Medications Used for Anxiety & Depression

Medications used to treat anxiety and/or depression are used as only part of the treatment for the condition and can have some severe side effects. Some of these medications can also be physically addictive, so the benefits must be weighed seriously against the side effects. They should be taken under the care of a doctor, and in conjunction with psychotherapy, to have the best effect. They are not a cure for the problem, but can help relieve some of the symptoms.

Selective Serotonin Reuptake Inhibitors (SSRIs)

• This class of drugs has been developed more recently and is now the most commonly used. This group includes Citalopram (Celexa), Escitalopram (Lexapro), Fluoxatine (Prozac), Fluvoxamine (Luvox), Paroxetine (Paxil), and Sertraline (Zoloft). These affect the levels of serotonin in the brain, which in turn affects mood as well as a number of other bodily functions. Side effects include nausea or changes in appetite and digestion, problems with sleep, decreased sex drive, anxiety or restlessness, dizziness, tremors, or headaches. Withdrawal symptoms can be severe if medication is stopped too abruptly.

Atypical antidepressants

• These medications can effect different combinations of the neurotransmitters serotonin, norepinephrine or dopamine. These are also fairly recently developed drugs. These include Bupropion (Wellbutrin), Duloxetine (Cymbalta), Mirtazapine (Remeron), Nefazodone (Serzone), Trazodone (Desyrel), or Venlafaxine (Effexor). Side effects can include nausea, weight gain or loss, nervousness, sleepiness, dizziness, dry mouth or blurred vision. Bupropion should not be taken by people who may be prone to seizures. These should not be taken with MAOIs, due to the possibility of serious or potentially fatal reactions.

Monoamine oxidase inhibitors (MAOIs)

• This is an older class of antidepressants and has more side effects than SSRIs or atypical antidepressants. MAOIs include Isocarboxazid (Marplan), Phenelzine sulfate (Nardil), Selegiline (Emsam) and Tranylpromine sulfate (Parnate). Monoamine oxidase works in the brain to break down the neurotransmitters such as serotonin, dopamine and norepinephrine, so these inhibitors help to increase their levels in the brain. The side effects include weight gain or appetite problems, decreased sex drive, difficulty with sleep, dizziness, dry mouth, blurred vision, high blood pressure or uneven heart rhythms, muscle twitching or restlessness, and potentially fatal interaction with other medications or foods.

Tricyclic antidepressants (TCAs)

• These antidepressants were some of the first developed to treat depression and have been used since the early 1950s. These act as serotonin-norepinephrine reuptake inhibitors (SNRIs), but do not usually effect dopamine levels. These include amitriptyline, amoxapine (Asendin), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), maprotiline, nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine maleate (Surmontil). Side effects include stomach and digestion problems, low blood pressure, weight gain, sexual problems, confusion, fatigue, difficulty urinating, dry mouth, blurred vision, tremors, sweating, or impaired cognitive abilities.

Considerations

• These medications can take anywhere from three to eight weeks before they start to have a beneficial effect. You may also end up trying different medications over the course of treatment if the one you are taking does not have enough of a beneficial effect or has undesired side effects. They can have additional effects in people over 65 such as bone loss, confusion, amnesia or loss of balance. These medications are usually not approved for use in people under 18 because of increased suicide risk. Monoamine oxidase inhibitors and tricyclic antidepressants are usually no longer prescribed except as a last resort because of the side effects.