Antidepressants are medications used to treat various forms of depression and other mental health conditions. They are classified based on their chemical structure and mechanism of action. Here's a general classification:
1. Selective Serotonin Reuptake Inhibitors (SSRIs)
Mechanism: SSRIs work by increasing the levels of serotonin, a neurotransmitter, in the brain by inhibiting its reuptake into the presynaptic cell.
Common SSRIs:
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
2. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Mechanism: SNRIs increase levels of both serotonin and norepinephrine by inhibiting their reuptake.
Common SNRIs:
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
- Levomilnacipran (Fetzima)
3. Tricyclic Antidepressants (TCAs)
Mechanism: TCAs work by blocking the reuptake of norepinephrine and serotonin, increasing their levels in the brain.
Common TCAs:
- Amitriptyline (Elavil)
- Nortriptyline (Pamelor)
- Imipramine (Tofranil)
- Clomipramine (Anafranil)
- Doxepin (Sinequan)
4. Monoamine Oxidase Inhibitors (MAOIs)
Mechanism: MAOIs inhibit the enzyme monoamine oxidase, which breaks down neurotransmitters like serotonin, norepinephrine, and dopamine, thereby increasing their levels.
Common MAOIs:
- Phenelzine (Nardil)
- Tranylcypromine (Parnate)
- isocarboxazid (Marplan)
- Selegiline (Emsam, also used in Parkinson's disease)
5. Atypical Antidepressants
Mechanism: This is a diverse group that works through various mechanisms and doesn't fit neatly into the other categories.
Common Atypical Antidepressants:
- Bupropion (Wellbutrin): A norepinephrine-dopamine reuptake inhibitor (NDRI)
- Mirtazapine (Remeron): Enhances norepinephrine and serotonin release
- Trazodone (Desyrel): Primarily a serotonin antagonist and reuptake inhibitor (SARI)
- Vortioxetine (Trintellix): A serotonin modulator and stimulator
6. Serotonin Modulators
Mechanism: These drugs affect serotonin receptors and modulate serotonin activity in different ways.
Examples:
- Trazodone (also classified as an atypical antidepressant)
- Nefazodone
7. Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs)
Mechanism: These work by antagonizing certain serotonin and norepinephrine receptors,
increasing neurotransmitter levels.
Example:
- Mirtazapine (Remeron) (also listed under atypical antidepressants)
8. Norepinephrine-dopamine reuptake Inhibitors (NDRIs)
Mechanism: These primarily inhibit the reuptake of norepinephrine and dopamine.
Example:
- Bupropion (Wellbutrin) (also listed under atypical antidepressants)
9. Serotonin Antagonists and Reuptake Inhibitors (SARIs)
Mechanism: These block serotonin receptors and inhibit serotonin reuptake.
Example:
- Trazodone (Desyrel) (also listed under atypical antidepressants)
Each class of antidepressants has its unique profile in terms of efficacy, side effects, and mechanisms, which are considered when choosing the best treatment for an individual.
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