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)
editSelective 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Discontinued/withdrawn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)
editSerotonin–norepinephrine reuptake inhibitors include:
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Levomilnacipran (Fetzima)
- Milnacipran (Ixel, Savella, Milnaneurax)
- Venlafaxine (Effexor, Trevilor)
Serotonin–dopamine reuptake inhibitor (SDRIs)
editSerotonin–dopamine reuptake inhibitors include:
None currently marketed
Discontinued/withdrawn
edit- Medifoxamine (Clédial, Gerdaxyl)
Serotonin–norepinephrine–dopamine reuptake inhibitors (SNDRIs)
editSerotonin–norepinephrine–dopamine reuptake inhibitors include:
- Toludesvenlafaxine (Ruoxinlin)
- Nefazodone (Serzone)[1]
Serotonin modulators and stimulators (SMSs)
editSerotonin modulators and stimulators include:
- Vilazodone (Viibryd)
- Vortioxetine (Trintellix, Brintellix)
Serotonin antagonist and reuptake inhibitors (SARIs)
editSerotonin 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- Nefazodone (Dutonin, Nefadar, Serzone) – withdrawn/discontinued in most countries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Discontinued/withdrawn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)
editNorepinephrine 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)
editNorepinephrine–dopamine reuptake inhibitors include:
- Bupropion (Wellbutrin, Elontril) – also a non-competitive antagonist of nicotinic acetylcholine receptors[6]
Off-label only
edit- Amphetamines (Adderall, Vyvanse) – actually norepinephrine–dopamine releasing agents (NDRAs)[7][5]
- Methylphenidate (Ritalin, Concerta)[8][9]
Discontinued/withdrawn
edit- Amineptine (Survector, Maneon)
- Nomifensine (Merital, Alival)
Tricyclic antidepressants (TCAs)
editTricyclic 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)
editTetracyclic 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)
editMonoamine oxidase inhibitors include
Irreversible
editNon-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
editNon-selective
editDiscontinued/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
editNon-selective
edit- Bifemelane (Alnert, Celeport) – RIMA, irreversible inhibitor of MAO-B, and weak NRI
Atypical antipsychotics
editAtypical antipsychotics include:
- Amisulpride (Solian) – approved in low doses as a monotherapy for persistent depression and major depressive disorder[10]
- Levosulpiride – approved in low doses for major depressive disorder[11]
- 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[12]
Others
editMarketed
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[13]
- 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[14]
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
editThe 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
editAtypical antipsychotics
editAtypical 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
editTypical antipsychotics include:
None currently approved
Off-label only
edit- Trifluoperazine (Stelazine)[15]
Dopamine reuptake inhibitor
editDopamine reuptake inhibitors include:
None currently approved
Off-label only
editOthers
editOff-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
editReferences
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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.
- ^ Fleurence R, Williamson R, Jing Y, Kim E, Tran QV, Pikalov AS, et al. (2009). "A systematic review of augmentation strategies for patients with major depressive disorder". Psychopharmacol Bull. 42 (3): 57–90. PMID 19752841.
- ^ 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.
- ^ Arias HR, Santamaría A, Ali SF (2009). "Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion". Int. Rev. Neurobiol. International Review of Neurobiology. 88: 223–55. doi:10.1016/S0074-7742(09)88009-4. ISBN 9780123745040. PMID 19897080.
- ^ 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.
- ^ "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.
- ^ 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.