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)
Selective serotonin reuptake inhibitors include:
- 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Discontinued/withdrawn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)
Serotonin–norepinephrine reuptake inhibitors include:
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Levomilnacipran (Fetzima)
- Milnacipran (Ixel, Savella, Milnaneurax)
- Venlafaxine (Effexor, Trevilor)
Serotonin–dopamine reuptake inhibitor (SDRIs)
Serotonin–dopamine reuptake inhibitors include:
None currently marketed
Discontinued/withdrawn
- Medifoxamine (Clédial, Gerdaxy)
Serotonin–norepinephrine–dopamine reuptake inhibitors (SNDRIs)
Serotonin–norepinephrine–dopamine reuptake inhibitors include:
- Dextromethorphan/bupropion (Auvelity)
- Toludesvenlafaxine (Ruoxinlin)
- Nefazodone (Serzone)[1]
Serotonin modulators and stimulators (SMSs)
Serotonin modulators and stimulators include:
- Vilazodone (Viibryd)
- Vortioxetine (Trintellix, Brintellix)
Serotonin antagonist and reuptake inhibitors (SARIs)
Serotonin antagonist and reuptake inhibitors include:
- Nefazodone (Dutonin, Nefadar, Serzone) – withdrawn/discontinued in most countries
- Trazodone (Desyrel)
Discontinued/withdrawn
- Etoperidone (Axiomin, Etonin)
Norepinephrine reuptake inhibitors (NRIs)
Norepinephrine 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
- Atomoxetine (Strattera)[2][3][4][5]
Norepinephrine–dopamine reuptake inhibitors (NDRIs)
Norepinephrine–dopamine reuptake inhibitors include:
- Bupropion (Wellbutrin, Elontril) – also a non-competitive antagonist of nicotinic acetylcholine receptors[6]
Off-label only
- Amphetamines (Adderall, Vyvanse) – actually norepinephrine–dopamine releasing agents (NDRAs)[7][5]
- Methylphenidate (Ritalin, Concerta)[8][9]
Discontinued/withdrawn
- Amineptine (Survector, Maneon)
- Nomifensine (Merital, Alival)
Tricyclic antidepressants (TCAs)
Tricyclic 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
- 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)
Tetracyclic 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)
Monoamine oxidase inhibitors include
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) – also a catecholaminergic activity enhancer and weak norepinephrine releasing agent (via metabolites)
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
Atypical 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
Marketed
- 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
- Dextromethorphan/bupropion (Auvelity)
- 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
- Ketamine (Ketalar) – non-competitive NMDA receptor antagonist[14]
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
- 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
Atypical 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
- Risperidone (Risperdal)
Typical antipsychotics
Typical antipsychotics include:
None currently approved
Off-label only
- Trifluoperazine (Stelazine)[15]
Dopamine reuptake inhibitor
Dopamine reuptake inhibitors include:
None currently approved
Off-label only
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
- Dextromethorphan/bupropion (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
References
- ↑ "Pharmacological profile of antidepressants and related compounds at human monoamine transporters". European Journal of Pharmacology 340 (2-3): 249–258. December 1997. doi:10.1016/s0014-2999(97)01393-9. PMID 9537821.
- ↑ "Atomoxetine". StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. March 2023. https://www.ncbi.nlm.nih.gov/books/NBK493234/.
- ↑ "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.
- ↑ "Amisulpride". 24 October 2021. https://adisinsight.springer.com/drugs/800005602.
- ↑ "Levosulpiride". 24 October 2021. https://adisinsight.springer.com/drugs/800003554.
- ↑ "Kusuri-no-Shiori(Drug Information Sheet)". https://www.rad-ar.or.jp/siori/english/search/result?n=35833.
- ↑ "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.
- ↑ "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.
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