Types of antidepressants
Certain brain chemicals called neurotransmitters are associated with depression and anxiety — particularly serotonin, norepinephrine and dopamine. Most antidepressants relieve symptoms by affecting these neurotransmitters. Each type (class) of antidepressant affects these neurotransmitters in slightly different ways.
Many types of antidepressant medications are available, including those below.
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs include fluoxetine (Prozac, Selfemra), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro).- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Examples of SNRI medications include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima). - Norepinephrine and dopamine reuptake inhibitors (NDRIs)
Bupropion (Wellbutrin, Aplenzin, Forfivo XL) falls into this category. It's one of the few antidepressants not frequently associated with sexual side effects. - Tricyclic antidepressants
Tricyclic antidepressants — such as imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil) - Atypical antidepressants.
These medications don't fit neatly into any of the other antidepressant categories. They include trazodone (Oleptro), mirtazapine (Remeron) and vortioxetine (Brintellix). A newer medication called vilazodone (Viibryd) is thought to have a low risk of sexual side effects. There is promising evidence of fast-acting antidepressant agents that dramatically cut the response-to-treatment time. The drug ketamine has been found to lift depression in hours, rather than weeks.
There are many other different types of medications besides antidepressants that are used to treat the mood and anxiety disorders that commonly occur in patients with pain. The selection of the right one depends on many factors and needs to be fit into the overall treatment plan.