Highlights
- Depression is one of the most common mental health concerns.
- Depression medications are commonly used as part of mental health treatment and paired with other approaches.
- There are several types of antidepressants, with different side effects and mechanisms of action.
- BidRx can help you to get the lowest price for antidepressants.
Depression medications are crucial tools to treat one of the most common mental health struggles we experience. Recurrent depressive episodes can interfere with daily life and cause other health concerns. Generally, doctors will recommend antidepressants as part of a comprehensive approach. Which antidepressant you use will depend on your body, your specific needs, and other medical factors.
BidRX can help you get the best price for antidepressants.
Depression Medications — Overview
Depression medications (antidepressants) are a category of drugs found to help with recurring moderate to severe depressive episodes, usually limiting both the length and severity of episodes. Antidepressants may also be used to treat other conditions unrelated to mental health, depending on the medication.
The main classes of antidepressants are:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
- Atypical agents
Each of these have different mechanisms of action, side effects, and risks.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs work by reducing the reabsorption of serotonin, a key neurotransmitter for regulating mood, on the theory that a serotonin deficiency accounts for at least some of the severity and frequency of depressive episodes.
In addition to depression, SSRIs are used to treat several other classes of emotional disturbances, including anxiety disorders and post-traumatic stress disorder.
Examples of SSRIs include:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)*
- Paroxetine (Paxil)*
- Sertraline (Zoloft)
*Available in long-acting controlled release (CR) formulations
Contraindications — SSRIs
SSRIs are not recommended if you have the following conditions:
- Bleeding disorders or currently healing injuries
- Diabetes
- Epilepsy
- Narrow angle glaucoma
- Kidney, liver, or heart disorders
Warnings — SSRIs
SSRIs, like other antidepressants, may increase the risk of suicidal thoughts, especially in younger patients. If you’re experiencing thoughts of suicide or suicidal ideation, discontinue your medication and contact your doctor immediately.
Side Effects — SSRIs
Common side effects of SSRIs may include:
- Nausea and vomiting
- Diarrhea
- Headache
- Dizziness
- Weight gain
- Sexual dysfunction
- Trouble going to sleep
Risk of abnormal bleeding and bone fracture may also be elevated.
Drug Interactions — SSRIs
SSRIs should not be taken with any other medication that affects serotonin, including:
- Other SSRIs and antidepressants
- Triptans (migraine medications)
- Meperidine (Demerol)
- Tramadol (Ultram)
Don’t take herbal supplements, such as St, John’s wort, with SSRIs. Also avoid street drugs, including cocaine and MDMA (ecstasy).
This may trigger serotonin syndrome, with too much of the neurotransmitter interfering with your physical and emotional state.
Due to the risk of increased bleeding, SSRIs should not be taken with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin and Advil) and acetaminophen (Tylenol), or with blood thinners, such as warfarin (Coumadin).
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Similar to SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs) increase the available amount of both serotonin and norepinephrine in the brain. In addition to depression, anxiety, and panic disorders, SNRIs may also be used to treat fibromyalgia and chronic pain.
Examples of SNRIs include:
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor)
- Milnacipran (Savella)
- Levomilnacipran (Fetzima)
Contraindications — SNRIs
People with uncontrolled high blood pressure, heart disease, or liver disease should not take SNRIs. They can also interact with duloxetine and milnacipran and should not be taken with those drugs.
People with eating disorders should use SNRIs cautiously, as they may cause loss of appetite.
Warnings — SNRIs
Like all antidepressants, there is an elevated risk of suicidal thoughts or suicidal ideation in younger populations when taking SNRIs. If this happens, discontinue your SNRI and seek medical assistance right away.
Side Effects — SNRIs
The most common side effects of SNRIs as a class are nausea, dizziness, and sweating. Sexual dysfunction is a possible side effect, particularly common with duloxetine, venlafaxine, and desvenlafaxine.
Rarer side effects will be dependent on the specific medication and may include:
- Fatigue
- Constipation
- Insomnia
- Headache
- Appetite loss
Not all SNRIs will have the same side effects for all people, so if one affects you badly, you may be able to switch to another drug in the class.
Drug Interactions — SNRIs
If you’re currently taking MAOIs, you’ll need to wait 14 days before beginning an SNRI regimen.
SNRIs should not be paired with any other antidepressants or other medications that affect serotonin or norepinephrine without talking to a doctor. Classes of drugs that may fall into this category include:
- Anticonvulsants
- Antiemetics
- Migraine medication
- Certain dyes such as methylene blue
- Herbal supplements
- Street drugs (cocaine, ecstasy, LSD)
In addition, some SNRIs may impact liver function, so reducing or eliminating alcohol consumption is recommended.
Abnormal bleeding is a risk with SNRIs and NSAIDs, and analgesics (pain relievers) should be taken with caution.
Tricyclic antidepressants (TCAs)
Tricyclic antidepressants work similarly to SNRIs to increase the amount of serotonin and norepinephrine in the body. However, unlike SNRIs, TCAs affect more areas of the body, including sodium channels and calcium channels, creating more side effects and introducing more risk.
As such, TCAs are considered a second-line treatment. TCAs are also used to treat chronic pain and tension headaches and may be part of a migraine treatment regimen.
Examples of TCAs include:
- Amitriptyline (Elavil)
- Desipramine (Norpramin)
- Doxepin (Sinequan)
- Imipramine (Tofranil)
- Nortriptyline (Pamelor)
- Amoxapine
- Clomipramine (Anafranil)
- Maprotiline (Ludiomil)
- Trimipramine (Surmontil)
- Protriptyline (Vivactil)
Contraindications — TCAs
If you have a heart condition, liver problems, uncontrolled high blood pressure, or are taking medication for migraines, TCAs should be avoided unless a doctor specifically prescribes them to you.
Warnings — TCAs
TCAs have a high risk of overdose and should be taken strictly according to instruction. Suicidal thoughts and ideation are also a possible risk.
Side Effects — TCAs
Common side effects of TCAs include:
- Dry mouth
- Constipation
- Vision problems
- Urine retention
- Dizziness
- Memory problems
- Delirium
- Tachycardia
Rarer side effects include:
- Orthostatic hypotension
- Weight gain
- Seizures
- Bone fracture
- Sexual dysfunction
- Excessive sweating
- Elevated or irregular heartbeat
Drug Interaction — TCAs
TCAs shouldn’t be taken within 14 days after taking an MAOI and shouldn’t be taken with other antidepressants. Due to its broader effects on the body, TCAs should not be combined with any drug that inhibits liver function. Also refrain from any drugs that depress the central nervous system, including alcohol, while taking TCAs.
Monoamine oxidase inhibitors (MAOIs)
Monoamine oxidase inhibitors (MAOIs) inhibit enzymes that break down neurotransmitters. MAOIs are most commonly used for treatment-resistant depression.
Examples of MAOIs include:
- Phenelzine (Nardil)
- Selegiline (Emsam)
- Tranylcypromine (Parnate)
Contraindications — MAOIs
MAOIs should not be used by anyone with:
- Heart, liver, or kidney disease or impairment
- Uncontrolled hypertension
- Severe or frequent headaches
- Cerebrovascular diseases
Warnings — MAOIs
MAOIs often have strong and dangerous drug interactions and should only be taken under medical supervision.
Side Effects — MAOIs
Common side effects include:
- Postural hypotension
- Weight gain
- Sexual side effects
Drug Interactions — MAOIs
MAOIs interact with a wide range of drugs, including many over-the-counter medications, herbal supplements, alcohol, tobacco, and street drugs. Before taking an MAOI, tell your doctor about every medication you use, as you may need to reduce your dosage or discontinue the drug.
If you’re using MAOIs, you’ll need to avoid any food that may contain tyramine, as this may trigger a hypertensive crisis, a rapid and severe elevation in blood pressure.
Atypical Agents — MAOIs
Drugs in this class have been shown to be effective in treating depression, often as a separate outcome from a study looking at other effects. As such, they’re less a class of drugs and more a separate list to be considered when typical antidepressants don’t work.
Examples include:
- Bupropion (Wellbutrin)
- Mirtazapine (Remeron)
- Nefazodone (Serzone)
- Trazodone (Desyrel, Oleptro)
- Vilazodone (Viibryd)
- Vortioxetine (Brintellix)
Because these drugs don’t fit into a specific class, each will have unique side effects, interactions, contraindications, and concerns.
Conclusion
A wide range of drugs fit into the antidepressant category. Even drugs within a class will have different effects on each individual who takes them. Taking antidepressants requires close supervision by your doctor until you find the drug that works best for you with a minimum of side effects.
Find the Lowest Price for Antidepressant Medications with BidRx
BidRx works by inviting pharmacies to compete to offer the best price. If you’re taking an antidepressant, we can help you find the lowest prices available.
How BidRx Works
After signing up on our secure site, you create a bid, and pharmacies from across the U.S. will bid on your prescription. BidRx’s participating pharmacies include local drug stores as well as online, mail-order, and specialty pharmacies. From there, just compare prices and choose your pharmacy.
Find the lowest price for your antidepressant medication with BidRx. Visit our depression medication page today to get started.
