List of antidepressants

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors include:

• Citalopram (Celexa, Cipramil)
• Escitalopram (Lexapro, Cipralex)
• Fluoxetine (Prozac, Sarafem)
• Fluvoxamine (Luvox, Faverin)
• Paroxetine (Paxil, Seroxat)
• Sertraline (Zoloft, Lustral)

Discontinued/withdrawn

• Indalpine (Upstene)
• Zimelidine (Normud, Zelmid)

Serotonin–norepinephrine reuptake inhibitors (SNRIs)

Serotonin–norepinephrine reuptake inhibitors include:

• Desvenlafaxine (Pristiq)
• Duloxetine (Cymbalta)
• Levomilnacipran (Fetzima)
• Milnacipran (Ixel, Savella, Milnaneurax)
• Venlafaxine (Effexor, Trevilor)

Serotonin–dopamine reuptake inhibitor (SDRIs)

Serotonin–dopamine reuptake inhibitors include:

None currently marketed

Discontinued/withdrawn

• Medifoxamine (Clédial, Gerdaxyl)

Serotonin–norepinephrine–dopamine reuptake inhibitors (SNDRIs)

Serotonin–norepinephrine–dopamine reuptake inhibitors include:

• Dextromethorphan/bupropion (Auvelity)
• Toludesvenlafaxine (Ruoxinlin)
• Nefazodone (Serzone)

Serotonin modulators and stimulators (SMSs)

Serotonin modulators and stimulators include:

• Vilazodone (Viibryd)
• Vortioxetine (Trintellix, Brintellix)

Serotonin antagonist and reuptake inhibitors (SARIs)

Serotonin antagonist and reuptake inhibitors include:

• Nefazodone (Dutonin, Nefadar, Serzone) – withdrawn/discontinued in most countries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

Discontinued/withdrawn

• Etoperidone (Axiomin, Etonin)

Norepinephrine reuptake inhibitors (NRIs)

Norepinephrine reuptake inhibitors include:

• Reboxetine (Edronax)
• Teniloxazine (Lucelan, Metatone) – also a 5-HT2A receptor antagonist
• Viloxazine (Qelbree, formerly Vivalan) – also a 5-HT2B receptor antagonist and 5-HT2C receptor agonist

Off-label only

• Atomoxetine (Strattera)

Norepinephrine–dopamine reuptake inhibitors (NDRIs)

Norepinephrine–dopamine reuptake inhibitors include:

• Bupropion (Wellbutrin, Elontril) – also a non-competitive antagonist of nicotinic acetylcholine receptors

Off-label only

• Amphetamines (Adderall, Vyvanse) – actually norepinephrine–dopamine releasing agents (NDRAs)
• Methylphenidate (Ritalin, Concerta)

Discontinued/withdrawn

• Amineptine (Survector, Maneon)
• Nomifensine (Merital, Alival)

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants include:

• Amitriptyline (Elavil, Endep)
• Amitriptylinoxide (Amioxid, Ambivalon, Equilibrin)
• Amoxapine (Asendin)
• Clomipramine (Anafranil)
• Desipramine (Norpramin, Pertofrane)
• Dibenzepin (Noveril, Victoril)
• Dimetacrine (Istonil)
• Dosulepin (Prothiaden)
• Doxepin (Adapin, Sinequan)
• Imipramine (Tofranil)
• Lofepramine (Lomont, Gamanil)
• Melitracen (Dixeran, Melixeran, Trausabun)
• Nitroxazepine (Sintamil)
• Nortriptyline (Pamelor, Aventyl)
• Noxiptiline (Agedal, Elronon, Nogedal)
• Pipofezine (Azafen/Azaphen)
• Protriptyline (Vivactil)
• Trimipramine (Surmontil)

Opipramol (Insidon), tianeptine (Stablon, Coaxil) and amineptine (discontinued; formerly Survector, Maneon) are chemically TCAs but are pharmacodynamically atypical, and are therefore grouped elsewhere.

Discontinued/withdrawn

• Butriptyline (Evadyne)
• Demexiptiline (Deparon, Tinoran)
• Fluacizine (Phtorazisin)
• Imipraminoxide (Imiprex, Elepsin)
• Iprindole (Prondol, Galatur, Tetran)
• Metapramine (Timaxel)
• Propizepine (Depressin, Vagran)
• Quinupramine (Kinupril, Kevopril)
• Tiazesim (Altinil) – actually not a TCA but a tricyclic-like antidepressant
• Tofenacin (Elamol, Tofacine) – actually not a TCA but a tricyclic-like antidepressant

Tetracyclic antidepressants (TeCAs)

Tetracyclic antidepressants include:

• Maprotiline (Ludiomil)
• Mianserin (Tolvon)
• Mirtazapine (Remeron)
• Setiptiline (Tecipul)

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

Monoamine oxidase inhibitors (MAOIs)

Monoamine oxidase inhibitors include

Irreversible

Non-selective

• Isocarboxazid (Marplan)
• Phenelzine (Nardil)
• Tranylcypromine (Parnate)

Discontinued/withdrawn

• Benmoxin (Neuralex)
• Iproclozide (Sursum)
• Iproniazid (Marsilid)
• Mebanazine (Actomol)
• Nialamide (Niamid)
• Octamoxin (Ximaol)
• Pheniprazine (Catron)
• Phenoxypropazine (Drazine)
• Pivhydrazine (Tersavid)
• Safrazine (Safra)

Selective for MAO-B

• Selegiline (Eldepryl, Zelapar, Emsam) – also a catecholaminergic activity enhancer and weak norepinephrine releasing agent (via metabolites)

Reversible

Non-selective

Discontinued/withdrawn

• Caroxazone (Surodil, Timostenil)

Selective for MAO-A

• Metralindole (Inkazan)
• Moclobemide (Aurorix, Manerix)
• Pirlindole (Pirazidol)

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

Discontinued/withdrawn

• Eprobemide (Befol)
• Minaprine (Brantur, Cantor)
• Toloxatone (Humoryl)

Mixed

Non-selective

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

Atypical antipsychotics

Atypical antipsychotics include:

• Amisulpride (Solian) – approved in low doses as a monotherapy for persistent depression and major depressive disorder
• Levosulpiride – approved in low doses for major depressive disorder
• Lumateperone (Caplyta) – approved as a monotherapy for bipolar depression
• Lurasidone (Latuda) – approved as a monotherapy for bipolar depression
• Quetiapine (Seroquel) – approved as a monotherapy for bipolar depression
• Sulpiride – approved in low doses as a monotherapy for major depressive disorder

Others

Marketed

• D-Phenylalanine (DPA, D-Phe; Deprenon, Sabiben, Sabiden) – enkephalinase inhibitor
• Agomelatine (Valdoxan) – 5-HT2C receptor antagonist and MT1 and MT2 receptor agonist
• Brexanolone (allopregnanolone; Zulresso) – GABAA receptor positive allosteric modulator – approved for postpartum depression
• Dextromethorphan/bupropion (Auvelity)
• Esketamine (Spravato) – non-competitive NMDA receptor antagonist, other actions
• Gepirone (Exxua) – 5-HT1A receptor partial agonist and α2-adrenergic receptor antagonist
• Opipramol (Insidon) — σ1 receptor agonist, other actions
• Tianeptine (Stablon, Coaxil, Tianeurax) – weak and atypical μ-opioid receptor agonist, other actions

Off-label only

• Ketamine (Ketalar) – non-competitive NMDA receptor antagonist

Discontinued/withdrawn

• α-Methyltryptamine [αMT] (Indopan) – non-selective serotonin receptor agonist, serotonin–norepinephrine–dopamine releasing agent (SNDRA), and weak RIMA
• Etryptamine [α-Ethyltryptamine (αET)] (Monase) – non-selective serotonin receptor agonist, SNDRA, and weak RIMA
• Indeloxazine (Elen, Noin) – serotonin releasing agent (SRA), NRI, and NMDA receptor antagonist
• Oxaflozane (Conflictan) – 5-HT1A, 5-HT2A, and 5-HT2C receptor agonist
• Pivagabine (Tonerg) – unknown/unclear mechanism of action

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
• Tryptophan (Tryptan, Optimax, Aminomine) – precursor in serotonin biosynthesis

Adjunctive treatments

Atypical antipsychotics

Atypical antipsychotics include:

• Aripiprazole (Abilify) – approved as an adjunct to antidepressant for major depression
• Brexpiprazole (Rexulti) – approved as an adjunct to antidepressant for major depression
• Lumateperone (Caplyta) – approved as an adjunct to mood stabilizer for bipolar depression
• Lurasidone (Latuda) – approved as an adjunct to mood stabilizer for bipolar depression
• Olanzapine (Zyprexa) – approved as an adjunct to antidepressant for major depression
• Quetiapine (Seroquel) – approved as an adjunct to antidepressant or mood stabilizer for major depression and bipolar depression

Off-label only

• Risperidone (Risperdal)

Typical antipsychotics

Typical antipsychotics include:

None currently approved

Off-label only

• Trifluoperazine (Stelazine) name="pmid27514300"

Dopamine reuptake inhibitor

Dopamine reuptake inhibitors include:

None currently approved

Off-label only

• Modafinil (Provigil)
• Armodafinil (Nuvigil)

Others

Off-label only

• Buspirone (Buspar) – 5-HT1A receptor partial agonist
• Lithium (Eskalith, Lithobid) – mood stabilizer (mechanism of action unknown/unclear)
• Thyroxine (T4) – thyroid hormone (thyroid hormone receptor agonist)
• Triiodothyronine (T3) – thyroid hormone (thyroid hormone receptor agonist)

Combination products

• Amitriptyline/chlordiazepoxide (Limbitrol) – TCA and benzodiazepine combination
• Amitriptyline/perphenazine (Etafron) – TCA and typical antipsychotic combination
• Dextromethorphan/bupropion (Auvelity) – non-competitive NMDA receptor antagonist, σ1 receptor agonist, SNRI, NDRI, other actions
• Flupentixol/melitracen (Deanxit) – TCA and typical antipsychotic combination
• Olanzapine/fluoxetine (Symbyax) – SSRI and atypical antipsychotic combination – approved as a monotherapy for bipolar depression and treatment-resistant depression
• Tranylcypromine/trifluoperazine (Parstelin, Parmodalin, Jatrosom N, Stelapar) – MAOI and typical antipsychotic combination

References

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