Friday, November 21, 2008

Types of Antidepressants and Differences

There are actually 5-types/classes of antidepressants:

  1. SSRI (Serotonin Selective Reuptake Inhibitor)
  2. SNRI (Serotonin-Norepinephrine Reuptake Inhibitor)
  3. MAOI (Monoamine Oxidase Inhibitor)
  4. Tricyclic (Also known as Heterocyclics)
  5. Others*

Most antidepressants work by slowing down the removal of certain chemicals called Neurotransmitters.
The right amount of Neurotransmitter is needed for proper brain function. An imbalance or low amount on one of the neurotransmitters causes the brain function to not work properly.

There are certain types of Neurotransmitters but what matters more to Depression, Panic Attacks and so on are:

  • Serotonin (also known as 5-HT)
  • Norepinephrine
  • Dopamine

As you all may have read one of the previous post, SSRI works by increasing Serotonin or stop the “reuptake” to leave more Serotonin.

works quite the same as SSRI, but instead of just Serotonin SNRI also increases Norepinephrine or stop the reuptake. For other words, it helps Serotonin and Norepinphrine production.

For MAOI, it blocks Monoamine Oxidase (a liver and brain enzyme) from burning up the monoamines (Serotonin, Norepinephrine and Dopamine) after it sent the “messages” or signals to the nerves in the brain. When the excess monoamines don’t get destroyed, they start filling up in the brain – this is how it helps. Unfortunately, it doesn’t just ignore the monoamines it also ignores thyramine, a molecule that affects blood pressure. So since Monoamine Oxidase gets blocked, thyramine begins to rise, too. This is when the negative effects or consequences come. An increase in tyramine is disastrous. Excess tyramine can cause a sudden, sometimes fatal increase in blood pressure so severe that it can burst blood vessels in the brain.
Lastly, if you are taking MAOI you have to follow a very strict diet (like you have to avoid cheese, chocolates, certain fruits, caviers and many other stuffs).

Tricyclic works by boosting up the brain's supplies of norepinephrine and serotonin. This allows the flow of nerve impulses to return to normal. The cyclics do not act by stimulating the central nervous system or by blocking monoamine oxidase. The problem with Tricyclics is that they don't stop there. They go on to interfere with a range of other neurotransmitter systems and a variety of brain cell receptors, affecting nerve cell communication all over the brain in the process. And the more neurotransmitter systems and receptors you affect, the more side effects a patient will have.

*I will skip "others"-type of antidepressants.

Now here are the list of medications in each type of antidepressants:

SSRIs: Celexa (Citalopram), Lexapro (Escitalopram Oxalate), Luvox (Fluvoxamine), Paxil (Paroxetine), Prozac (Fluoxetine), and Zoloft (Sertraline).
SNRIs: Cymbalta (Duloxetine), Effexor (Venlafaxine), and Pristiq (Desvenlafaxine).
MAOIs: Nardil (Phenelzine), and Parnate (Tranylcypromine).
Tricyclics: Adapin (Doxepin), Anafranil (Clomipramine), Elavil (Amitriptyline), Endep (Amitriptyline), Ludiomil (Maprotiline), Norpramin (Desipramine), Pamelor (Nortryptyline), Pertofrane (Desipramine), Sinequan (Doxepin), Surmontil (Trimipramine), Tofranil (Imipramine), and Vivactil (Protriptyline).
Others: Buspar (Buspirone), Desyrel (Trazodone), Edronax, Vestra (Reboxetine), Remeron (Mirtazapine), Serzone (Nefazodone), and Wellbutrin (Bupropion).

It is said that Prozac (Fluoxetine) in the SSRI classification of antidepressant is the miracle drug or the best drug.
In the SNRI classification of antidepressant, the best drugs are Cymbalta (Duloxetine) and Effexor XR (Extended-Release Venlafaxine).

References: HealthyPlace and a few other resources which I forgot to save its address (if you're the webmaster of those sites and realized your content is here but isn't citied, please inform me and I will cite you in this entry).

Sometimes you will be prescribed Psychoactive drugs like Benzodiazepines to give you instant relieve. An example of a drug under Benzodiazepines is Lorazepam. What it does is it binds your Nervous System to make you feel relax or sedated - you won't be able to feel any anxiety and such. The negative consequences of using Psychoactive drugs is you will be addicted and start to be dependent on it.

However, it is best that you listen to your doctor or Psychiatrist and let them prescribe what is best for you. If you feel that your condition (whether is it Depression, Anxiety or Panic Attacks) gets worser, consult your doctor or Psychiatrist - they will know what to do and what is best for you - trust them.

Lastly, I will be researching on herbal antidepressants and natural substitutes. I will post my findings in the next entry, so do visit this site soon! Live with passion and all the best!


Lalit said...

melzap falls under which type of anti-depressent...?

Seng said...

Hey there, Lalit.

Melzap is a Benzodiazepines which provides instant relieve.