Antidepressants, General (Noncyclic)
Many noncyclic antidepressants are available. These can be classified as selective serotonin reuptake inhibitors (SSRIs), including fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), and fluvoxamine (Luvox); serotonin-norepinephrine reuptake inhibitors (SNRIs), including venlafaxine (Effexor), desvenlafaxine (Pristiq), and duloxetine (Cymbalta); norepinephrine-dopamine reuptake inhibitors (NDRIs), including bupropion (Wellbutrin); and others, including trazodone (Desyrel) and mirtazapine (Remeron), the latter a tetracyclic antidepressant. Bupropion is also marketed under the brand name Zyban for smoking cessation. In general, these drugs are much less toxic than the tricyclic antidepressants (See Anticholinergics) and the monoamine oxidase (MAO) inhibitors (See Monoamine Oxidase Inhibitors), although serious effects, such as seizures, hypotension, and serotonin syndrome, occasionally occur. Noncyclic and tricyclic antidepressants are described in Table II–7.
Usual Adult Daily Dose (mg) | Neurotransmitter Effectsa | Toxicityb | |
|---|---|---|---|
Tricyclic antidepressants | |||
Amitriptyline | 75–200 | NE, 5-HT | A, H, QRS, Sz |
Amoxapine | 150–300 | NE, DA | A, H, Sz |
Clomipramine | 100–250 | NE, 5-HT | A, H, QRS, Sz |
Desipramine | 75–200 | NE | A, H, Sz |
Doxepin | 75–300 | NE, 5-HT | A, H, QRS, Sz |
Imipramine | 75–200 | NE, 5-HT | A, H, QRS, Sz |
Maprotiline | 75–300 | NE | A, H, QRS, Sz |
Nortriptyline | 75–150 | NE | A, H, QRS, Sz |
Protriptyline | 20–40 | NE | A, H, QRS, Sz |
Trimipramine | 75–200 |
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