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Discontinued/withdrawn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  • Nefazodone (Dutonin, Nefadar, Serzone) – withdrawn/discontinued in most countries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Discontinued/withdrawn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Discontinued/withdrawn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

  1. ↑ 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. 
  2. ↑ Atomoxetine. 2021. PMID 29630286. 
  3. ↑ "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. 
  4. ↑ "A systematic review of augmentation strategies for patients with major depressive disorder". Psychopharmacol Bull 42 (3): 57–90. 2009. PMID 19752841. 
  5. ↑ 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. 
  6. ↑ "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. 
  7. ↑ "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. 
  8. ↑ "Methylphenidate: its pharmacology and uses". Mayo Clin. Proc. 75 (7): 711–21. 2000. doi:10.4065/75.7.711. PMID 10907387. 
  9. ↑ "Methylphenidate: established and expanding roles in symptom management". Am J Hosp Palliat Care 29 (6): 483–90. 2012. doi:10.1177/1049909111427029. PMID 22144657. 
  10. ↑ "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. 
  11. ↑ "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. 
  12. ↑ "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. 
  13. ↑ "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. 
  14. ↑ "SPRAVATO™ (esketamine) nasal spray FDA label". Food and Drug Administration. 5 March 2019. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf. 
  15. ↑ "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. 
  16. ↑ "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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