Antidepressant “Menu”
PsychEducation.org Revised 11/ 2003 J. Phelps, M.D.
Name All
Top Advantage
Usually pretty simple to use
Top Disadv.
Some writers urge greater caution; e.g. Prozac Backlash
Can Cause
Severe sleep, anxiety in some
Comments
If any doubt, rule out bipolar first with MDQ
Tricyclics
Inexpensive: pennies vs. dollars
Slower to increase to Dangerous heart full doses? Maybe rhythm: ECG if not, anymore? >45; lethal if O.D.
Not much more side effects than SRI’s, but more people get minor ones like dry mouth
SRI’s: Lexapro Serzone Prozac Paxil Zoloft Wellbutrin
Fewer SE’s? Almost no sexual Generic More anti-anxiety? Less interactions ? No sexual
As strong? Sl. less effective? Long lasting Weight gain More agitation? Headaches, insomnia, edgy
Sedation
Major liver risks
Agitation Light headed Insomnia
Seizures: not for use in bulimia; watch other seizurethreshold lowering med’s
All can be excellent for some people, and cause side effects in others. Don’t give up if you get side effects; consider trying another. (Helps stop smoking, even a little weight loss)
EffexorXR
Remeron St. John’s Wort
0.12 standard deviations more effective than the rest Useful in elderly “Natural” Few side effects
Watch blood pressure
Same sexual side effects as SRI’s
Weight gain (big) Interacts with HIV medications, anticlotting med’s Can’t eat cheese (or some beer, wine)
Very sleepy Headache
Too new to know; best in geriatric age range? Big negative study, (funded by Zoloft maker) in severe depression; effectiveness debated Only for use by specialist
MAOI
Can work when others don’t
Fatalities if fail to watch diet