Chemistry:List of antidepressants
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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)
- Citalopram (Celexa, Cipramil)
- Escitalopram (Lexapro, Cipralex)
- Fluoxetine (Prozac, Sarafem)
- Fluvoxamine (Luvox, Faverin)
- Paroxetine (Paxil, Seroxat)
- Sertraline (Zoloft, Lustral)
Discontinued/withdrawn
- Indalpine (Upstene)
- Zimelidine (Normud, Zelmid)
Serotonin–norepinephrine reuptake inhibitors (SNRIs)
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Levomilnacipran (Fetzima)
- Milnacipran (Ixel, Savella, Milnaneurax)
- Venlafaxine (Effexor, Trevilor)
Serotonin–norepinephrine–dopamine reuptake inhibitors (SNDRIs)
- Toludesvenlafaxine (Ruoxinlin)
- Nefazodone (Serzone)[1]
Serotonin modulators and stimulators (SMSs)
- Vilazodone (Viibryd)
- Vortioxetine (Trintellix, Brintellix)
Serotonin antagonist and reuptake inhibitors (SARIs)
- Nefazodone (Dutonin, Nefadar, Serzone) – withdrawn/discontinued in most countries
- Trazodone (Desyrel)
Discontinued/withdrawn
- Etoperidone (Axiomin, Etonin)
Norepinephrine reuptake inhibitors (NRIs)
- Reboxetine (Edronax)
- Teniloxazine (Lucelan, Metatone) – also a 5-HT2A receptor antagonist
- Viloxazine (Vivalan) – also a 5-HT2B receptor antagonist and 5-HT2C receptor agonist
Off-label only
- Atomoxetine (Strattera)[2][3][4][5]
Norepinephrine–dopamine reuptake inhibitors (NDRIs)
- Bupropion (Wellbutrin, Elontril) – also a non-competitive antagonist of nicotinic acetylcholine receptors[6]
Off-label only
- 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Discontinued/withdrawn
- Amineptine (Survector, Maneon)
- Nomifensine (Merital, Alival)
Tricyclic antidepressants (TCAs)
- Amitriptyline (Elavil, Endep)
- Amitriptylinoxide (Amioxid, Ambivalon, Equilibrin)
- 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
- 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)
- Amoxapine (Asendin)
- 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)
Irreversible
Non-selective
- 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
- Selegiline (Eldepryl, Zelapar, Emsam)
Reversible
Non-selective
Discontinued/withdrawn
- Caroxazone (Surodil, Timostenil)
Selective for MAO-A
- 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
Non-selective
- Bifemelane (Alnert, Celeport) – RIMA, irreversible inhibitor of MAO-B, and weak NRI
Atypical antipsychotics
- Amisulpride (Solian) – approved in low doses as a monotherapy for persistent depression
- 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
Others
Marketed
- 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[14]
- 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
- Ketamine (Ketalar) – non-competitive NMDA receptor antagonist[15]
Discontinued/withdrawn
- 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
- Medifoxamine (Clédial, Gerdaxyl) – weak serotonin–dopamine reuptake inhibitor (SDRI) and 5-HT2A and 5-HT2C receptor antagonist
- Oxaflozane (Conflictan) – 5-HT1A, 5-HT2A, and 5-HT2C receptor agonist
- Pivagabine (Tonerg) – unknown/unclear mechanism of action
Over-the-counter
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
Atypical antipsychotics
- 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
- Risperidone (Risperdal)
Typical antipsychotics
Off-label only
- Trifluoperazine (Stelazine)[16]
Others
Off-label only
- 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
- Amitriptyline/chlordiazepoxide (Limbitrol) – TCA and benzodiazepine combination
- Amitriptyline/perphenazine (Etafron) – TCA and typical antipsychotic combination
- 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
- Bupropion/dextromethorphan (Auvelity) – non-competitive NMDA receptor antagonist, σ1 receptor agonist, SNRI, NDRI, other actions
References
- ↑ Tatsumi, M; Groshan, K; Blakely, RD; Richelson, E (11 December 1997). "Pharmacological profile of antidepressants and related compounds at human monoamine transporters.". European Journal of Pharmacology 340 (2–3): 249–58. doi:10.1016/s0014-2999(97)01393-9. PMID 9537821.
- ↑ Atomoxetine. 2021. PMID 29630286.
- ↑ "The noradrenergic action in antidepressant treatments: pharmacological and clinical aspects". CNS Neurosci Ther 17 (6): 723–32. December 2011. doi:10.1111/j.1755-5949.2010.00217.x. PMID 21155988.
- ↑ "A systematic review of augmentation strategies for patients with major depressive disorder". Psychopharmacol Bull 42 (3): 57–90. 2009. PMID 19752841.
- ↑ 5.0 5.1 "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. September 2014. doi:10.4088/JCP.13r08851. PMID 25295426.
- ↑ "Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion". Int. Rev. Neurobiol.. International Review of Neurobiology 88: 223–55. 2009. doi:10.1016/S0074-7742(09)88009-4. ISBN 9780123745040. PMID 19897080.
- ↑ "Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs". Biochem. Pharmacol. 95 (2): 81–97. 2015. doi:10.1016/j.bcp.2015.03.011. PMID 25813654.
- ↑ "Methylphenidate: its pharmacology and uses". Mayo Clin. Proc. 75 (7): 711–21. 2000. doi:10.4065/75.7.711. PMID 10907387.
- ↑ "Methylphenidate: established and expanding roles in symptom management". Am J Hosp Palliat Care 29 (6): 483–90. 2012. doi:10.1177/1049909111427029. PMID 22144657.
- ↑ "The role of eugeroics in the treatment of affective disorders". Psychiatr Pol 54 (1): 21–33. February 2020. doi:10.12740/PP/OnlineFirst/90687. PMID 32447354.
- ↑ "Efficacy of off-label augmentation in unipolar depression: A systematic review of the evidence". Eur Neuropsychopharmacol 27 (5): 423–441. May 2017. doi:10.1016/j.euroneuro.2017.03.003. PMID 28318897.
- ↑ "Efficacy and tolerability of adjunctive modafinil/armodafinil in bipolar depression: A meta-analysis of randomized controlled trials". Bipolar Disord 22 (2): 109–120. March 2020. doi:10.1111/bdi.12859. PMID 31643130.
- ↑ "Dopaminergic agents in the treatment of bipolar depression: a systematic review and meta-analysis". Acta Psychiatr Scand 135 (6): 527–538. June 2017. doi:10.1111/acps.12712. PMID 28256707.
- ↑ "SPRAVATO™ (esketamine) nasal spray FDA label". Food and Drug Administration. 5 March 2019. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf.
- ↑ "Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications". BMC Med Ethics 17: 4. 2016. doi:10.1186/s12910-016-0087-3. PMID 26768892.
- ↑ "Adverse Effects of Second-Generation Antipsychotics as Adjuncts to Antidepressants: Are the Risks Worth the Benefits?". Psychiatr. Clin. North Am. 39 (3): 477–86. 2016. doi:10.1016/j.psc.2016.04.008. PMID 27514300.
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