Depression and women

National Women's Health Report,  August, 2003  

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MEDICATION FOR DEPRESSION

Medication Class/Type *              How it Works

Selective Serotonin Reuptake         Blocks reuptake of serotonin,
Inhibitors (SSRIs). Includes         allowing more of this
fluoxetine (Prozac, Sarafem),        neurotransmitter to remain
sertraline (Zoloft), paroxetine      available to the brain
(Paxil), citalopram (Celexa),
escitalopram oxalate (Lexapro)

Monoamine oxidase inhibitors         Inhibits the action of monoamine
(MAOIs). Includes phenelzine         oxidase, an enzyme that breaks
(Nardil), isocarboxazid              down neurotransmitter.
(Marplan), tracylpromine
(Parnate)

Tricyclics (TCAs). Includes          Either inhibits norepinephrine
imipramine (Tofranil),               reuptake or both norepinephrine
desipramine, (Norpramin),            and serotonin reuptake.
nortriptyline (Pamelor),
amitriptyline-HCI (Elavil),
maprotiline (Ludiomil)

Mixed reuptake inhibitors.           Bupropion appears to regulate
Includes bupropion (Wellbutrin)      transmission of both
and venlafaxine (Effexor)            norepinephrine and dopamine,
                                     while venlafaxine appears to
                                     inhibit the reuptake of those two
                                     chemicals as well as serotonin

5-HT modulators. Includes            Strong effects on blocking 5-HT (a
nefazodone (Serzone) and             precursors of serotonin) serotonin
trazodone (Desyrel)                  receptors.

Norepinephrine and 5-HT              Block serotonin receptors.
modulators. Includes mirtazapine
(Remeron)

What Studies Show                    Potential Side Effects & Warnings

During initial stages of taking      Sexual side effects, nervousness,
the medicine, about 10 to 20         nausea, diarrhea, insomia.
percent of patient quit because
of side effects.

Particularly effective for           Dry mouth. Can cause life-
patients who don't respond to        threatening interactions with
more conventional treatments.        aged cheese and meats, and with
                                     common over-the-counter
                                     medications, such as some flu and
                                     cold remedies.

About 30 percent of people stop      Can be lethal with just small
taking TACs due to side effects      overdose and may require blood
such as fainting, weight gain and    tests to monitor levels.
headaches.

Bupropion: Substantially lower       Nausea, headaches. Venlafaxine
incidence of sexual side effects     may results in sexual side effects
compared to SSRIs; may be            as well as a risk of elevated
particularly useful for treatment    blood pressure.
of depressions characterized by
weight gain, loss of energy and
oversleeping. Venlafaxine: Seems
to be better than SSRIs at
treating major depression.

Improves sleep and has a low risk    Sudden drop in blood pressure upon
of sexual side effects.              standing, headaches, daytime
                                     drowsiness. In rare cases,
                                     nefazodone may cause liver damage.

Relieves symptoms sooner than the    Weight gain and daytime
SSRIs.                               drowsiness.

* Not all drugs within a class are listed

Source; Hollon, SA, Michael ET, Markowitz, JC. "Treatment and
Prevention of Depression." Psychological Science in the Public
Interest. Nov. 2003 3(2):39-70.