as an antidepressant, a meta-analysis found that reboxetine was ineffective and potentially harmful.[1]

Norepinephrine–dopamine reuptake inhibitors (NDRIs)

Tricyclic antidepressants (TCAs)

Tetracyclic antidepressants (TeCAs)

Mianserin, mirtazapine, and setiptiline are also sometimes described as noradrenergic and specific serotonergic antidepressants (NaSSAs).

Monoamine oxidase inhibitors (MAOIs)

Irreversible

Non-selective

Selective for MAO-B

Reversible

Non-selective

Caroxazone (Surodil, Timostenil) was formerly used as an antidepressant, but has been discontinued.

Selective for MAO-A

These drugs are sometimes described as reversible inhibitors of MAO-A (RIMAs).

Eprobemide (Befol) and minaprine (Brantur, Cantor) were also formerly used as antidepressants, but have been discontinued.

Mixed

Non-selective

  • Bifemelane (Alnert, Celeport) – RIMA, irreversible inhibitor of MAO-B, and weak NRI

Others

Marketed

Discontinued/withdrawn

Over-the-counter

The following antidepressants are available both with a prescription and over-the-counter:

  • Ademetionine [S-Adenosyl-L-methionine (SAMe)] (Heptral, Transmetil, Samyl) – cofactor in monoamine neurotransmitter biosynthesis
  • Hypericum perforatum [St. John's Wort (SJW)] (Jarsin, Kira, Movina) – TRPC6 activator, and various other actions
  • Oxitriptan [5-Hydroxytryptophan (5-HTP)] (Cincofarm, Levothym, Triptum) – precursor in serotonin biosynthesis
  • Rubidium chloride [RbCl] (Rubinorm) – unknown/unclear mechanism of action[5]
  • Tryptophan (Tryptan, Optimax, Aminomine) – precursor in serotonin biosynthesis

Adjunctive treatments

Atypical antipsychotics

  • Amisulpride (Solian) – specifically approved, in low doses, as a monotherapy for dysthymia
  • Aripiprazole (Abilify) – specifically approved as an adjunct for major depressive disorder
  • Brexpiprazole (Rexulti) – specifically approved as an adjunct for major depressive disorder
  • Lurasidone (Latuda) – specifically approved for depressive episodes in bipolar disorder
  • Olanzapine (Zyprexa) – specifically approved as an adjunct for major depressive disorder
  • Quetiapine (Seroquel) – approved as an adjunct for both major depressive disorder and depressive episodes in bipolar disorder
  • Risperidone (Risperdal) – not specifically approved as an adjunct for major depressive disorder (used off-label)[6]

Others

  • Buspirone (Buspar) – 5-HT1A receptor partial agonist – not specifically approved for depression (used off-label)
  • Lithium (Eskalith, Lithobid) – mood stabilizer (mechanism of action unknown/unclear) – not specifically approved for depression (used off-label)
  • Modafinil - marketed as an eugeroic or wakefulness-promoting drug, a weak dopamine reuptake inhibitor with other pharmacodynamic effects of relevance in improving depressive symptoms, used off-label[7][8][9]
  • Thyroxine (T4) – thyroid hormone (thyroid hormone receptor agonist) – not specifically approved for depression (used off-label)
  • Triiodothyronine (T3) – thyroid hormone (thyroid hormone receptor agonist) – not specifically approved for depression (used off-label)
  • MinocyclineMicroglia inhibitor (Tetracycline antibiotics) – the overall antidepressant effect size of compared to placebo was -0.78 (95% CI: -0.4 to -1.33, P=0.005) in Meta-analysis.[10] – not specifically approved for depression (used off-label).[11]

Combination products

See also

References

  1. Eyding D, Lelgemann M, Grouven U, Härter M, Kromp M, Kaiser T, Kerekes MF, Gerken M, Wieseler B (2010). "Reboxetine for acute treatment of major depression: systematic review and meta-analysis of published and unpublished placebo and selective serotonin reuptake inhibitor controlled trials". BMJ. 341: c4737. doi:10.1136/bmj.c4737. PMC 2954275. PMID 20940209.
  2. Arias HR, Santamaría A, Ali SF (2009). "Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion". Int. Rev. Neurobiol. International Review of Neurobiology. 88: 223–55. doi:10.1016/S0074-7742(09)88009-4. ISBN 9780123745040. PMID 19897080.
  3. "SPRAVATO™ (esketamine) nasal spray FDA label" (PDF). Food and Drug Administration. 5 March 2019. Retrieved 6 March 2019.
  4. Zhang MW, Harris KM, Ho RC (2016). "Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications". BMC Med Ethics. 17: 4. doi:10.1186/s12910-016-0087-3. PMC 4714497. PMID 26768892.
  5. Gian F. Placidi; Liliana Dell'Osso; Giuseppe Nistico; Hagop S. Akiskal (6 December 2012). Recurrent Mood Disorders: New Perspectives in Therapy. Springer Science & Business Media. pp. 293–. ISBN 978-3-642-76646-6.
  6. Thase ME (2016). "Adverse Effects of Second-Generation Antipsychotics as Adjuncts to Antidepressants: Are the Risks Worth the Benefits?". Psychiatr. Clin. North Am. 39 (3): 477–86. doi:10.1016/j.psc.2016.04.008. PMID 27514300.
  7. Nasr, S (2004). "Modafinil as adjunctive therapy in depressed outpatients". Annals of Clinical Psychiatry. 16 (3): 133–8. doi:10.1080/10401230490486954. PMID 15517845.
  8. Vaishnavi, Sandeep; Gadde, Kishore; Alamy, Sayed; Zhang, Wei; Connor, Kathryn; Davidson, Jonathan R. T. (August 2006). "Modafinil for atypical depression: effects of open-label and double-blind discontinuation treatment". Journal of Clinical Psychopharmacology. 26 (4): 373–378. doi:10.1097/01.jcp.0000227700.263.75.39. ISSN 0271-0749. PMID 16855454.
  9. Ferraro, Luca; Fuxe, Kjell; Tanganelli, Sergio; Tomasini, Maria Cristina; Rambert, Francis A.; Antonelli, Tiziana (2002-04-01). "Differential enhancement of dialysate serotonin levels in distinct brain regions of the awake rat by modafinil: possible relevance for wakefulness and depression". Journal of Neuroscience Research. 68 (1): 107–112. doi:10.1002/jnr.10196. ISSN 0360-4012. PMID 11933055.
  10. Rosenblat JD, McIntyre RS (2017-10-28). "Efficacy and tolerability of minocycline for depression: A systematic review and meta-analysis of clinical trials". Journal of Affective Disorders. 227: 219–225. doi:10.1016/j.jad.2017.10.042. PMID 29102836.
  11. Dean, Olivia M.; Kanchanatawan, Buranee; Ashton, Melanie; Mohebbi, Mohammadreza; Ng, Chee Hong; Maes, Michael; Berk, Lesley; Sughondhabirom, Atapol; Tangwongchai, Sookjaroen (August 2017). "Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial". The Australian and New Zealand Journal of Psychiatry. 51 (8): 829–840. doi:10.1177/0004867417709357. ISSN 1440-1614. PMID 28578592.
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