List of antidepressants
This is a complete list of clinically approved prescription antidepressants throughout the world, as well as clinically approved prescription drugs used to augment antidepressants or mood stabilizers, by pharmacological and/or structural classification. Chemical/generic names are listed first, with brand names in parentheses. All drugs listed are approved specifically for major depressive disorder unless noted otherwise.
Selective serotonin reuptake inhibitors (SSRIs)
[edit]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Discontinued/withdrawn
[edit]- Indalpine (Upstene)
- Zimelidine (Normud, Zelmid)
Serotonin–norepinephrine reuptake inhibitors (SNRIs)
[edit]Serotonin–norepinephrine reuptake inhibitors include:
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Levomilnacipran (Fetzima)
- Milnacipran (Ixel, Savella, Milnaneurax)
- Venlafaxine (Effexor, Trevilor)
Serotonin–dopamine reuptake inhibitor (SDRIs)
[edit]Serotonin–dopamine reuptake inhibitors include:
None currently marketed
Discontinued/withdrawn
[edit]- Medifoxamine (Clédial, Gerdaxyl)
Serotonin–norepinephrine–dopamine reuptake inhibitors (SNDRIs)
[edit]Serotonin–norepinephrine–dopamine reuptake inhibitors include:
- Toludesvenlafaxine (Ruoxinlin)
- Nefazodone (Serzone)[1]
Serotonin modulators and stimulators (SMSs)
[edit]Serotonin modulators and stimulators include:
- Vilazodone (Viibryd)
- Vortioxetine (Trintellix, Brintellix)
Serotonin antagonist and reuptake inhibitors (SARIs)
[edit]Serotonin antagonist and reuptake inhibitors include:
- Nefazodone (Dutonin, Nefadar, Serzone) – withdrawn/discontinued in most countries
- Trazodone (Desyrel)
Discontinued/withdrawn
[edit]- Etoperidone (Axiomin, Etonin)
Norepinephrine reuptake inhibitors (NRIs)
[edit]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
[edit]- Atomoxetine (Strattera)[2][3][4][5]
Norepinephrine–dopamine reuptake inhibitors (NDRIs)
[edit]Norepinephrine–dopamine reuptake inhibitors include:
- Bupropion (Wellbutrin, Elontril) – also a non-competitive antagonist of nicotinic acetylcholine receptors[6]
Off-label only
[edit]- Amphetamines (e.g., Adderall, Dexedrine, Vyvanse) – actually norepinephrine–dopamine releasing agents (NDRAs)[7][5]
- Methylphenidate (Ritalin, Concerta)[8][9]
- Modafinil (Provigil) – actually a selective dopamine reuptake inhibitor plus other actions[10][11][12][13]
Discontinued/withdrawn
[edit]- Amineptine (Survector, Maneon)
- Nomifensine (Merital, Alival)
Tricyclic antidepressants (TCAs)
[edit]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
[edit]- 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)
[edit]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)
[edit]Monoamine oxidase inhibitors include
Irreversible
[edit]Non-selective
[edit]- 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
[edit]- Selegiline (Eldepryl, Zelapar, Emsam) – also a catecholaminergic activity enhancer and weak norepinephrine releasing agent (via metabolites)
Reversible
[edit]Non-selective
[edit]Discontinued/withdrawn
- Caroxazone (Surodil, Timostenil)
Selective for MAO-A
[edit]- 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
[edit]Non-selective
[edit]- Bifemelane (Alnert, Celeport) – RIMA, irreversible inhibitor of MAO-B, and weak NRI
Atypical antipsychotics
[edit]Atypical antipsychotics include:
- Amisulpride (Solian) – approved in low doses as a monotherapy for persistent depression and major depressive disorder[14]
- Levosulpiride – approved in low doses for major depressive disorder[15]
- 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[16]
Others
[edit]Marketed
[edit]- 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
- Esketamine (Spravato) – non-competitive NMDA receptor antagonist, other actions[17]
- 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
[edit]- Ketamine (Ketalar) – non-competitive NMDA receptor antagonist[18]
Discontinued/withdrawn
[edit]- 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
[edit]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
[edit]Atypical antipsychotics
[edit]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
[edit]- Risperidone (Risperdal)
Typical antipsychotics
[edit]Typical antipsychotics include:
None currently approved
Off-label only
[edit]- Trifluoperazine (Stelazine)[19]
Dopamine reuptake inhibitor
[edit]Dopamine reuptake inhibitors include:
None currently approved
Off-label only
[edit]- Modafinil (Provigil)
- Armodafinil (Nuvigil)
Others
[edit]Off-label only
[edit]- 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
[edit]- Amitriptyline/chlordiazepoxide (Limbitrol) – TCA and benzodiazepine combination
- Amitriptyline/perphenazine (Etafron) – TCA and typical antipsychotic combination
- Bupropion/dextromethorphan (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
See also
[edit]References
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- ^ Fedder D, Patel H, Saadabadi A (March 2023). "Atomoxetine". StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. PMID 29630286.
- ^ Dell'Osso B, Palazzo MC, Oldani L, Altamura AC (December 2011). "The noradrenergic action in antidepressant treatments: pharmacological and clinical aspects". CNS Neurosci Ther. 17 (6): 723–32. doi:10.1111/j.1755-5949.2010.00217.x. PMC 6493872. PMID 21155988.
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- ^ a b Corp SA, Gitlin MJ, Altshuler LL (September 2014). "A review of the use of stimulants and stimulant alternatives in treating bipolar depression and major depressive disorder". J Clin Psychiatry. 75 (9): 1010–8. doi:10.4088/JCP.13r08851. PMID 25295426.
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- ^ Dale E, Bang-Andersen B, Sánchez C (2015). "Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs". Biochem. Pharmacol. 95 (2): 81–97. doi:10.1016/j.bcp.2015.03.011. PMID 25813654.
- ^ Challman TD, Lipsky JJ (2000). "Methylphenidate: its pharmacology and uses". Mayo Clin. Proc. 75 (7): 711–21. doi:10.4065/75.7.711. PMID 10907387.
- ^ Prommer E (2012). "Methylphenidate: established and expanding roles in symptom management". Am J Hosp Palliat Care. 29 (6): 483–90. doi:10.1177/1049909111427029. PMID 22144657. S2CID 21384037.
- ^ Urban AE, Cubała WJ (February 2020). "The role of eugeroics in the treatment of affective disorders". Psychiatr Pol. 54 (1): 21–33. doi:10.12740/PP/OnlineFirst/90687. PMID 32447354.
- ^ Kleeblatt J, Betzler F, Kilarski LL, Bschor T, Köhler S (May 2017). "Efficacy of off-label augmentation in unipolar depression: A systematic review of the evidence". Eur Neuropsychopharmacol. 27 (5): 423–441. doi:10.1016/j.euroneuro.2017.03.003. PMID 28318897. S2CID 3740987.
- ^ Nunez NA, Singh B, Romo-Nava F, Joseph B, Veldic M, Cuellar-Barboza A, et al. (March 2020). "Efficacy and tolerability of adjunctive modafinil/armodafinil in bipolar depression: A meta-analysis of randomized controlled trials". Bipolar Disord. 22 (2): 109–120. doi:10.1111/bdi.12859. PMID 31643130.
- ^ Szmulewicz AG, Angriman F, Samamé C, Ferraris A, Vigo D, Strejilevich SA (June 2017). "Dopaminergic agents in the treatment of bipolar depression: a systematic review and meta-analysis". Acta Psychiatr Scand. 135 (6): 527–538. doi:10.1111/acps.12712. PMID 28256707. S2CID 3712257.
- ^ "Amisulpride". AdisInsight. 24 October 2021. Retrieved 22 October 2024.
- ^ "Levosulpiride". AdisInsight. 24 October 2021. Retrieved 22 October 2024.
- ^ "Kusuri-no-Shiori(Drug Information Sheet)". くすりの適正使用協議会. Retrieved 22 October 2024.
- ^ "SPRAVATO™ (esketamine) nasal spray FDA label" (PDF). Food and Drug Administration. 5 March 2019. Retrieved 6 March 2019.
- ^ Zhang MW, Harris KM, Ho RC (2016). "Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications". BMC Med Ethics. 17: 4. doi:10.1186/s12910-016-0087-3. PMC 4714497. PMID 26768892.
- ^ Thase ME (2016). "Adverse Effects of Second-Generation Antipsychotics as Adjuncts to Antidepressants: Are the Risks Worth the Benefits?". Psychiatr. Clin. North Am. 39 (3): 477–86. doi:10.1016/j.psc.2016.04.008. PMID 27514300.