Depression is a debilitating disorder that is widely affecting people all over the world. There are many antidepressants that are designed to help all types of depressive disorders. So which ones are the best for managing certain types of depressions? Well, a list was put together by IMS Health where they talk about the 100 most prescribed drugs. Some of the antidepressants on this list were quite high on the overall list. The likes of Cymbalta was three times more prescribed that than the next most prescribed antidepressant.
Addiction and Antidepressants
It’s important to note that antidepressants do change the brain’s chemical makeup. This is how depression is treated. Some may abuse antidepressants, causing a co-occurring disorder. In fact, people with certain mood disorders are more likely to abuse prescription drugs. Antidepressant medications aren’t addictive in the way that heroin or alcohol is. The cravings are much less but there is a possibility of physical dependence. It also causes the potential for abuse of other drugs.
Dependence on antidepressants of all kinds can form for those who never had a problem with drugs before. A study found that doctors misdiagnosed nearly two-thirds of people, giving them prescriptions they didn’t need. Antidepressants of any kind should be taken as directed and you should regularly see your doctor to make sure you’re not becoming addicted to your prescription.
1. Cymbalta (Duloxetine)
During 2013 to 2014, there were nearly 10 million prescriptions monthly given out, says Mental Health Daily. Approved in 2004, Cymbalta is the brand name with the generic version being Duloxetine. It has been prescribed far more than any other antidepressant on the market. It’s good for treating depression, chronic pain, and anxiety. It isn’t recommended for those who drink alcohol, have any liver or kidney issues or high blood pressure.
Cymbalta is known as a SNRI which is a serotonin and norepinephrine reuptake inhibitor. What this means is that the drug increases serotonin and norepinephrine activity in the brain. This helps to regulate a person’s mood. Most antidepressants will cause suicidal behavior or thoughts specifically in those aged 24 or younger. This is actually quite a common warning for any antidepressant.
58% of people who have taken Cymbalta have stated it’s worth taking while 25% said it’s not worth taking. Some users have said there is a risk of addiction and it’s not easy to get off but is effective for dealing with depression.
Some of the side effects that are common with Cymbalta include:
- Dry Mouth
- Difficulty Sleeping
- Decreased Appetite
- Abdominal Pain
2. Pristiq (Desvenlafaxine)
Pristiq is similar to Effexor but costs less because you can get it in a generic version. It’s the second most common antidepressant used for major depressive disorder. It relieves symptoms of depression and also lowers depressive relapse rates. Between 2013-2014, there were over 3 million prescriptions given out monthly.
Pristiq belongs to drugs known as selective serotonin and norepinephrine reuptake inhibitors (SNRIs). They work by blocking the reuptake of brain chemicals, serotonin, and norepinephrine. What this means is that it restores balance of those substances in the brain that helps with one’s mood.
There is a risk of serotonin syndrome when taking SNRIs. While it’s rare, it can be extremely dangerous. The syndrome involves a high level of serotonin developing which causes:
- Severe sweating
- Problems with coordination.
- An increase of heart rate.
More common side effects include:
- Problems with vision.
- May have a hard time urinating.
- Strange dreams.
- Rashes may break out.
- Difficulty speaking.
- Decreased libido.
- A rise in blood pressure.
- Eye pain or swelling.
- Black stools.
- Chest pain.
Withdrawing from Pristiq can cause anxiety and other side effects that cause discomfort. This include diarrhea, dizziness, exhaustion, muscle aches, and other symptoms that feel like a flu. Desvenlafaxine can cause angle-closure glaucoma which can cause you to lose your eyesight.
Reviews say that six out of ten people using an antidepressant says Pristiq works for them. There were people that liked the fact that this particular antidepressant helped them to lose weight while other antidepressants caused weight gain.
3. Viibryd/Vilazodone HCI
Viibryd is a serotonergic antidepressant. It is a selective serotonin reuptake inhibitor (SSRI) and serotonin receptor agonist. It helps with depression because it adjusts levels of serotonin in the brain which is the chemical responsible for how we feel. When it’s low, there is an absence of feeling happy and full of energy. While it’s good for treating patients with major depression, it can cause stomach and intestinal issues.
Compared to other antidepressants, Viibryd can be used for someone with severe kidney disease. There is less of a risk of gaining weight and it also causes less problems with the libido. If you have severe liver problems, you shouldn’t take it. Also, it shouldn’t interact with drugs known as MAOIs. There is a risk of depression worsening with an increased suicidal thoughts and behaviors and Viibryd shouldn’t be taken by anyone under 18 years old.
Side Effects of Vilazodone HCI include:
- Diarrhea (very common).
- Nausea and vomiting.
- Dry Mouth.
- Strange dreams.
When people reviewed their experience with Viibryd, they said it was costly and it’s recommended that you taper off of it. 67% said it’s not worth it while 14% said it wasn’t worth taking.
Celexa has been a popular medication for those with depression. In 2011, there were 37.7 million prescriptions written. It’s an SSRI that was FDA-approved in 1998 for major depression. It can also be prescribed for other conditions that are off-label. Patients say that it improves your energy level and heightens levels of well-being. As an SSRI, it restores balance of serotonin in the brain.
As with any SSRI, common symptoms include nausea, diarrhea, strange dreams, and dry mouth. Ciralopram is the active ingredient that does cause less side effects than other antidepressants. However, it’s not ideal for those with heart or liver problems. There are sexual side effects with Celexa that include a lack of libido, difficulties having an orgasm, and weight gain between 1 to 5 pounds.
Reviews of Citalopram included warnings against drinking when on the medication. It was also suggested that it takes time for it to really start working. Some said it took 4-6 weeks to notice a major difference in mood.
Over 25 million prescriptions of Lexapro were filled in 2009. During that time, it was the most popular antidepressant on the market. These numbers indicate how much more prevalent antidepressants are as the years go by. Lexapro, also known as escitalopram is good for treating mood disorders such as anxiety and depression. There are not a lot of side effects involved and drug interactions are minimal.
For those suffering with liver or heart problems, Lexapro is not recommended. It is a selective serotonin reuptake inhibitor (SSRI). When taken, the mood is regulated because serotonin is increased in the brain. Symptoms of anxiety and depression are relieved. Lexapro also lowers the possibility of depression coming back.
Some people who have taken this medication have said they gained weight. You should only gain between 1-5 pounds however.
Some of the side effects include:
- Problems ejaculating
- Sleepiness or insomnia
- Dry mouth
Those who reviewed Lexapro found that the side effects were often minimal but the withdrawal was challenging.
6. Zoloft/ Sertraline
In 2011, there were more than 37 million prescriptions written out for those with depression. The generic name is sertraline and it is a selective serotonin reuptake inhibitor antidepressant. As an SSRI, it raises levels of serotonin in the brain, enhancing your mood. It also helps people relax which is why it’s good for depression and anxiety. It is also used for panic disorder and obsessive compulsive disorder. In reviews of Zoloft, many professionals and patients say that it’s highly effective.
The recommended dose for Zoloft is one 50 mg pill daily. While it is better tolerated than other antidepressants in its class, it interacts with many other medicines. One of the benefits of Zoloft in terms of tolerance is that it causes less sleepiness when compared to other antidepressants. It is also considered the best choice if someone is pregnant and in need of antidepressants. It does take at least 1 week to start working and may take up to 12 weeks to be fully effective.
It can decrease your sex drive and some may not be able to orgasm or ejaculate. Minor weight gain has been reported (1-5 pounds). Zoloft does tend to cause diarrhea more when compared to other antidepressants.
Mental Health Daily reported that in 2011, Desyrel was prescribed more than 22 million times. The generic version is Trazodone which is used for major depressive disorder and insomnia associated with depression. It also treats anxiety disorders and alcohol addiction. This SSRI antidepressant works by restoring the balance or serotonin in the brain, it improves mood, appetite, and energy levels. Anxiety and insomnia related to depression are also reduced.
For depression, dosage should be 150 mg per day. The dose can increase to 400 mg per day with dosages being divided up throughout the day. The maximum dose for severely depressed patients can be administered to 600 mg per day. For those looking to use it for insomnia, it should given in much smaller doses daily. Desyrel isn’t as effective as other medications for depression, especially as other medications have come out through the years. One of the main side effects also makes it challenging to live a normal life, it’s highly sedative.
Common side effects include:
- Upset stomach.
- Irregular heartbeat.
When reviewed, six out of ten people who were being prescribed antidepressants for the first time said it worked for them.
In 2011, there were over 24 million prescriptions written for Prozac. The generic version is fluoxetine which is good for treating depression and anxiety. It gives people more energy than other antidepressants which may not work well for someone with insomnia as well as depression. That being said, for those with low energy, it can be helpful. Fluoxetine treats many mental health issues which includes depression, OCD, and panic disorders.
Prozac isn’t hard on the heart like other antidepressants and can cause a significant amount of weight loss. Prozac can take more time to help with symptoms of depression compared to other SSRIs. It can also lower your libido.
Side Effects Include:
- Lack of energy.
9. Paroxetine (Paxil, Pexeva, Brisdelle)
Paroxetine is a generic brand of antidepressants that includes Paxil, Pexeva, and Brisdelle. Paroxetine treats anxiety and depression. The issues is that is causes more undesirable side effects than other SSRI medications. It has a greater likelihood of decreasing the libido and may even prevent ejaculation.
All the brand names that have paroxetine help to improve your mood. You will have a greater appetite and energy level. It should effectively help you to sleep also. It can help decrease any fear or anxiety one might have. It has also been shown to reduce anxiety attacks. Primarily, it is used for Generalized Anxiety Disorder so using it as an antidepressant isn’t ideal.
Side effects include:
- Abnormal ejaculation.
- Difficulty sleeping.
Reviews Withdrawal was challenging for many and it’s recommended you taper off. Others also said it made them gain weight.
Luvox is the brand name that primarily treats obsessive-compulsive disorder. The generic name is fluvoxamine, which is an SSRI. There is an immediate release and extended release version of Luvox CR. It is used off-label for depression that doesn’t cause weight gain. It can effect your sex drive however.
Luvox CR is used for children with OCD and can be used for depression if other antidepressants are causing unwanted side effects. In the reviews, people with anxiety and depression says it stabilized their moods.
Common side effects include:
- Problems with bleeding.
- Physical weakness.
In 2011, there were over 12 million prescriptions written for Effexor. The generic version is venlafaxine and differs from other antidepressants. It is a serotonin and norepinephrine reuptake inhibitor antidepressant. It works to regulate your mood and allows you to feel more relaxed. This is why it can be used for both anxiety and depression. It is also used for panic disorder. It may work when other antidepressants don’t because it’s affecting two chemicals in the brain that are responsible for depression or anxiety. If you’re also suffering from insomnia, Effexor is beneficial because it causes sleepiness.
Effexor is problematic in the sense that it’s harder to discontinue use. In reviews, users have said that withdrawal comes quickly and it’s advised not to run out. Instead, it’s likely you would have to taper off from using this particular antidepressant.
Side effects include:
- Dry mouth.
- Decreased libido.
Wellbutrin is an atypical antidepressant and it’s unclear exactly how it works. It’s not chemically related to other antidepressants but studies do show that it’s effective. The belief is that it changes dopamine and norepinephrine activity in the brain. This regulates your mood and relieves symptoms of depression. It’s good for treating depression in bipolar disorder and comes with less side effects than other antidepressants on this list. Notably, it has less sexual side effects than other medications for depression. It’s highly recommended that you don’t drink alcohol with this particular antidepressant however.
There are stimulant effects with bupropion so someone may feel energized. This can be helpful for those with depression but it could cause insomnia or anxiety. The drug has helped people suppress their appetite and can help you to stop smoking. It’s less likely that you would gain weight using Bupropion. If you have a seizure disorder, it’s not recommended that you take this antidepressant.
Wellbutrin is available in immediate release tablets in 75 mg and 100 mg doses. There is also a sustained release sold in 100 mg and 150 mg formulas.
Generally, those who reviewed Wellbutrin said their intrusive thoughts diminished but anxiety was heightened.
Abilify, also known as aripiprazole, is prescribed to those with schizophrenia, depression, and bipolar disorder. It is another atypical antipsychotic that stabilizeds dopamine and serotonin levels in the brain. This helps to control thoughts and positively affects your mood. The drug primarily relieves psychotic symptoms and manic episodes. When compared to other antipsychotics, it does come with less side effects.
Studies have found that Abilify is helpful for depression, especially for women. If symptoms are not dissipating when using an antidepressant, your physician may also incorporate this antipsychotic. There is a slight risk of EPS which is a movement disorder. You may experiences stiffness, involuntary movements, restlessness, or tremors. If you’re put on Abilify, you’ll likely be asked to do routine blood tests to determine how it’s affecting your body. While this particular brand has less side effects than other antipsychotics, it’s important to note that it has more challenging side effects than antidepressants.
Side effects in include:
- Problems with the stomach
- Uncontrolled movements
Antidepressants can be a helpful medication for many. They also come with their own hazards and side effects. Once you get off antidepressants, there may be withdrawal symptoms that are challenging to manage. Recovery at an inpatient or outpatient clinic can help you manage your emotions through one-on-one therapy and group therapy. You will begin to understand why you became addicted and perhaps start to dig into the underlying problems that were causing depression in your life.