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1. Shard Calculation

Query:

Response:

Calculated Shard: 157 (from laksa169)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa157.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086","crawl_time":1776151076,"first_indexed_time":1517856283,"http_code":200,"src_unparsed":"com,verywellmind!www,\/what-are-the-major-classes-of-antidepressants-1065086 s443","src_root_hash":"10064058272378209957","history_drop_reason":null,"meta_title":"Types of Antidepressants and How They Work","meta_descriptions":["There are 5 major types of antidepressants: SSRIs, SNRIs, MAOIs, tricyclics, and atypicals. Learn how they work, why they are prescribed, and their side effects."],"attrs_boilerpipe_text":"Key Takeaways\nSSRIs are the most commonly prescribed type of antidepressant and are used as the first line of treatment.\nAntidepressants work by increasing the availability of neurotransmitters like dopamine, norepinephrine, and serotonin in the brain.\nDifferent types of antidepressants can have various side effects, so it's important to speak to a doctor if you have any serious reactions.\nAntidepressants adjust neurotransmitter levels in the brain to treat depression and other\nmental health conditions\n. There are five main types:\nSelective serotonin reuptake inhibitors (SSRIs)\nSerotonin and norepinephrine reuptake inhibitors (SNRIs)\nTricyclic antidepressants (TCAs)\nMonoamine oxidase inhibitors (MAOIs)\nAtypical antidepressants\nWhile some may be considered preferred options, the drug selection can vary based on your symptoms, treatment history, and co-existing\npsychological disorders\n.\nHow Antidepressants Work\nThere are three basic molecules, known chemically as monoamines, believed to be involved in mood regulation. These primarily\nserve as neurotransmitters\n, which transmit nerve signals to their corresponding receptors in the brain.\nAntidepressants work by influencing neurotransmitters such as:\nDopamine\n: Plays a central role in decision-making, motivation, arousal, and the signaling of pleasure and reward\nNorepinephrine\n: Influences alertness and motor function, and helps regulate blood pressure and heart rate in response to stress\nSerotonin\n: Regulates mood, appetite, sleep, memory, social behavior, and sexual desire\nIn people with depression, the availability of these neurotransmitters in the brain is characteristically low. Antidepressants increase the availability of one or several of these neurotransmitters in different, distinctive ways.\nHow Antidepressants are Categorized\nAs the name implies, an antidepressant is a drug primarily used to\ntreat depression\n. Depression is a common disorder that affects brain chemistry and function. Antidepressants can help correct the dysfunction by altering the circuits and chemicals that pass signals along nerve routes to the brain.\nAntidepressants are grouped into classes based on how they affect the chemistry of the brain. While the antidepressants in a class will tend to have similar side effects and\nmechanisms of action\n, there are differences in their molecular structures, which can influence how well the drug is absorbed, disseminated, or tolerated in different people.\nOf the five major types of antidepressants, SSRIs are the most commonly prescribed, particularly in first-line treatment.\nOther antidepressants may be used if these drugs fail or in cases of intractable depression, also referred to as\ntreatment-resistant depression\n.\nSelective Serotonin Reuptake Inhibitors (SSRIs)\nThere are a number of antidepressants that work by preventing the reabsorption (reuptake) of neurotransmitters into the body. Collectively known as\nreuptake inhibitors\n, they prevent the reuptake of one or more neurotransmitters so more are available and active in the brain.\nSelective serotonin reuptake inhibitors\n(SSRIs) work by specifically inhibiting the reuptake of serotonin. SSRIs are a newer class of antidepressants first developed during the 1970s.\nExamples include:\nCelexa (citalopram)\nLexapro (escitalopram)\nLuvox (fluvoxamine)\nPaxil (paroxetine)\nProzac (fluoxetine)\nViibryd (vilazodone)\nZoloft (sertraline)\nPotential SSRI Side Effects\nSSRIs tend to have fewer side effects than older antidepressants but are still known to cause side effects such as dry mouth, gastrointestinal issues, sexual dysfunction, and irregular heart rhythm.\nIn addition to treating depression, SSRIs are also sometimes used to treat\nanxiety disorders\n,\neating disorders\n,\nautism spectrum disorders\n, and\npremenstrual dysmorphic disorder\n.\nThey have also proved helpful during stroke recovery.\nSerotonin and Norepinephrine Reuptake Inhibitors (SNRIs)\nSerotonin and norepinephrine reuptake inhibitors\n(SNRIs) work in a similar way to SSRIs except that they inhibit the reuptake of both norepinephrine and serotonin. The first SNRI was FDA-approved in December of 1993.\nIncreasing norepinephrine levels in tandem with serotonin levels can be particularly useful for people with\npsychomotor retardation\n(the slowing of physical movement and thought). Examples of SNRIs include:\nCymbalta (duloxetine)\nEffexor (venlafaxine)\nFetzima (levomilnacipran)\nPristiq (desvenlafaxine)\nSavella (milnacipran)\nSNRI Side Effects\nCommon side effects of SNRIs include nausea, drowsiness, fatigue, constipation, and dry mouth.\nSome SNRIs, like Cymbalta, can also be used to\ntreat chronic pain\n, a condition closely linked to the development of depression. They have also proven useful in treating generalized anxiety,\npost-traumatic stress disorder\n(PTSD),\nsocial anxiety disorder\n(SAD),\npanic disorder\n, and nerve pain associated with fibromyalgia.\nTricyclic Antidepressants (TCAs)\nTricyclic antidepressants\n(TCAs) are an older class of drugs first designed in the 1950s.\nThey were named after their chemical structure, which is composed of three interconnected rings of atoms.\nTCAs work similarly to reuptake inhibitors in that they block the absorption of serotonin and norepinephrine into nerve cells, as well as another neurotransmitter known as acetylcholine (which helps regulate the movement of skeletal muscles). Examples of TCAs include:\nAnafranil (clomipramine)\nAsendin (amoxapine)\nElavil (amitriptyline)\nNorpramin (desipramine)\nPamelor (nortriptyline)\nSinequan (doxepin)\nSurmontil (trimipramine)\nTofranil (imipramine)\nVivactil (protriptyline)\nLudiomil (maprotiline) belongs to the same class of drugs. However, it is more appropriately described as a tetracyclic antidepressant (TeCA) due to its fourth atomic ring.\nTCA Side Effects\nCommon side effects of TCAs include constipation, dry mouth, blurry vision, drowsiness, dizziness, and weight gain. In some cases, irregular heartbeat, low blood pressure, and seizures can also occur.\nIn addition to their use in depression, tricyclic antidepressants can help treat chronic pain.\nThey were also once commonly used in\nchildren with attention deficit hyperactivity disorder\n(ADHD) but have since been replaced with more effective drug agents with fewer side effects.\nMonoamine Oxidase Inhibitors (MAOIs)\nOne of the first types of antidepressants developed was \nmonoamine oxidase inhibitors\n(MAOIs). This antidepressant class, first discovered in the 1950s,\ninhibits the action of an enzyme called monoamine oxidase, whose role is to break down monoamines. By blocking this effect, more neurotransmitters are available for mood regulation.\nExamples of MAOIs include:\nEmsam (selegiline)\nMarplan (isocarboxazid)\nNardil (phenelzine)\nParnate (tranylcypromine)\nMAOI Side Effects\nMAOIs are less commonly used due to potentially severe reactions with\nfoods high in tyramine\n, potentially triggering critical increases in blood pressure. To avoid this, MAOI treatment usually involves dietary restrictions. Other side effects include nausea, dizziness, drowsiness, dry mouth, and insomnia.\nDespite the risks, MAOIs have proven useful in treating agoraphobia, social phobia, bulimia, PTSD,\nborderline personality disorder\n, and bipolar depression. Even so, its use is usually reserved for when other antidepressant options have failed.\nAtypical Antidepressants\nThere are also other fairly new types of antidepressants that do not fit into any of the above-listed categories. Broadly described as atypical antidepressants, they affect serotonin, norepinephrine, and dopamine levels in unique ways.  \nExamples include:\nOleptro (trazodone)\nand\nBrintellix (vortioxetine)\n: Serotonin antagonist and reuptake inhibitors\n(SARIs) used for major depression that both inhibits serotonin reuptake and block adrenergic receptors\nRemeron (mirtazapine)\n: A noradrenergic antagonist\nused for major depression, that blocks receptors of the stress hormone epinephrine (adrenaline) on the brain\nSymbax\n: Combines the SSRI fluoxetine with the antipsychotic drug olanzapine to treat bipolar depression or treatment-resistant depression\nWellbutrin (bupropion)\n: Classified as a dopamine reuptake inhibitor, used to treat depression and seasonal affective disorder as well as a smoking cessation aid\nAtypical Antidepressant Side Effects\nSide effects can vary by drug type but may include dizziness, dry mouth, insomnia, nausea, vomiting, constipation, blurry vision, weight gain, and\nsexual dysfunction\n.\nAntidepressant Effectiveness\nAntidepressants are effective in treating depression, although individual responses may vary. One 2018 review of 21 different types of antidepressants found that all of these medications were more effective at treating depression than placebo.\nHowever, a 2020 meta-analysis concluded that for many people, the treatment effects of antidepressants were relatively small.\nSo which type of antidepressant is the most effective? According to the 2018 review, the five most effective antidepressants that people were least likely to stop taking were:\nLexapro (escitalopram)\nPaxil (paroxetine)\nZoloft (sertraline)\nValdoxan\/Thymanax (agomelatine)\nRemeron (mirtazapine)\nIn general, SSRIs are the most commonly prescribed, primarily because they are effective, well-tolerated, and produce relatively few side effects. Wellbutrin and SNRIs also typically have fewer side effects and good efficacy.\nAll types of antidepressants take a few weeks to begin working. For many people, this means it may take up to eight weeks to feel the full effects of an antidepressant medication.\nChoosing the Right Antidepressant\nThere are several factors that go into\nchoosing the right antidepressant\n. Chief among them is tolerability. Because many different types of antidepressants are equally effective in treating depression, a greater emphasis is placed on prescribing the drugs with the fewest short- and long-term side effects.\nThis is especially true with nausea and\nweight gain\n. Both of these effects can impact a person's quality of life and lead to the premature discontinuation of treatment.\nAntidepressants are most effective when\nused in conjunction with psychotherapy\n, self-help strategies, social support, and the treatment of co-existing conditions (such as chronic pain, anxiety, bipolar disorder, and personality disorders).\nNatural Antidepressants\nIn addition to the different types of prescription antidepressants, some people opt to try\nnatural antidepressant options\n. Options include herbs and supplements that may have a beneficial effect on mood, such as\nSt. John's wort\n. Some people may find that alternative therapies such as brain stimulation therapy and acupuncture can be helpful.\nEven natural options can have side effects, may come with risks, and can interact with other medications you are taking. Always talk to your healthcare provider before trying a natural antidepressant.\nLifestyle modifications can also play an important role in depression treatment and augment medication and therapy. Exercise, nutrition, social support, and\nspending time in nature\nare just a few things you can do to feel better.\nAntidepressant Risks and Considerations\nAntidepressants are sometimes used in combination with other drugs to treat a variety of conditions. In some cases, the combined use of drugs that both exert serotonergic action can lead to\nserotonin syndrome\n. This is the toxic accumulation of serotonin that can trigger a cascade of potentially dangerous physical and psychiatric symptoms.\nTo avoid this, always advise your physician about any and all drugs you are taking, including prescription drugs, over-the-counter medication, nutritional supplements, or herbal remedies.\nAntidepressants should only be used as prescribed and may take up to eight weeks before the benefits are fully felt. It is important never to stop, interrupt, decrease, or increase doses without first speaking with your physician.\nStopping abruptly can lead to disruptive and often debilitating\nwithdrawal symptoms\n, including nausea, vomiting, tremors, nightmares, dizziness, depression, and electrical shock sensations. This can be avoided by gradually\ntapering the dose\n, preferably under the direction of a medical professional.\nAntidepressants should be used with extreme caution in children, teens, and younger adults. In 2007, the FDA issued a black box warning about the increased risk of suicidal thoughts and actions in people under 24 on antidepressants of any type.\nAntidepressants should only be used in children, teens, and younger adults when absolutely needed and only after weighing the potential benefits of treatment against the potential risks.","attrs_markdown":"[Skip to content](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#skip-to-content)\n\nMenu\n\n- [Conditions A-Z](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n  - [Addiction](https:\/\/www.verywellmind.com\/addiction-overview-4581803)\n  - [Depression](https:\/\/www.verywellmind.com\/depression-4157261)\n  - [ADHD](https:\/\/www.verywellmind.com\/adhd-overview-4581801)\n  - [Anxiety](https:\/\/www.verywellmind.com\/anxiety-7508391)\n  - [Bipolar Disorder](https:\/\/www.verywellmind.com\/bipolar-disorder-4157274)\n  - [PTSD](https:\/\/www.verywellmind.com\/ptsd-4157229)\n  - [View All](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n- [Therapy](https:\/\/www.verywellmind.com\/therapy-4581775)\n  - 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[Mental Health in the Classroom](https:\/\/www.verywellmind.com\/mental-health-in-the-classroom-survey-7569880)\n- [About Us](https:\/\/www.verywellmind.com\/about-us-5184564)\n  - [Editorial Process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n  - [Meet Our Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n  - [Crisis Support](https:\/\/www.verywellmind.com\/crisis-support-6666353)\n\nSearch\n\n- [Conditions A-Z](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n  - [Addiction](https:\/\/www.verywellmind.com\/addiction-overview-4581803)\n  - [Depression](https:\/\/www.verywellmind.com\/depression-4157261)\n  - [ADHD](https:\/\/www.verywellmind.com\/adhd-overview-4581801)\n  - [Anxiety](https:\/\/www.verywellmind.com\/anxiety-7508391)\n  - [Bipolar Disorder](https:\/\/www.verywellmind.com\/bipolar-disorder-4157274)\n  - [PTSD](https:\/\/www.verywellmind.com\/ptsd-4157229)\n  - [View All](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n- [Therapy](https:\/\/www.verywellmind.com\/therapy-4581775)\n  - 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[View All](https:\/\/www.verywellmind.com\/living-well-7510832)\n- [Relationships](https:\/\/www.verywellmind.com\/relationships-4157190)\n  - [Healthy Relationships](https:\/\/www.verywellmind.com\/strengthening-relationships-4162997)\n  - [Dating](https:\/\/www.verywellmind.com\/dating-tips-and-strategies-7511571)\n  - [Intimacy](https:\/\/www.verywellmind.com\/sex-and-relationships-7511610)\n  - [View All](https:\/\/www.verywellmind.com\/relationships-4157190)\n- [Psychology](https:\/\/www.verywellmind.com\/psychology-4157187)\n  - [Theories](https:\/\/www.verywellmind.com\/theories-of-psychology-4157184)\n  - [Student Resources](https:\/\/www.verywellmind.com\/student-resources-overview-4581768)\n  - [Personality Types](https:\/\/www.verywellmind.com\/the-myers-briggs-type-indicator-2795583)\n  - [View All](https:\/\/www.verywellmind.com\/psychology-4157187)\n- [Trending](https:\/\/www.verywellmind.com\/news-latest-research-and-trending-topics-4846421)\n  - [Quizzes](https:\/\/www.verywellmind.com\/quizzes-8609222)\n  - [Guided Meditations](https:\/\/www.verywellmind.com\/guided-meditations-8609227)\n  - [Verywell Mind Insights](https:\/\/www.verywellmind.com\/mental-health-data-insights-5185693)\n  - [2024 Verywell Mind 25](https:\/\/www.verywellmind.com\/the-verywell-mind-25-2024-7484480)\n  - [Mental Health in the Classroom](https:\/\/www.verywellmind.com\/mental-health-in-the-classroom-survey-7569880)\n  - [View All](https:\/\/www.verywellmind.com\/news-latest-research-and-trending-topics-4846421)\n\n[More in Depression](https:\/\/www.verywellmind.com\/depression-4157261)\n\n- [Treatment](https:\/\/www.verywellmind.com\/depression-treatment-4157258)\n- [Living With](https:\/\/www.verywellmind.com\/living-with-depression-7508413)\n- [Causes](https:\/\/www.verywellmind.com\/depression-causes-4157256)\n- [Symptoms and Diagnosis](https:\/\/www.verywellmind.com\/depression-symptoms-and-diagnosis-4157260)\n- [Types](https:\/\/www.verywellmind.com\/depression-types-4157254)\n- [Childhood Depression](https:\/\/www.verywellmind.com\/childhood-depression-4157255)\n- [Suicide](https:\/\/www.verywellmind.com\/suicide-4157253)\n\n[View More](https:\/\/www.verywellmind.com\/depression-4157261)\n\n- [About Us](https:\/\/www.verywellmind.com\/about-us-5184564)\n- [Editorial Process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n- [Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n- [Crisis Support](https:\/\/www.verywellmind.com\/crisis-support-6666353)\n\nVerywell Mind's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.\n\nⒸ 2026 People Inc. — All rights reserved\n\n# The 5 Types of Antidepressants\nThe use of antidepressants has changed over the years\n\nBy\n\n[Nancy Schimelpfening](https:\/\/www.verywellmind.com\/nancy-schimelpfening-ms-4781235)\n\n[Nancy Schimelpfening](https:\/\/www.verywellmind.com\/nancy-schimelpfening-ms-4781235)\n\nNancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.\n\nLearn about our  [editorial process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n\nUpdated on April 08, 2026\n\nMedically reviewed\n\nVerywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. [Learn more](https:\/\/www.verywellmind.com\/review-board-4796494).\n\nby\n\n[Amy Morin, LCSW](https:\/\/www.verywellmind.com\/amy-morin-4842552)\n\n![Amy Morin]()\n\n![Amy Morin](https:\/\/www.verywellmind.com\/thmb\/6w-MU4IiNC6Ybaigog3YKa3jl0w=\/200x200\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/VW-MIND-Amy-2b338105f1ee493f94d7e333e410fa76.jpg)\n\nMedically reviewed by [Amy Morin, LCSW](https:\/\/www.verywellmind.com\/amy-morin-4842552)\n\nAmy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including \"13 Things Mentally Strong People Don't Do,\" have been translated into more than 40 languages. Her TEDx talk, \"The Secret of Becoming Mentally Strong,\" is one of the most viewed talks of all time.\n\nLearn about our  [Medical Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n\n![What are antidepressants?](https:\/\/www.verywellmind.com\/thmb\/qBFRdPd6ZEeZpOD1nfA7-DFJGuI=\/1500x0\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/what-are-the-major-classes-of-antidepressants-1065086_final-337da97ed4304a1598a3eaec40d53e9c.png)\n\n![What are antidepressants?](https:\/\/www.verywellmind.com\/thmb\/qBFRdPd6ZEeZpOD1nfA7-DFJGuI=\/1500x0\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/what-are-the-major-classes-of-antidepressants-1065086_final-337da97ed4304a1598a3eaec40d53e9c.png)\n\nVerywell \/ Bailey Mariner\n\nTable of Contents\n\nView All\n\nTable of Contents\n\n- [How They Work](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-how-antidepressants-work)\n- [Categorization](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-how-antidepressants-are-categorized)\n- [SSRIs](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-selective-serotonin-reuptake-inhibitors-ssris)\n- [SNRIs](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-serotonin-and-norepinephrine-reuptake-inhibitors-snris)\n- [TCAs](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-tricyclic-antidepressants-tcas)\n- [MAOIs](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-monoamine-oxidase-inhibitors-maois)\n- [Atypical Antidepressants](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-atypical-antidepressants)\n- [Effectiveness](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-antidepressant-effectiveness)\n- [Treatment Options](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-choosing-the-right-antidepressant)\n- [Risks and Considerations](https:\/\/www.verywellmind.com\/what-are-the-major-classes-of-antidepressants-1065086#toc-antidepressant-risks-and-considerations)\n\nClose\n\n### Key Takeaways\n- SSRIs are the most commonly prescribed type of antidepressant and are used as the first line of treatment.\n- Antidepressants work by increasing the availability of neurotransmitters like dopamine, norepinephrine, and serotonin in the brain.\n- Different types of antidepressants can have various side effects, so it's important to speak to a doctor if you have any serious reactions.\n\nAntidepressants adjust neurotransmitter levels in the brain to treat depression and other [mental health conditions](https:\/\/www.verywellmind.com\/definition-of-mental-illness-4587855). There are five main types:\n\n- Selective serotonin reuptake inhibitors (SSRIs)\n- Serotonin and norepinephrine reuptake inhibitors (SNRIs)\n- Tricyclic antidepressants (TCAs)\n- Monoamine oxidase inhibitors (MAOIs)\n- Atypical antidepressants\n\nWhile some may be considered preferred options, the drug selection can vary based on your symptoms, treatment history, and co-existing [psychological disorders](https:\/\/www.verywellmind.com\/a-list-of-psychological-disorders-2794776).\n\n## How Antidepressants Work\nThere are three basic molecules, known chemically as monoamines, believed to be involved in mood regulation. These primarily [serve as neurotransmitters](https:\/\/www.verywellmind.com\/what-is-a-neurotransmitter-2795394), which transmit nerve signals to their corresponding receptors in the brain.\n\nAntidepressants work by influencing neurotransmitters such as:\n\n- **Dopamine**: Plays a central role in decision-making, motivation, arousal, and the signaling of pleasure and reward\n- **Norepinephrine**: Influences alertness and motor function, and helps regulate blood pressure and heart rate in response to stress\n- **Serotonin**: Regulates mood, appetite, sleep, memory, social behavior, and sexual desire\n\nIn people with depression, the availability of these neurotransmitters in the brain is characteristically low. Antidepressants increase the availability of one or several of these neurotransmitters in different, distinctive ways.\n\n## How Antidepressants are Categorized\nAs the name implies, an antidepressant is a drug primarily used to [treat depression](https:\/\/www.verywellmind.com\/the-latest-in-depression-treatment-6665754). Depression is a common disorder that affects brain chemistry and function. Antidepressants can help correct the dysfunction by altering the circuits and chemicals that pass signals along nerve routes to the brain.\n\nAntidepressants are grouped into classes based on how they affect the chemistry of the brain. While the antidepressants in a class will tend to have similar side effects and [mechanisms of action](https:\/\/www.verywellmind.com\/meaning-of-mechanism-of-action-in-health-care-425245), there are differences in their molecular structures, which can influence how well the drug is absorbed, disseminated, or tolerated in different people.\n\nOf the five major types of antidepressants, SSRIs are the most commonly prescribed, particularly in first-line treatment. Other antidepressants may be used if these drugs fail or in cases of intractable depression, also referred to as [treatment-resistant depression](https:\/\/www.verywellmind.com\/what-is-treatment-resistant-depression-4588737).\n\n[The Chemistry of Depression](https:\/\/www.verywellmind.com\/the-chemistry-of-depression-1065137)\n\n## Selective Serotonin Reuptake Inhibitors (SSRIs)\nThere are a number of antidepressants that work by preventing the reabsorption (reuptake) of neurotransmitters into the body. Collectively known as [reuptake inhibitors](https:\/\/www.verywellmind.com\/snris-and-ssnris-380183), they prevent the reuptake of one or more neurotransmitters so more are available and active in the brain.\n\n[Selective serotonin reuptake inhibitors](https:\/\/www.verywellmind.com\/list-of-ssris-380594) (SSRIs) work by specifically inhibiting the reuptake of serotonin. SSRIs are a newer class of antidepressants first developed during the 1970s. Examples include:\n\n- Celexa (citalopram)\n- Lexapro (escitalopram)\n- Luvox (fluvoxamine)\n- Paxil (paroxetine)\n- Prozac (fluoxetine)\n- Viibryd (vilazodone)\n- Zoloft (sertraline)\n\n### Potential SSRI Side Effects\nSSRIs tend to have fewer side effects than older antidepressants but are still known to cause side effects such as dry mouth, gastrointestinal issues, sexual dysfunction, and irregular heart rhythm.\n\nIn addition to treating depression, SSRIs are also sometimes used to treat [anxiety disorders](https:\/\/www.verywellmind.com\/anxiety-disorder-2510539), [eating disorders](https:\/\/www.verywellmind.com\/eating-disorders-4157252), [autism spectrum disorders](https:\/\/www.verywellmind.com\/autism-signs-symptoms-5194920), and [premenstrual dysmorphic disorder](https:\/\/www.verywellmind.com\/premenstrual-dysphoric-disorder-4767096). They have also proved helpful during stroke recovery.\n\n## Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)\n[Serotonin and norepinephrine reuptake inhibitors](https:\/\/www.verywellmind.com\/norepinephrine-380039) (SNRIs) work in a similar way to SSRIs except that they inhibit the reuptake of both norepinephrine and serotonin. The first SNRI was FDA-approved in December of 1993.\n\nIncreasing norepinephrine levels in tandem with serotonin levels can be particularly useful for people with [psychomotor retardation](https:\/\/www.verywellmind.com\/psychomotor-retardation-380166) (the slowing of physical movement and thought). Examples of SNRIs include:\n\n- Cymbalta (duloxetine)\n- Effexor (venlafaxine)\n- Fetzima (levomilnacipran)\n- Pristiq (desvenlafaxine)\n- Savella (milnacipran)\n\n### SNRI Side Effects\nCommon side effects of SNRIs include nausea, drowsiness, fatigue, constipation, and dry mouth.\n\nSome SNRIs, like Cymbalta, can also be used to [treat chronic pain](https:\/\/www.verywellmind.com\/psychological-based-strategies-for-chronic-pain-management-5205535), a condition closely linked to the development of depression. They have also proven useful in treating generalized anxiety, [post-traumatic stress disorder](https:\/\/www.verywellmind.com\/ptsd-in-the-dsm-5-2797324) (PTSD), [social anxiety disorder](https:\/\/www.verywellmind.com\/social-anxiety-disorder-4157220) (SAD), [panic disorder](https:\/\/www.verywellmind.com\/what-is-a-panic-disorder-2795468), and nerve pain associated with fibromyalgia.\n\n## Tricyclic Antidepressants (TCAs)\n[Tricyclic antidepressants](https:\/\/www.verywellmind.com\/tricyclic-antidepressants-379652) (TCAs) are an older class of drugs first designed in the 1950s. They were named after their chemical structure, which is composed of three interconnected rings of atoms.\n\nTCAs work similarly to reuptake inhibitors in that they block the absorption of serotonin and norepinephrine into nerve cells, as well as another neurotransmitter known as acetylcholine (which helps regulate the movement of skeletal muscles). Examples of TCAs include:\n\n- Anafranil (clomipramine)\n- Asendin (amoxapine)\n- Elavil (amitriptyline)\n- Norpramin (desipramine)\n- Pamelor (nortriptyline)\n- Sinequan (doxepin)\n- Surmontil (trimipramine)\n- Tofranil (imipramine)\n- Vivactil (protriptyline)\n\nLudiomil (maprotiline) belongs to the same class of drugs. However, it is more appropriately described as a tetracyclic antidepressant (TeCA) due to its fourth atomic ring.\n\n### TCA Side Effects\nCommon side effects of TCAs include constipation, dry mouth, blurry vision, drowsiness, dizziness, and weight gain. In some cases, irregular heartbeat, low blood pressure, and seizures can also occur.\n\nIn addition to their use in depression, tricyclic antidepressants can help treat chronic pain. They were also once commonly used in [children with attention deficit hyperactivity disorder](https:\/\/www.verywellmind.com\/adhd-in-children-20844) (ADHD) but have since been replaced with more effective drug agents with fewer side effects.\n\n## Monoamine Oxidase Inhibitors (MAOIs)\nOne of the first types of antidepressants developed was [monoamine oxidase inhibitors](https:\/\/www.verywellmind.com\/monoamine-oxidase-inhibitors-maois-2584303) (MAOIs). This antidepressant class, first discovered in the 1950s, inhibits the action of an enzyme called monoamine oxidase, whose role is to break down monoamines. By blocking this effect, more neurotransmitters are available for mood regulation.\n\nExamples of MAOIs include:\n\n- Emsam (selegiline)\n- Marplan (isocarboxazid)\n- Nardil (phenelzine)\n- Parnate (tranylcypromine)\n\n### MAOI Side Effects\nMAOIs are less commonly used due to potentially severe reactions with [foods high in tyramine](https:\/\/www.verywellmind.com\/foods-to-avoid-when-taking-maois-4136871), potentially triggering critical increases in blood pressure. To avoid this, MAOI treatment usually involves dietary restrictions. Other side effects include nausea, dizziness, drowsiness, dry mouth, and insomnia.\n\nDespite the risks, MAOIs have proven useful in treating agoraphobia, social phobia, bulimia, PTSD, [borderline personality disorder](https:\/\/www.verywellmind.com\/what-is-borderline-personality-disorder-bpd-425487), and bipolar depression. Even so, its use is usually reserved for when other antidepressant options have failed.\n\n## Atypical Antidepressants\nThere are also other fairly new types of antidepressants that do not fit into any of the above-listed categories. Broadly described as atypical antidepressants, they affect serotonin, norepinephrine, and dopamine levels in unique ways.\n\nExamples include:\n\n- **Oleptro (trazodone)** and **Brintellix (vortioxetine)**: Serotonin antagonist and reuptake inhibitors(SARIs) used for major depression that both inhibits serotonin reuptake and block adrenergic receptors\n- **Remeron (mirtazapine)**: A noradrenergic antagonistused for major depression, that blocks receptors of the stress hormone epinephrine (adrenaline) on the brain\n- **Symbax**: Combines the SSRI fluoxetine with the antipsychotic drug olanzapine to treat bipolar depression or treatment-resistant depression\n- **Wellbutrin (bupropion)**: Classified as a dopamine reuptake inhibitor, used to treat depression and seasonal affective disorder as well as a smoking cessation aid\n\n### Atypical Antidepressant Side Effects\nSide effects can vary by drug type but may include dizziness, dry mouth, insomnia, nausea, vomiting, constipation, blurry vision, weight gain, and [sexual dysfunction](https:\/\/www.verywellmind.com\/how-to-reduce-sexual-side-effects-1067490).\n\n[Over-the-Counter Antidepressants](https:\/\/www.verywellmind.com\/over-the-counter-antidepressants-1066678)\n\n## Antidepressant Effectiveness\nAntidepressants are effective in treating depression, although individual responses may vary. One 2018 review of 21 different types of antidepressants found that all of these medications were more effective at treating depression than placebo. However, a 2020 meta-analysis concluded that for many people, the treatment effects of antidepressants were relatively small.\n\nSo which type of antidepressant is the most effective? According to the 2018 review, the five most effective antidepressants that people were least likely to stop taking were:\n\n- Lexapro (escitalopram)\n- Paxil (paroxetine)\n- Zoloft (sertraline)\n- Valdoxan\/Thymanax (agomelatine)\n- Remeron (mirtazapine)\n\nIn general, SSRIs are the most commonly prescribed, primarily because they are effective, well-tolerated, and produce relatively few side effects. Wellbutrin and SNRIs also typically have fewer side effects and good efficacy.\n\nAll types of antidepressants take a few weeks to begin working. For many people, this means it may take up to eight weeks to feel the full effects of an antidepressant medication.\n\n## Choosing the Right Antidepressant\nThere are several factors that go into [choosing the right antidepressant](https:\/\/www.verywellmind.com\/how-doctors-choose-the-best-antidepressant-for-you-1065501). Chief among them is tolerability. Because many different types of antidepressants are equally effective in treating depression, a greater emphasis is placed on prescribing the drugs with the fewest short- and long-term side effects.\n\nThis is especially true with nausea and [weight gain](https:\/\/www.verywellmind.com\/antidepressant-and-weight-1067613). Both of these effects can impact a person's quality of life and lead to the premature discontinuation of treatment.\n\nAntidepressants are most effective when [used in conjunction with psychotherapy](https:\/\/www.verywellmind.com\/psychotherapy-4157172), self-help strategies, social support, and the treatment of co-existing conditions (such as chronic pain, anxiety, bipolar disorder, and personality disorders).\n\n### Natural Antidepressants\nIn addition to the different types of prescription antidepressants, some people opt to try [natural antidepressant options](https:\/\/www.verywellmind.com\/natural-antidepressants-for-depression-5270480). Options include herbs and supplements that may have a beneficial effect on mood, such as [St. John's wort](https:\/\/www.verywellmind.com\/st-johns-wort-a2-89959). Some people may find that alternative therapies such as brain stimulation therapy and acupuncture can be helpful.\n\nEven natural options can have side effects, may come with risks, and can interact with other medications you are taking. Always talk to your healthcare provider before trying a natural antidepressant.\n\nLifestyle modifications can also play an important role in depression treatment and augment medication and therapy. Exercise, nutrition, social support, and [spending time in nature](https:\/\/www.verywellmind.com\/how-nature-therapy-helps-your-mental-health-5210448) are just a few things you can do to feel better.\n\n[How to Switch to a New Antidepressant Safely](https:\/\/www.verywellmind.com\/how-to-switch-to-a-new-antidepressant-safely-5223705)\n\n## Antidepressant Risks and Considerations\nAntidepressants are sometimes used in combination with other drugs to treat a variety of conditions. In some cases, the combined use of drugs that both exert serotonergic action can lead to [serotonin syndrome](https:\/\/www.verywellmind.com\/what-is-serotonin-syndrome-379651). This is the toxic accumulation of serotonin that can trigger a cascade of potentially dangerous physical and psychiatric symptoms.\n\nTo avoid this, always advise your physician about any and all drugs you are taking, including prescription drugs, over-the-counter medication, nutritional supplements, or herbal remedies.\n\nAntidepressants should only be used as prescribed and may take up to eight weeks before the benefits are fully felt. It is important never to stop, interrupt, decrease, or increase doses without first speaking with your physician.\n\nStopping abruptly can lead to disruptive and often debilitating [withdrawal symptoms](https:\/\/www.verywellmind.com\/antidepressant-withdrawal-4172110), including nausea, vomiting, tremors, nightmares, dizziness, depression, and electrical shock sensations. This can be avoided by gradually [tapering the dose](https:\/\/www.verywellmind.com\/how-to-taper-off-your-antidepressant-1067626), preferably under the direction of a medical professional.\n\nAntidepressants should be used with extreme caution in children, teens, and younger adults. In 2007, the FDA issued a black box warning about the increased risk of suicidal thoughts and actions in people under 24 on antidepressants of any type.\n\nIf you are having suicidal thoughts, contact the [National Suicide Prevention Lifeline](https:\/\/suicidepreventionlifeline.org\/) at **988** for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.\n\nFor more mental health resources, see our [National Helpline Database](https:\/\/www.verywellmind.com\/national-helpline-database-4799696).\n\nAntidepressants should only be used in children, teens, and younger adults when absolutely needed and only after weighing the potential benefits of treatment against the potential risks.\n\n[How Real Is the Risk of Suicide With Antidepressants?](https:\/\/www.verywellmind.com\/should-my-teen-take-an-antidepressant-3200841)\n\nRead more:\n\n- [Conditions A-Z](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n- [Depression](https:\/\/www.verywellmind.com\/depression-4157261)\n- [Treatment](https:\/\/www.verywellmind.com\/depression-treatment-4157258)\n\n20 Sources\n\nVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our [editorial process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006) to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.\n\n1. Institute for Quality and Efficiency in Health Care. [Depression: Learn more — How effective are antidepressants?](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK361016\/)\n2. NIH MedlinePlus Magazine. [Commonly prescribed antidepressants and how they work](https:\/\/magazine.medlineplus.gov\/article\/commonly-prescribed-antidepressants-and-how-they-work). National Library of Medicine.\n3. Bremshey S, Groß J, Renken K, Masseck OA. [The role of serotonin in depression—A historical roundup and future directions](https:\/\/doi.org\/10.1111\/jnc.16097). *J Neurochem*. 2024. doi:10.1111.jnc.16097\n4. Fasipe O. [Neuropharmacological classification of antidepressant agents based on their mechanisms of action.](https:\/\/doi.org\/10.4103\/amhs.amhs_7_18) *Arc Med Heal Sci.* 2018:6(1):81-94. doi:10.4103\/amhs.amhs\\_7\\_18.\n5. Edinoff AN, Akuly HA, Hanna TA, et al. [Selective serotonin reuptake inhibitors and adverse effects: A narrative review](https:\/\/doi.org\/10.3390\/neurolint13030038). *Neurol Int*. 2021;13(3):387-401. doi:10.3390\/neurolint13030038\n6. Lin DJ, Finklestein SP, Cramer SC. [New directions in treatments targeting stroke recovery](https:\/\/doi.org\/10.1161\/STROKEAHA.118.021359). *Stroke*. 2018;49:3107-3114. doi:10.1161\/STROKEAHA.118.021359\n7. Sansone RA, Sansone LA. [Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison.](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4008300\/) *Innov Clin Neurosci*. 2014;11(3-4):37-42.\n8. Cleveland Clinic. [Beyond depression: Other uses for tricyclic antidepressants](https:\/\/consultqd.clevelandclinic.org\/beyond-depression-other-uses-for-tricyclic-antidepressants).\n9. Cleveland Clinic. [Tricyclic antidepressants](https:\/\/my.clevelandclinic.org\/health\/treatments\/25146-tricyclic-antidepressants).\n10. Beal BR, Wallace MS. [An overview of pharmacologic management of chronic pain](https:\/\/doi.org\/10.1016\/j.mcna.2015.08.006). *Med Clin*. 2015;100(1):65-79. doi:10.1016\/j.mcna.2015.08.006\n11. Singh J. [Pharmacotherapeutic options for attention deficit hyperactivity disorder (ADHD)](https:\/\/www.researchgate.net\/profile\/Jarnail-Singh-8\/publication\/320676731_Pharmacotherapeutic_options_for_attention_deficit_hyperactivity_disorder_ADHD\/links\/5f0d4408a6fdcca32ae98df0\/Pharmacotherapeutic-options-for-attention-deficit-hyperactivity-disorder-ADHD.pdf). *Int J Res Med Sci*. 2017;5(11):4677-4682. doi:10.18203\/2320-6012.ijrms20170001\n12. O'Connor AD, Mills KC. [Monoamine oxidase inhibitors](https:\/\/doi.org\/10.1007\/978-3-319-20790-2_28-2). *Crit Care Toxicol*. 2016:1-18. doi:10.1007\/978-3-319-20790-2\\_28-2\n13. Cleveland Clinic. [MAOIs (Monoamine oxidase inhibitors)](https:\/\/my.clevelandclinic.org\/health\/treatments\/25220-maois-monoamine-oxidase-inhibitors).\n14. Cipriani A, Furukawa TA, Salanti G, et al. [Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis](https:\/\/doi.org\/10.1016\/S0140-6736%2817%2932802-7). *Lancet*. 2018;391(10128):1357-1366. doi:10.1016\/S0140-6736(17)32802-7\n15. Hengartner MP, Jakobsen JC, Sørensen A, Plöderl M. [Efficacy of new-generation antidepressants assessed with the Montgomery-Asberg Depression Rating Scale, the gold standard clinician rating scale: A meta-analysis of randomised placebo-controlled trials](https:\/\/doi.org\/10.1371\/journal.pone.0229381). *PLoS One*. 2020;15(2):e0229381. doi:10.1371\/journal.pone.0229381\n16. Marasine NR, Sankhi S, Lamichhane R, Marasini NR, Dangi NB. [Use of antidepressants among patients diagnosed with depression: A scoping review](https:\/\/doi.org\/10.1155\/2021\/6699028). *Biomed Res Int*. 2021;2021:6699028. doi:10.1155\/2021\/6699028\n17. Arterburn D, Sofer T, Boudreau DM, et al. [Long-Term Weight Change after Initiating Second-Generation Antidepressants.](https:\/\/doi.org\/10.3390\/jcm5040048) *J Clin Med.* 2016;5(4) doi:10.3390\/jcm5040048\n18. National Institute of Mental Health. [Depression](https:\/\/www.nimh.nih.gov\/health\/topics\/depression\/index.shtml#part_145399).\n19. Cleveland Clinic. [Serotonin syndrome](https:\/\/my.clevelandclinic.org\/health\/diseases\/17687-serotonin-syndrome).\n20. Friedman RA. [Antidepressants' black-box warning--10 years later.](https:\/\/doi.org\/10.1056\/NEJMp1408480) *N Engl J Med.* 2014;371(18):1666-8. doi:10.1056\/NEJMp1408480\n\nAdditional Reading\n\n- Hillhouse, T. and Porter, J. [A brief history of the development of antidepressant drugs: From monoamines to glutamate.](https:\/\/doi.org\/10.1037\/a0038550) *Exp Clin Psychopharmacol.* 2015;23(1):1-21. DOI: 10.1037\/a0038550.\n\nBy [Nancy Schimelpfening](https:\/\/www.verywellmind.com\/nancy-schimelpfening-ms-4781235)   \n Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.\n\n[See Our Editorial Process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n\n[Meet Our Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n\nShare Feedback\n\nWas this page helpful?\n\nThanks for your feedback\\!\n\nWhat is your feedback?\n\nHelpful\n\nReport an Error\n\nOther\n\nRelated Articles\n\n[What to Know About Cipralex (Escitalopram)](https:\/\/www.verywellmind.com\/how-cipralex-treats-depression-5093926)\n\n[![One young man sits, sad, while his friends take a picture]() ![One young man sits, sad, while his friends take a picture](https:\/\/www.verywellmind.com\/thmb\/YFXfuchrI3VvU265PNpf8qcXB3M=\/400x250\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/GettyImages-698202208-5beb4503c9e77c0026fc076f.jpg) Emotional Blunting: Causes, Symptoms & Treatment](https:\/\/www.verywellmind.com\/can-antidepressants-make-you-feel-emotionally-numb-1067348)\n\n[![Person holding a handful of antidepressants]() ![Person holding a handful of antidepressants](https:\/\/www.verywellmind.com\/thmb\/k-rNaoFc4tswvRJb-BOA7l6Wqn0=\/400x250\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/GettyImages-951246244-aafb86a3556145b8b2ad04415d62b09b.jpg) Common Antidepressant Medications](https:\/\/www.verywellmind.com\/most-common-antidepressants-1066939)\n\n[![Dizzy woman by side of road]() ![Dizzy woman by side of road](https:\/\/www.verywellmind.com\/thmb\/5iH_Iq0Fi1iv2edYo3sqLQgcT-g=\/400x250\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/GettyImages-1000229966-d6098f4824a94ae590e196f0de7e40d6.jpg) Symptoms of a Zoloft Overdose](https:\/\/www.verywellmind.com\/zoloft-overdose-1067483)\n\n[![doctor's prescription for citalopram]() ![doctor's prescription for citalopram](https:\/\/www.verywellmind.com\/thmb\/ASojRH9B9bYpjUTo80WyK_uaPdc=\/400x250\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/GettyImages-870295882-184f88cf459c48ab88971c1dc4542187.jpg) Celexa Withdrawal: Symptoms, Timeline & Treatment](https:\/\/www.verywellmind.com\/celexa-withdrawal-symptoms-timeline-and-treatment-4771846)\n\n[![Paxil withdrawal]() ![Paxil withdrawal](https:\/\/www.verywellmind.com\/thmb\/4JQvw_Y7cz6JIZeD8U_h5D2v5-Y=\/400x250\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/paxil-withdrawal-symptoms-timeline-and-treatment-4769771_final_no-text-ee8973e5fa504997a3807561a1e50062.png) How Long Does Withdrawal From Paxil Last?](https:\/\/www.verywellmind.com\/paxil-withdrawal-symptoms-timeline-and-treatment-4769771)\n\n[![Prozac overdose]() ![Prozac overdose](https:\/\/www.verywellmind.com\/thmb\/8WR79jYLEGYA6IwKK_aB9JNtSV0=\/400x250\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/prozac-overdose-1067020-color01-e288bf80afcd4cd0bdc548b17b72399d.png) Can You Overdose on Prozac? 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supplement](https:\/\/www.verywellmind.com\/thmb\/TM2ErUtIC9r34lzV-XaQCOt9DcY=\/400x250\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/woman-taking-vitamins-and-supplements--1175476815-8f0d045018e24cf2b15368225eefa7c6.jpg) The Health Benefits of Chromium Picolinate](https:\/\/www.verywellmind.com\/chromium-for-depression-1066922)\n\n- [Conditions A-Z](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n- [Therapy](https:\/\/www.verywellmind.com\/therapy-4581775)\n- [Living Well](https:\/\/www.verywellmind.com\/living-well-7510832)\n- [Relationships](https:\/\/www.verywellmind.com\/relationships-4157190)\n- [Psychology](https:\/\/www.verywellmind.com\/psychology-4157187)\n- [Trending](https:\/\/www.verywellmind.com\/news-latest-research-and-trending-topics-4846421)\n\n- [Meet Our Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n- [About Us](https:\/\/www.verywellmind.com\/about-us-5184564)\n- [Editorial Process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n- [Privacy Policy](https:\/\/www.people.inc\/brands-privacy)\n- [In the News](https:\/\/www.verywellmind.com\/in-the-news-4782525)\n- [Advertise](https:\/\/www.people.inc\/advertising)\n- [Terms of Service](https:\/\/www.people.inc\/brands-termsofservice)\n- [Careers](https:\/\/www.people.inc\/careers)\n- [Contact](https:\/\/www.verywellmind.com\/about-us-5184564#toc-contact-us)\n- [Crisis Support](https:\/\/www.verywellmind.com\/crisis-support-6666353)\n\nFollow Us\n\nVerywell Mind's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.\n\nⒸ 2026 People Inc. — All rights reserved\n\nVerywell Mind is part of the [People Inc.](https:\/\/www.people.inc\/) publishing family.","attrs_readable_markdown":"### Key Takeaways\n- SSRIs are the most commonly prescribed type of antidepressant and are used as the first line of treatment.\n- Antidepressants work by increasing the availability of neurotransmitters like dopamine, norepinephrine, and serotonin in the brain.\n- Different types of antidepressants can have various side effects, so it's important to speak to a doctor if you have any serious reactions.\n\nAntidepressants adjust neurotransmitter levels in the brain to treat depression and other [mental health conditions](https:\/\/www.verywellmind.com\/definition-of-mental-illness-4587855). There are five main types:\n\n- Selective serotonin reuptake inhibitors (SSRIs)\n- Serotonin and norepinephrine reuptake inhibitors (SNRIs)\n- Tricyclic antidepressants (TCAs)\n- Monoamine oxidase inhibitors (MAOIs)\n- Atypical antidepressants\n\nWhile some may be considered preferred options, the drug selection can vary based on your symptoms, treatment history, and co-existing [psychological disorders](https:\/\/www.verywellmind.com\/a-list-of-psychological-disorders-2794776).\n\n## How Antidepressants Work\nThere are three basic molecules, known chemically as monoamines, believed to be involved in mood regulation. These primarily [serve as neurotransmitters](https:\/\/www.verywellmind.com\/what-is-a-neurotransmitter-2795394), which transmit nerve signals to their corresponding receptors in the brain.\n\nAntidepressants work by influencing neurotransmitters such as:\n\n- **Dopamine**: Plays a central role in decision-making, motivation, arousal, and the signaling of pleasure and reward\n- **Norepinephrine**: Influences alertness and motor function, and helps regulate blood pressure and heart rate in response to stress\n- **Serotonin**: Regulates mood, appetite, sleep, memory, social behavior, and sexual desire\n\nIn people with depression, the availability of these neurotransmitters in the brain is characteristically low. Antidepressants increase the availability of one or several of these neurotransmitters in different, distinctive ways.\n\n## How Antidepressants are Categorized\nAs the name implies, an antidepressant is a drug primarily used to [treat depression](https:\/\/www.verywellmind.com\/the-latest-in-depression-treatment-6665754). Depression is a common disorder that affects brain chemistry and function. Antidepressants can help correct the dysfunction by altering the circuits and chemicals that pass signals along nerve routes to the brain.\n\nAntidepressants are grouped into classes based on how they affect the chemistry of the brain. While the antidepressants in a class will tend to have similar side effects and [mechanisms of action](https:\/\/www.verywellmind.com\/meaning-of-mechanism-of-action-in-health-care-425245), there are differences in their molecular structures, which can influence how well the drug is absorbed, disseminated, or tolerated in different people.\n\nOf the five major types of antidepressants, SSRIs are the most commonly prescribed, particularly in first-line treatment. Other antidepressants may be used if these drugs fail or in cases of intractable depression, also referred to as [treatment-resistant depression](https:\/\/www.verywellmind.com\/what-is-treatment-resistant-depression-4588737).\n\n## Selective Serotonin Reuptake Inhibitors (SSRIs)\nThere are a number of antidepressants that work by preventing the reabsorption (reuptake) of neurotransmitters into the body. Collectively known as [reuptake inhibitors](https:\/\/www.verywellmind.com\/snris-and-ssnris-380183), they prevent the reuptake of one or more neurotransmitters so more are available and active in the brain.\n\n[Selective serotonin reuptake inhibitors](https:\/\/www.verywellmind.com\/list-of-ssris-380594) (SSRIs) work by specifically inhibiting the reuptake of serotonin. SSRIs are a newer class of antidepressants first developed during the 1970s. Examples include:\n\n- Celexa (citalopram)\n- Lexapro (escitalopram)\n- Luvox (fluvoxamine)\n- Paxil (paroxetine)\n- Prozac (fluoxetine)\n- Viibryd (vilazodone)\n- Zoloft (sertraline)\n\n### Potential SSRI Side Effects\nSSRIs tend to have fewer side effects than older antidepressants but are still known to cause side effects such as dry mouth, gastrointestinal issues, sexual dysfunction, and irregular heart rhythm.\n\nIn addition to treating depression, SSRIs are also sometimes used to treat [anxiety disorders](https:\/\/www.verywellmind.com\/anxiety-disorder-2510539), [eating disorders](https:\/\/www.verywellmind.com\/eating-disorders-4157252), [autism spectrum disorders](https:\/\/www.verywellmind.com\/autism-signs-symptoms-5194920), and [premenstrual dysmorphic disorder](https:\/\/www.verywellmind.com\/premenstrual-dysphoric-disorder-4767096). They have also proved helpful during stroke recovery.\n\n## Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)\n[Serotonin and norepinephrine reuptake inhibitors](https:\/\/www.verywellmind.com\/norepinephrine-380039) (SNRIs) work in a similar way to SSRIs except that they inhibit the reuptake of both norepinephrine and serotonin. The first SNRI was FDA-approved in December of 1993.\n\nIncreasing norepinephrine levels in tandem with serotonin levels can be particularly useful for people with [psychomotor retardation](https:\/\/www.verywellmind.com\/psychomotor-retardation-380166) (the slowing of physical movement and thought). Examples of SNRIs include:\n\n- Cymbalta (duloxetine)\n- Effexor (venlafaxine)\n- Fetzima (levomilnacipran)\n- Pristiq (desvenlafaxine)\n- Savella (milnacipran)\n\n### SNRI Side Effects\nCommon side effects of SNRIs include nausea, drowsiness, fatigue, constipation, and dry mouth.\n\nSome SNRIs, like Cymbalta, can also be used to [treat chronic pain](https:\/\/www.verywellmind.com\/psychological-based-strategies-for-chronic-pain-management-5205535), a condition closely linked to the development of depression. They have also proven useful in treating generalized anxiety, [post-traumatic stress disorder](https:\/\/www.verywellmind.com\/ptsd-in-the-dsm-5-2797324) (PTSD), [social anxiety disorder](https:\/\/www.verywellmind.com\/social-anxiety-disorder-4157220) (SAD), [panic disorder](https:\/\/www.verywellmind.com\/what-is-a-panic-disorder-2795468), and nerve pain associated with fibromyalgia.\n\n## Tricyclic Antidepressants (TCAs)\n[Tricyclic antidepressants](https:\/\/www.verywellmind.com\/tricyclic-antidepressants-379652) (TCAs) are an older class of drugs first designed in the 1950s. They were named after their chemical structure, which is composed of three interconnected rings of atoms.\n\nTCAs work similarly to reuptake inhibitors in that they block the absorption of serotonin and norepinephrine into nerve cells, as well as another neurotransmitter known as acetylcholine (which helps regulate the movement of skeletal muscles). Examples of TCAs include:\n\n- Anafranil (clomipramine)\n- Asendin (amoxapine)\n- Elavil (amitriptyline)\n- Norpramin (desipramine)\n- Pamelor (nortriptyline)\n- Sinequan (doxepin)\n- Surmontil (trimipramine)\n- Tofranil (imipramine)\n- Vivactil (protriptyline)\n\nLudiomil (maprotiline) belongs to the same class of drugs. However, it is more appropriately described as a tetracyclic antidepressant (TeCA) due to its fourth atomic ring.\n\n### TCA Side Effects\nCommon side effects of TCAs include constipation, dry mouth, blurry vision, drowsiness, dizziness, and weight gain. In some cases, irregular heartbeat, low blood pressure, and seizures can also occur.\n\nIn addition to their use in depression, tricyclic antidepressants can help treat chronic pain. They were also once commonly used in [children with attention deficit hyperactivity disorder](https:\/\/www.verywellmind.com\/adhd-in-children-20844) (ADHD) but have since been replaced with more effective drug agents with fewer side effects.\n\n## Monoamine Oxidase Inhibitors (MAOIs)\nOne of the first types of antidepressants developed was [monoamine oxidase inhibitors](https:\/\/www.verywellmind.com\/monoamine-oxidase-inhibitors-maois-2584303) (MAOIs). This antidepressant class, first discovered in the 1950s, inhibits the action of an enzyme called monoamine oxidase, whose role is to break down monoamines. By blocking this effect, more neurotransmitters are available for mood regulation.\n\nExamples of MAOIs include:\n\n- Emsam (selegiline)\n- Marplan (isocarboxazid)\n- Nardil (phenelzine)\n- Parnate (tranylcypromine)\n\n### MAOI Side Effects\nMAOIs are less commonly used due to potentially severe reactions with [foods high in tyramine](https:\/\/www.verywellmind.com\/foods-to-avoid-when-taking-maois-4136871), potentially triggering critical increases in blood pressure. To avoid this, MAOI treatment usually involves dietary restrictions. Other side effects include nausea, dizziness, drowsiness, dry mouth, and insomnia.\n\nDespite the risks, MAOIs have proven useful in treating agoraphobia, social phobia, bulimia, PTSD, [borderline personality disorder](https:\/\/www.verywellmind.com\/what-is-borderline-personality-disorder-bpd-425487), and bipolar depression. Even so, its use is usually reserved for when other antidepressant options have failed.\n\n## Atypical Antidepressants\nThere are also other fairly new types of antidepressants that do not fit into any of the above-listed categories. Broadly described as atypical antidepressants, they affect serotonin, norepinephrine, and dopamine levels in unique ways.\n\nExamples include:\n\n- **Oleptro (trazodone)** and **Brintellix (vortioxetine)**: Serotonin antagonist and reuptake inhibitors(SARIs) used for major depression that both inhibits serotonin reuptake and block adrenergic receptors\n- **Remeron (mirtazapine)**: A noradrenergic antagonistused for major depression, that blocks receptors of the stress hormone epinephrine (adrenaline) on the brain\n- **Symbax**: Combines the SSRI fluoxetine with the antipsychotic drug olanzapine to treat bipolar depression or treatment-resistant depression\n- **Wellbutrin (bupropion)**: Classified as a dopamine reuptake inhibitor, used to treat depression and seasonal affective disorder as well as a smoking cessation aid\n\n### Atypical Antidepressant Side Effects\nSide effects can vary by drug type but may include dizziness, dry mouth, insomnia, nausea, vomiting, constipation, blurry vision, weight gain, and [sexual dysfunction](https:\/\/www.verywellmind.com\/how-to-reduce-sexual-side-effects-1067490).\n## Antidepressant Effectiveness\nAntidepressants are effective in treating depression, although individual responses may vary. One 2018 review of 21 different types of antidepressants found that all of these medications were more effective at treating depression than placebo. However, a 2020 meta-analysis concluded that for many people, the treatment effects of antidepressants were relatively small.\n\nSo which type of antidepressant is the most effective? According to the 2018 review, the five most effective antidepressants that people were least likely to stop taking were:\n\n- Lexapro (escitalopram)\n- Paxil (paroxetine)\n- Zoloft (sertraline)\n- Valdoxan\/Thymanax (agomelatine)\n- Remeron (mirtazapine)\n\nIn general, SSRIs are the most commonly prescribed, primarily because they are effective, well-tolerated, and produce relatively few side effects. Wellbutrin and SNRIs also typically have fewer side effects and good efficacy.\n\nAll types of antidepressants take a few weeks to begin working. For many people, this means it may take up to eight weeks to feel the full effects of an antidepressant medication.\n\n## Choosing the Right Antidepressant\nThere are several factors that go into [choosing the right antidepressant](https:\/\/www.verywellmind.com\/how-doctors-choose-the-best-antidepressant-for-you-1065501). Chief among them is tolerability. Because many different types of antidepressants are equally effective in treating depression, a greater emphasis is placed on prescribing the drugs with the fewest short- and long-term side effects.\n\nThis is especially true with nausea and [weight gain](https:\/\/www.verywellmind.com\/antidepressant-and-weight-1067613). Both of these effects can impact a person's quality of life and lead to the premature discontinuation of treatment.\n\nAntidepressants are most effective when [used in conjunction with psychotherapy](https:\/\/www.verywellmind.com\/psychotherapy-4157172), self-help strategies, social support, and the treatment of co-existing conditions (such as chronic pain, anxiety, bipolar disorder, and personality disorders).\n\n### Natural Antidepressants\nIn addition to the different types of prescription antidepressants, some people opt to try [natural antidepressant options](https:\/\/www.verywellmind.com\/natural-antidepressants-for-depression-5270480). Options include herbs and supplements that may have a beneficial effect on mood, such as [St. John's wort](https:\/\/www.verywellmind.com\/st-johns-wort-a2-89959). Some people may find that alternative therapies such as brain stimulation therapy and acupuncture can be helpful.\n\nEven natural options can have side effects, may come with risks, and can interact with other medications you are taking. Always talk to your healthcare provider before trying a natural antidepressant.\n\nLifestyle modifications can also play an important role in depression treatment and augment medication and therapy. Exercise, nutrition, social support, and [spending time in nature](https:\/\/www.verywellmind.com\/how-nature-therapy-helps-your-mental-health-5210448) are just a few things you can do to feel better.\n\n## Antidepressant Risks and Considerations\nAntidepressants are sometimes used in combination with other drugs to treat a variety of conditions. In some cases, the combined use of drugs that both exert serotonergic action can lead to [serotonin syndrome](https:\/\/www.verywellmind.com\/what-is-serotonin-syndrome-379651). This is the toxic accumulation of serotonin that can trigger a cascade of potentially dangerous physical and psychiatric symptoms.\n\nTo avoid this, always advise your physician about any and all drugs you are taking, including prescription drugs, over-the-counter medication, nutritional supplements, or herbal remedies.\n\nAntidepressants should only be used as prescribed and may take up to eight weeks before the benefits are fully felt. It is important never to stop, interrupt, decrease, or increase doses without first speaking with your physician.\n\nStopping abruptly can lead to disruptive and often debilitating [withdrawal symptoms](https:\/\/www.verywellmind.com\/antidepressant-withdrawal-4172110), including nausea, vomiting, tremors, nightmares, dizziness, depression, and electrical shock sensations. This can be avoided by gradually [tapering the dose](https:\/\/www.verywellmind.com\/how-to-taper-off-your-antidepressant-1067626), preferably under the direction of a medical professional.\n\nAntidepressants should be used with extreme caution in children, teens, and younger adults. In 2007, the FDA issued a black box warning about the increased risk of suicidal thoughts and actions in people under 24 on antidepressants of any type.\n\nAntidepressants should only be used in children, teens, and younger adults when absolutely needed and only after weighing the potential benefits of treatment against the potential risks.","meta_canonical":null}

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Meta Description	There are 5 major types of antidepressants: SSRIs, SNRIs, MAOIs, tricyclics, and atypicals. Learn how they work, why they are prescribed, and their side effects.
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Boilerpipe Text	Key Takeaways SSRIs are the most commonly prescribed type of antidepressant and are used as the first line of treatment. Antidepressants work by increasing the availability of neurotransmitters like dopamine, norepinephrine, and serotonin in the brain. Different types of antidepressants can have various side effects, so it's important to speak to a doctor if you have any serious reactions. Antidepressants adjust neurotransmitter levels in the brain to treat depression and other mental health conditions . There are five main types: Selective serotonin reuptake inhibitors (SSRIs) Serotonin and norepinephrine reuptake inhibitors (SNRIs) Tricyclic antidepressants (TCAs) Monoamine oxidase inhibitors (MAOIs) Atypical antidepressants While some may be considered preferred options, the drug selection can vary based on your symptoms, treatment history, and co-existing psychological disorders . How Antidepressants Work There are three basic molecules, known chemically as monoamines, believed to be involved in mood regulation. These primarily serve as neurotransmitters , which transmit nerve signals to their corresponding receptors in the brain. Antidepressants work by influencing neurotransmitters such as: Dopamine : Plays a central role in decision-making, motivation, arousal, and the signaling of pleasure and reward Norepinephrine : Influences alertness and motor function, and helps regulate blood pressure and heart rate in response to stress Serotonin : Regulates mood, appetite, sleep, memory, social behavior, and sexual desire In people with depression, the availability of these neurotransmitters in the brain is characteristically low. Antidepressants increase the availability of one or several of these neurotransmitters in different, distinctive ways. How Antidepressants are Categorized As the name implies, an antidepressant is a drug primarily used to treat depression . Depression is a common disorder that affects brain chemistry and function. Antidepressants can help correct the dysfunction by altering the circuits and chemicals that pass signals along nerve routes to the brain. Antidepressants are grouped into classes based on how they affect the chemistry of the brain. While the antidepressants in a class will tend to have similar side effects and mechanisms of action , there are differences in their molecular structures, which can influence how well the drug is absorbed, disseminated, or tolerated in different people. Of the five major types of antidepressants, SSRIs are the most commonly prescribed, particularly in first-line treatment. Other antidepressants may be used if these drugs fail or in cases of intractable depression, also referred to as treatment-resistant depression . Selective Serotonin Reuptake Inhibitors (SSRIs) There are a number of antidepressants that work by preventing the reabsorption (reuptake) of neurotransmitters into the body. Collectively known as reuptake inhibitors , they prevent the reuptake of one or more neurotransmitters so more are available and active in the brain. Selective serotonin reuptake inhibitors (SSRIs) work by specifically inhibiting the reuptake of serotonin. SSRIs are a newer class of antidepressants first developed during the 1970s. Examples include: Celexa (citalopram) Lexapro (escitalopram) Luvox (fluvoxamine) Paxil (paroxetine) Prozac (fluoxetine) Viibryd (vilazodone) Zoloft (sertraline) Potential SSRI Side Effects SSRIs tend to have fewer side effects than older antidepressants but are still known to cause side effects such as dry mouth, gastrointestinal issues, sexual dysfunction, and irregular heart rhythm. In addition to treating depression, SSRIs are also sometimes used to treat anxiety disorders , eating disorders , autism spectrum disorders , and premenstrual dysmorphic disorder . They have also proved helpful during stroke recovery. Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) Serotonin and norepinephrine reuptake inhibitors (SNRIs) work in a similar way to SSRIs except that they inhibit the reuptake of both norepinephrine and serotonin. The first SNRI was FDA-approved in December of 1993. Increasing norepinephrine levels in tandem with serotonin levels can be particularly useful for people with psychomotor retardation (the slowing of physical movement and thought). Examples of SNRIs include: Cymbalta (duloxetine) Effexor (venlafaxine) Fetzima (levomilnacipran) Pristiq (desvenlafaxine) Savella (milnacipran) SNRI Side Effects Common side effects of SNRIs include nausea, drowsiness, fatigue, constipation, and dry mouth. Some SNRIs, like Cymbalta, can also be used to treat chronic pain , a condition closely linked to the development of depression. They have also proven useful in treating generalized anxiety, post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), panic disorder , and nerve pain associated with fibromyalgia. Tricyclic Antidepressants (TCAs) Tricyclic antidepressants (TCAs) are an older class of drugs first designed in the 1950s. They were named after their chemical structure, which is composed of three interconnected rings of atoms. TCAs work similarly to reuptake inhibitors in that they block the absorption of serotonin and norepinephrine into nerve cells, as well as another neurotransmitter known as acetylcholine (which helps regulate the movement of skeletal muscles). Examples of TCAs include: Anafranil (clomipramine) Asendin (amoxapine) Elavil (amitriptyline) Norpramin (desipramine) Pamelor (nortriptyline) Sinequan (doxepin) Surmontil (trimipramine) Tofranil (imipramine) Vivactil (protriptyline) Ludiomil (maprotiline) belongs to the same class of drugs. However, it is more appropriately described as a tetracyclic antidepressant (TeCA) due to its fourth atomic ring. TCA Side Effects Common side effects of TCAs include constipation, dry mouth, blurry vision, drowsiness, dizziness, and weight gain. In some cases, irregular heartbeat, low blood pressure, and seizures can also occur. In addition to their use in depression, tricyclic antidepressants can help treat chronic pain. They were also once commonly used in children with attention deficit hyperactivity disorder (ADHD) but have since been replaced with more effective drug agents with fewer side effects. Monoamine Oxidase Inhibitors (MAOIs) One of the first types of antidepressants developed was monoamine oxidase inhibitors (MAOIs). This antidepressant class, first discovered in the 1950s, inhibits the action of an enzyme called monoamine oxidase, whose role is to break down monoamines. By blocking this effect, more neurotransmitters are available for mood regulation. Examples of MAOIs include: Emsam (selegiline) Marplan (isocarboxazid) Nardil (phenelzine) Parnate (tranylcypromine) MAOI Side Effects MAOIs are less commonly used due to potentially severe reactions with foods high in tyramine , potentially triggering critical increases in blood pressure. To avoid this, MAOI treatment usually involves dietary restrictions. Other side effects include nausea, dizziness, drowsiness, dry mouth, and insomnia. Despite the risks, MAOIs have proven useful in treating agoraphobia, social phobia, bulimia, PTSD, borderline personality disorder , and bipolar depression. Even so, its use is usually reserved for when other antidepressant options have failed. Atypical Antidepressants There are also other fairly new types of antidepressants that do not fit into any of the above-listed categories. Broadly described as atypical antidepressants, they affect serotonin, norepinephrine, and dopamine levels in unique ways. Examples include: Oleptro (trazodone) and Brintellix (vortioxetine) : Serotonin antagonist and reuptake inhibitors (SARIs) used for major depression that both inhibits serotonin reuptake and block adrenergic receptors Remeron (mirtazapine) : A noradrenergic antagonist used for major depression, that blocks receptors of the stress hormone epinephrine (adrenaline) on the brain Symbax : Combines the SSRI fluoxetine with the antipsychotic drug olanzapine to treat bipolar depression or treatment-resistant depression Wellbutrin (bupropion) : Classified as a dopamine reuptake inhibitor, used to treat depression and seasonal affective disorder as well as a smoking cessation aid Atypical Antidepressant Side Effects Side effects can vary by drug type but may include dizziness, dry mouth, insomnia, nausea, vomiting, constipation, blurry vision, weight gain, and sexual dysfunction . Antidepressant Effectiveness Antidepressants are effective in treating depression, although individual responses may vary. One 2018 review of 21 different types of antidepressants found that all of these medications were more effective at treating depression than placebo. However, a 2020 meta-analysis concluded that for many people, the treatment effects of antidepressants were relatively small. So which type of antidepressant is the most effective? According to the 2018 review, the five most effective antidepressants that people were least likely to stop taking were: Lexapro (escitalopram) Paxil (paroxetine) Zoloft (sertraline) Valdoxan/Thymanax (agomelatine) Remeron (mirtazapine) In general, SSRIs are the most commonly prescribed, primarily because they are effective, well-tolerated, and produce relatively few side effects. Wellbutrin and SNRIs also typically have fewer side effects and good efficacy. All types of antidepressants take a few weeks to begin working. For many people, this means it may take up to eight weeks to feel the full effects of an antidepressant medication. Choosing the Right Antidepressant There are several factors that go into choosing the right antidepressant . Chief among them is tolerability. Because many different types of antidepressants are equally effective in treating depression, a greater emphasis is placed on prescribing the drugs with the fewest short- and long-term side effects. This is especially true with nausea and weight gain . Both of these effects can impact a person's quality of life and lead to the premature discontinuation of treatment. Antidepressants are most effective when used in conjunction with psychotherapy , self-help strategies, social support, and the treatment of co-existing conditions (such as chronic pain, anxiety, bipolar disorder, and personality disorders). Natural Antidepressants In addition to the different types of prescription antidepressants, some people opt to try natural antidepressant options . Options include herbs and supplements that may have a beneficial effect on mood, such as St. John's wort . Some people may find that alternative therapies such as brain stimulation therapy and acupuncture can be helpful. Even natural options can have side effects, may come with risks, and can interact with other medications you are taking. Always talk to your healthcare provider before trying a natural antidepressant. Lifestyle modifications can also play an important role in depression treatment and augment medication and therapy. Exercise, nutrition, social support, and spending time in nature are just a few things you can do to feel better. Antidepressant Risks and Considerations Antidepressants are sometimes used in combination with other drugs to treat a variety of conditions. In some cases, the combined use of drugs that both exert serotonergic action can lead to serotonin syndrome . This is the toxic accumulation of serotonin that can trigger a cascade of potentially dangerous physical and psychiatric symptoms. To avoid this, always advise your physician about any and all drugs you are taking, including prescription drugs, over-the-counter medication, nutritional supplements, or herbal remedies. Antidepressants should only be used as prescribed and may take up to eight weeks before the benefits are fully felt. It is important never to stop, interrupt, decrease, or increase doses without first speaking with your physician. Stopping abruptly can lead to disruptive and often debilitating withdrawal symptoms , including nausea, vomiting, tremors, nightmares, dizziness, depression, and electrical shock sensations. This can be avoided by gradually tapering the dose , preferably under the direction of a medical professional. Antidepressants should be used with extreme caution in children, teens, and younger adults. In 2007, the FDA issued a black box warning about the increased risk of suicidal thoughts and actions in people under 24 on antidepressants of any type. Antidepressants should only be used in children, teens, and younger adults when absolutely needed and only after weighing the potential benefits of treatment against the potential risks.
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Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Ⓒ 2026 People Inc. — All rights reserved # The 5 Types of Antidepressants The use of antidepressants has changed over the years By [Nancy Schimelpfening](https://www.verywellmind.com/nancy-schimelpfening-ms-4781235) [Nancy Schimelpfening](https://www.verywellmind.com/nancy-schimelpfening-ms-4781235) Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. Learn about our [editorial process](https://www.verywellmind.com/our-editorial-process-4778006) Updated on April 08, 2026 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. [Learn more](https://www.verywellmind.com/review-board-4796494). by [Amy Morin, LCSW](https://www.verywellmind.com/amy-morin-4842552) ![Amy Morin]() ![Amy Morin](https://www.verywellmind.com/thmb/6w-MU4IiNC6Ybaigog3YKa3jl0w=/200x200/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/VW-MIND-Amy-2b338105f1ee493f94d7e333e410fa76.jpg) Medically reviewed by [Amy Morin, LCSW](https://www.verywellmind.com/amy-morin-4842552) Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk, "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time. Learn about our [Medical Review Board](https://www.verywellmind.com/review-board-4796494) ![What are antidepressants?](https://www.verywellmind.com/thmb/qBFRdPd6ZEeZpOD1nfA7-DFJGuI=/1500x0/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/what-are-the-major-classes-of-antidepressants-1065086_final-337da97ed4304a1598a3eaec40d53e9c.png) ![What are antidepressants?](https://www.verywellmind.com/thmb/qBFRdPd6ZEeZpOD1nfA7-DFJGuI=/1500x0/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/what-are-the-major-classes-of-antidepressants-1065086_final-337da97ed4304a1598a3eaec40d53e9c.png) Verywell / Bailey Mariner Table of Contents View All Table of Contents - [How They Work](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-how-antidepressants-work) - [Categorization](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-how-antidepressants-are-categorized) - [SSRIs](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-selective-serotonin-reuptake-inhibitors-ssris) - [SNRIs](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-serotonin-and-norepinephrine-reuptake-inhibitors-snris) - [TCAs](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-tricyclic-antidepressants-tcas) - [MAOIs](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-monoamine-oxidase-inhibitors-maois) - [Atypical Antidepressants](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-atypical-antidepressants) - [Effectiveness](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-antidepressant-effectiveness) - [Treatment Options](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-choosing-the-right-antidepressant) - [Risks and Considerations](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086#toc-antidepressant-risks-and-considerations) Close ### Key Takeaways - SSRIs are the most commonly prescribed type of antidepressant and are used as the first line of treatment. - Antidepressants work by increasing the availability of neurotransmitters like dopamine, norepinephrine, and serotonin in the brain. - Different types of antidepressants can have various side effects, so it's important to speak to a doctor if you have any serious reactions. Antidepressants adjust neurotransmitter levels in the brain to treat depression and other [mental health conditions](https://www.verywellmind.com/definition-of-mental-illness-4587855). There are five main types: - Selective serotonin reuptake inhibitors (SSRIs) - Serotonin and norepinephrine reuptake inhibitors (SNRIs) - Tricyclic antidepressants (TCAs) - Monoamine oxidase inhibitors (MAOIs) - Atypical antidepressants While some may be considered preferred options, the drug selection can vary based on your symptoms, treatment history, and co-existing [psychological disorders](https://www.verywellmind.com/a-list-of-psychological-disorders-2794776). ## How Antidepressants Work There are three basic molecules, known chemically as monoamines, believed to be involved in mood regulation. These primarily [serve as neurotransmitters](https://www.verywellmind.com/what-is-a-neurotransmitter-2795394), which transmit nerve signals to their corresponding receptors in the brain. Antidepressants work by influencing neurotransmitters such as: - Dopamine: Plays a central role in decision-making, motivation, arousal, and the signaling of pleasure and reward - Norepinephrine: Influences alertness and motor function, and helps regulate blood pressure and heart rate in response to stress - Serotonin: Regulates mood, appetite, sleep, memory, social behavior, and sexual desire In people with depression, the availability of these neurotransmitters in the brain is characteristically low. Antidepressants increase the availability of one or several of these neurotransmitters in different, distinctive ways. ## How Antidepressants are Categorized As the name implies, an antidepressant is a drug primarily used to [treat depression](https://www.verywellmind.com/the-latest-in-depression-treatment-6665754). Depression is a common disorder that affects brain chemistry and function. Antidepressants can help correct the dysfunction by altering the circuits and chemicals that pass signals along nerve routes to the brain. Antidepressants are grouped into classes based on how they affect the chemistry of the brain. While the antidepressants in a class will tend to have similar side effects and [mechanisms of action](https://www.verywellmind.com/meaning-of-mechanism-of-action-in-health-care-425245), there are differences in their molecular structures, which can influence how well the drug is absorbed, disseminated, or tolerated in different people. Of the five major types of antidepressants, SSRIs are the most commonly prescribed, particularly in first-line treatment. Other antidepressants may be used if these drugs fail or in cases of intractable depression, also referred to as [treatment-resistant depression](https://www.verywellmind.com/what-is-treatment-resistant-depression-4588737). [The Chemistry of Depression](https://www.verywellmind.com/the-chemistry-of-depression-1065137) ## Selective Serotonin Reuptake Inhibitors (SSRIs) There are a number of antidepressants that work by preventing the reabsorption (reuptake) of neurotransmitters into the body. Collectively known as [reuptake inhibitors](https://www.verywellmind.com/snris-and-ssnris-380183), they prevent the reuptake of one or more neurotransmitters so more are available and active in the brain. [Selective serotonin reuptake inhibitors](https://www.verywellmind.com/list-of-ssris-380594) (SSRIs) work by specifically inhibiting the reuptake of serotonin. SSRIs are a newer class of antidepressants first developed during the 1970s. Examples include: - Celexa (citalopram) - Lexapro (escitalopram) - Luvox (fluvoxamine) - Paxil (paroxetine) - Prozac (fluoxetine) - Viibryd (vilazodone) - Zoloft (sertraline) ### Potential SSRI Side Effects SSRIs tend to have fewer side effects than older antidepressants but are still known to cause side effects such as dry mouth, gastrointestinal issues, sexual dysfunction, and irregular heart rhythm. In addition to treating depression, SSRIs are also sometimes used to treat [anxiety disorders](https://www.verywellmind.com/anxiety-disorder-2510539), [eating disorders](https://www.verywellmind.com/eating-disorders-4157252), [autism spectrum disorders](https://www.verywellmind.com/autism-signs-symptoms-5194920), and [premenstrual dysmorphic disorder](https://www.verywellmind.com/premenstrual-dysphoric-disorder-4767096). They have also proved helpful during stroke recovery. ## Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) [Serotonin and norepinephrine reuptake inhibitors](https://www.verywellmind.com/norepinephrine-380039) (SNRIs) work in a similar way to SSRIs except that they inhibit the reuptake of both norepinephrine and serotonin. The first SNRI was FDA-approved in December of 1993. Increasing norepinephrine levels in tandem with serotonin levels can be particularly useful for people with [psychomotor retardation](https://www.verywellmind.com/psychomotor-retardation-380166) (the slowing of physical movement and thought). Examples of SNRIs include: - Cymbalta (duloxetine) - Effexor (venlafaxine) - Fetzima (levomilnacipran) - Pristiq (desvenlafaxine) - Savella (milnacipran) ### SNRI Side Effects Common side effects of SNRIs include nausea, drowsiness, fatigue, constipation, and dry mouth. Some SNRIs, like Cymbalta, can also be used to [treat chronic pain](https://www.verywellmind.com/psychological-based-strategies-for-chronic-pain-management-5205535), a condition closely linked to the development of depression. They have also proven useful in treating generalized anxiety, [post-traumatic stress disorder](https://www.verywellmind.com/ptsd-in-the-dsm-5-2797324) (PTSD), [social anxiety disorder](https://www.verywellmind.com/social-anxiety-disorder-4157220) (SAD), [panic disorder](https://www.verywellmind.com/what-is-a-panic-disorder-2795468), and nerve pain associated with fibromyalgia. ## Tricyclic Antidepressants (TCAs) [Tricyclic antidepressants](https://www.verywellmind.com/tricyclic-antidepressants-379652) (TCAs) are an older class of drugs first designed in the 1950s. They were named after their chemical structure, which is composed of three interconnected rings of atoms. TCAs work similarly to reuptake inhibitors in that they block the absorption of serotonin and norepinephrine into nerve cells, as well as another neurotransmitter known as acetylcholine (which helps regulate the movement of skeletal muscles). Examples of TCAs include: - Anafranil (clomipramine) - Asendin (amoxapine) - Elavil (amitriptyline) - Norpramin (desipramine) - Pamelor (nortriptyline) - Sinequan (doxepin) - Surmontil (trimipramine) - Tofranil (imipramine) - Vivactil (protriptyline) Ludiomil (maprotiline) belongs to the same class of drugs. However, it is more appropriately described as a tetracyclic antidepressant (TeCA) due to its fourth atomic ring. ### TCA Side Effects Common side effects of TCAs include constipation, dry mouth, blurry vision, drowsiness, dizziness, and weight gain. In some cases, irregular heartbeat, low blood pressure, and seizures can also occur. In addition to their use in depression, tricyclic antidepressants can help treat chronic pain. They were also once commonly used in [children with attention deficit hyperactivity disorder](https://www.verywellmind.com/adhd-in-children-20844) (ADHD) but have since been replaced with more effective drug agents with fewer side effects. ## Monoamine Oxidase Inhibitors (MAOIs) One of the first types of antidepressants developed was [monoamine oxidase inhibitors](https://www.verywellmind.com/monoamine-oxidase-inhibitors-maois-2584303) (MAOIs). This antidepressant class, first discovered in the 1950s, inhibits the action of an enzyme called monoamine oxidase, whose role is to break down monoamines. By blocking this effect, more neurotransmitters are available for mood regulation. Examples of MAOIs include: - Emsam (selegiline) - Marplan (isocarboxazid) - Nardil (phenelzine) - Parnate (tranylcypromine) ### MAOI Side Effects MAOIs are less commonly used due to potentially severe reactions with [foods high in tyramine](https://www.verywellmind.com/foods-to-avoid-when-taking-maois-4136871), potentially triggering critical increases in blood pressure. To avoid this, MAOI treatment usually involves dietary restrictions. Other side effects include nausea, dizziness, drowsiness, dry mouth, and insomnia. Despite the risks, MAOIs have proven useful in treating agoraphobia, social phobia, bulimia, PTSD, [borderline personality disorder](https://www.verywellmind.com/what-is-borderline-personality-disorder-bpd-425487), and bipolar depression. Even so, its use is usually reserved for when other antidepressant options have failed. ## Atypical Antidepressants There are also other fairly new types of antidepressants that do not fit into any of the above-listed categories. Broadly described as atypical antidepressants, they affect serotonin, norepinephrine, and dopamine levels in unique ways. Examples include: - Oleptro (trazodone) and Brintellix (vortioxetine): Serotonin antagonist and reuptake inhibitors(SARIs) used for major depression that both inhibits serotonin reuptake and block adrenergic receptors - Remeron (mirtazapine): A noradrenergic antagonistused for major depression, that blocks receptors of the stress hormone epinephrine (adrenaline) on the brain - Symbax: Combines the SSRI fluoxetine with the antipsychotic drug olanzapine to treat bipolar depression or treatment-resistant depression - Wellbutrin (bupropion): Classified as a dopamine reuptake inhibitor, used to treat depression and seasonal affective disorder as well as a smoking cessation aid ### Atypical Antidepressant Side Effects Side effects can vary by drug type but may include dizziness, dry mouth, insomnia, nausea, vomiting, constipation, blurry vision, weight gain, and [sexual dysfunction](https://www.verywellmind.com/how-to-reduce-sexual-side-effects-1067490). [Over-the-Counter Antidepressants](https://www.verywellmind.com/over-the-counter-antidepressants-1066678) ## Antidepressant Effectiveness Antidepressants are effective in treating depression, although individual responses may vary. One 2018 review of 21 different types of antidepressants found that all of these medications were more effective at treating depression than placebo. However, a 2020 meta-analysis concluded that for many people, the treatment effects of antidepressants were relatively small. So which type of antidepressant is the most effective? According to the 2018 review, the five most effective antidepressants that people were least likely to stop taking were: - Lexapro (escitalopram) - Paxil (paroxetine) - Zoloft (sertraline) - Valdoxan/Thymanax (agomelatine) - Remeron (mirtazapine) In general, SSRIs are the most commonly prescribed, primarily because they are effective, well-tolerated, and produce relatively few side effects. Wellbutrin and SNRIs also typically have fewer side effects and good efficacy. All types of antidepressants take a few weeks to begin working. For many people, this means it may take up to eight weeks to feel the full effects of an antidepressant medication. ## Choosing the Right Antidepressant There are several factors that go into [choosing the right antidepressant](https://www.verywellmind.com/how-doctors-choose-the-best-antidepressant-for-you-1065501). Chief among them is tolerability. Because many different types of antidepressants are equally effective in treating depression, a greater emphasis is placed on prescribing the drugs with the fewest short- and long-term side effects. This is especially true with nausea and [weight gain](https://www.verywellmind.com/antidepressant-and-weight-1067613). Both of these effects can impact a person's quality of life and lead to the premature discontinuation of treatment. Antidepressants are most effective when [used in conjunction with psychotherapy](https://www.verywellmind.com/psychotherapy-4157172), self-help strategies, social support, and the treatment of co-existing conditions (such as chronic pain, anxiety, bipolar disorder, and personality disorders). ### Natural Antidepressants In addition to the different types of prescription antidepressants, some people opt to try [natural antidepressant options](https://www.verywellmind.com/natural-antidepressants-for-depression-5270480). Options include herbs and supplements that may have a beneficial effect on mood, such as [St. John's wort](https://www.verywellmind.com/st-johns-wort-a2-89959). Some people may find that alternative therapies such as brain stimulation therapy and acupuncture can be helpful. Even natural options can have side effects, may come with risks, and can interact with other medications you are taking. Always talk to your healthcare provider before trying a natural antidepressant. Lifestyle modifications can also play an important role in depression treatment and augment medication and therapy. Exercise, nutrition, social support, and [spending time in nature](https://www.verywellmind.com/how-nature-therapy-helps-your-mental-health-5210448) are just a few things you can do to feel better. [How to Switch to a New Antidepressant Safely](https://www.verywellmind.com/how-to-switch-to-a-new-antidepressant-safely-5223705) ## Antidepressant Risks and Considerations Antidepressants are sometimes used in combination with other drugs to treat a variety of conditions. In some cases, the combined use of drugs that both exert serotonergic action can lead to [serotonin syndrome](https://www.verywellmind.com/what-is-serotonin-syndrome-379651). This is the toxic accumulation of serotonin that can trigger a cascade of potentially dangerous physical and psychiatric symptoms. To avoid this, always advise your physician about any and all drugs you are taking, including prescription drugs, over-the-counter medication, nutritional supplements, or herbal remedies. Antidepressants should only be used as prescribed and may take up to eight weeks before the benefits are fully felt. It is important never to stop, interrupt, decrease, or increase doses without first speaking with your physician. Stopping abruptly can lead to disruptive and often debilitating [withdrawal symptoms](https://www.verywellmind.com/antidepressant-withdrawal-4172110), including nausea, vomiting, tremors, nightmares, dizziness, depression, and electrical shock sensations. This can be avoided by gradually [tapering the dose](https://www.verywellmind.com/how-to-taper-off-your-antidepressant-1067626), preferably under the direction of a medical professional. Antidepressants should be used with extreme caution in children, teens, and younger adults. In 2007, the FDA issued a black box warning about the increased risk of suicidal thoughts and actions in people under 24 on antidepressants of any type. If you are having suicidal thoughts, contact the [National Suicide Prevention Lifeline](https://suicidepreventionlifeline.org/) at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our [National Helpline Database](https://www.verywellmind.com/national-helpline-database-4799696). Antidepressants should only be used in children, teens, and younger adults when absolutely needed and only after weighing the potential benefits of treatment against the potential risks. [How Real Is the Risk of Suicide With Antidepressants?](https://www.verywellmind.com/should-my-teen-take-an-antidepressant-3200841) Read more: - [Conditions A-Z](https://www.verywellmind.com/conditions-a-z-4797402) - [Depression](https://www.verywellmind.com/depression-4157261) - [Treatment](https://www.verywellmind.com/depression-treatment-4157258) 20 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our [editorial process](https://www.verywellmind.com/our-editorial-process-4778006) to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. 1. Institute for Quality and Efficiency in Health Care. [Depression: Learn more — How effective are antidepressants?](https://www.ncbi.nlm.nih.gov/books/NBK361016/) 2. NIH MedlinePlus Magazine. [Commonly prescribed antidepressants and how they work](https://magazine.medlineplus.gov/article/commonly-prescribed-antidepressants-and-how-they-work). National Library of Medicine. 3. Bremshey S, Groß J, Renken K, Masseck OA. [The role of serotonin in depression—A historical roundup and future directions](https://doi.org/10.1111/jnc.16097). J Neurochem. 2024. doi:10.1111.jnc.16097 4. Fasipe O. [Neuropharmacological classification of antidepressant agents based on their mechanisms of action.](https://doi.org/10.4103/amhs.amhs_7_18) Arc Med Heal Sci. 2018:6(1):81-94. doi:10.4103/amhs.amhs\_7\_18. 5. Edinoff AN, Akuly HA, Hanna TA, et al. [Selective serotonin reuptake inhibitors and adverse effects: A narrative review](https://doi.org/10.3390/neurolint13030038). Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038 6. Lin DJ, Finklestein SP, Cramer SC. [New directions in treatments targeting stroke recovery](https://doi.org/10.1161/STROKEAHA.118.021359). Stroke. 2018;49:3107-3114. doi:10.1161/STROKEAHA.118.021359 7. Sansone RA, Sansone LA. [Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008300/) Innov Clin Neurosci. 2014;11(3-4):37-42. 8. Cleveland Clinic. [Beyond depression: Other uses for tricyclic antidepressants](https://consultqd.clevelandclinic.org/beyond-depression-other-uses-for-tricyclic-antidepressants). 9. Cleveland Clinic. [Tricyclic antidepressants](https://my.clevelandclinic.org/health/treatments/25146-tricyclic-antidepressants). 10. Beal BR, Wallace MS. [An overview of pharmacologic management of chronic pain](https://doi.org/10.1016/j.mcna.2015.08.006). Med Clin. 2015;100(1):65-79. doi:10.1016/j.mcna.2015.08.006 11. Singh J. [Pharmacotherapeutic options for attention deficit hyperactivity disorder (ADHD)](https://www.researchgate.net/profile/Jarnail-Singh-8/publication/320676731_Pharmacotherapeutic_options_for_attention_deficit_hyperactivity_disorder_ADHD/links/5f0d4408a6fdcca32ae98df0/Pharmacotherapeutic-options-for-attention-deficit-hyperactivity-disorder-ADHD.pdf). Int J Res Med Sci. 2017;5(11):4677-4682. doi:10.18203/2320-6012.ijrms20170001 12. O'Connor AD, Mills KC. [Monoamine oxidase inhibitors](https://doi.org/10.1007/978-3-319-20790-2_28-2). Crit Care Toxicol. 2016:1-18. doi:10.1007/978-3-319-20790-2\_28-2 13. Cleveland Clinic. [MAOIs (Monoamine oxidase inhibitors)](https://my.clevelandclinic.org/health/treatments/25220-maois-monoamine-oxidase-inhibitors). 14. Cipriani A, Furukawa TA, Salanti G, et al. [Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis](https://doi.org/10.1016/S0140-6736%2817%2932802-7). Lancet. 2018;391(10128):1357-1366. doi:10.1016/S0140-6736(17)32802-7 15. Hengartner MP, Jakobsen JC, Sørensen A, Plöderl M. [Efficacy of new-generation antidepressants assessed with the Montgomery-Asberg Depression Rating Scale, the gold standard clinician rating scale: A meta-analysis of randomised placebo-controlled trials](https://doi.org/10.1371/journal.pone.0229381). PLoS One. 2020;15(2):e0229381. doi:10.1371/journal.pone.0229381 16. Marasine NR, Sankhi S, Lamichhane R, Marasini NR, Dangi NB. [Use of antidepressants among patients diagnosed with depression: A scoping review](https://doi.org/10.1155/2021/6699028). Biomed Res Int. 2021;2021:6699028. doi:10.1155/2021/6699028 17. Arterburn D, Sofer T, Boudreau DM, et al. [Long-Term Weight Change after Initiating Second-Generation Antidepressants.](https://doi.org/10.3390/jcm5040048) J Clin Med. 2016;5(4) doi:10.3390/jcm5040048 18. National Institute of Mental Health. [Depression](https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145399). 19. Cleveland Clinic. [Serotonin syndrome](https://my.clevelandclinic.org/health/diseases/17687-serotonin-syndrome). 20. Friedman RA. [Antidepressants' black-box warning--10 years later.](https://doi.org/10.1056/NEJMp1408480) N Engl J Med. 2014;371(18):1666-8. doi:10.1056/NEJMp1408480 Additional Reading - Hillhouse, T. and Porter, J. [A brief history of the development of antidepressant drugs: From monoamines to glutamate.](https://doi.org/10.1037/a0038550) Exp Clin Psychopharmacol. 2015;23(1):1-21. DOI: 10.1037/a0038550. By [Nancy Schimelpfening](https://www.verywellmind.com/nancy-schimelpfening-ms-4781235) Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. [See Our Editorial Process](https://www.verywellmind.com/our-editorial-process-4778006) [Meet Our Review Board](https://www.verywellmind.com/review-board-4796494) Share Feedback Was this page helpful? Thanks for your feedback\! What is your feedback? 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Readable Markdown	### Key Takeaways - SSRIs are the most commonly prescribed type of antidepressant and are used as the first line of treatment. - Antidepressants work by increasing the availability of neurotransmitters like dopamine, norepinephrine, and serotonin in the brain. - Different types of antidepressants can have various side effects, so it's important to speak to a doctor if you have any serious reactions. Antidepressants adjust neurotransmitter levels in the brain to treat depression and other [mental health conditions](https://www.verywellmind.com/definition-of-mental-illness-4587855). There are five main types: - Selective serotonin reuptake inhibitors (SSRIs) - Serotonin and norepinephrine reuptake inhibitors (SNRIs) - Tricyclic antidepressants (TCAs) - Monoamine oxidase inhibitors (MAOIs) - Atypical antidepressants While some may be considered preferred options, the drug selection can vary based on your symptoms, treatment history, and co-existing [psychological disorders](https://www.verywellmind.com/a-list-of-psychological-disorders-2794776). ## How Antidepressants Work There are three basic molecules, known chemically as monoamines, believed to be involved in mood regulation. These primarily [serve as neurotransmitters](https://www.verywellmind.com/what-is-a-neurotransmitter-2795394), which transmit nerve signals to their corresponding receptors in the brain. Antidepressants work by influencing neurotransmitters such as: - Dopamine: Plays a central role in decision-making, motivation, arousal, and the signaling of pleasure and reward - Norepinephrine: Influences alertness and motor function, and helps regulate blood pressure and heart rate in response to stress - Serotonin: Regulates mood, appetite, sleep, memory, social behavior, and sexual desire In people with depression, the availability of these neurotransmitters in the brain is characteristically low. Antidepressants increase the availability of one or several of these neurotransmitters in different, distinctive ways. ## How Antidepressants are Categorized As the name implies, an antidepressant is a drug primarily used to [treat depression](https://www.verywellmind.com/the-latest-in-depression-treatment-6665754). Depression is a common disorder that affects brain chemistry and function. Antidepressants can help correct the dysfunction by altering the circuits and chemicals that pass signals along nerve routes to the brain. Antidepressants are grouped into classes based on how they affect the chemistry of the brain. While the antidepressants in a class will tend to have similar side effects and [mechanisms of action](https://www.verywellmind.com/meaning-of-mechanism-of-action-in-health-care-425245), there are differences in their molecular structures, which can influence how well the drug is absorbed, disseminated, or tolerated in different people. Of the five major types of antidepressants, SSRIs are the most commonly prescribed, particularly in first-line treatment. Other antidepressants may be used if these drugs fail or in cases of intractable depression, also referred to as [treatment-resistant depression](https://www.verywellmind.com/what-is-treatment-resistant-depression-4588737). ## Selective Serotonin Reuptake Inhibitors (SSRIs) There are a number of antidepressants that work by preventing the reabsorption (reuptake) of neurotransmitters into the body. Collectively known as [reuptake inhibitors](https://www.verywellmind.com/snris-and-ssnris-380183), they prevent the reuptake of one or more neurotransmitters so more are available and active in the brain. [Selective serotonin reuptake inhibitors](https://www.verywellmind.com/list-of-ssris-380594) (SSRIs) work by specifically inhibiting the reuptake of serotonin. SSRIs are a newer class of antidepressants first developed during the 1970s. Examples include: - Celexa (citalopram) - Lexapro (escitalopram) - Luvox (fluvoxamine) - Paxil (paroxetine) - Prozac (fluoxetine) - Viibryd (vilazodone) - Zoloft (sertraline) ### Potential SSRI Side Effects SSRIs tend to have fewer side effects than older antidepressants but are still known to cause side effects such as dry mouth, gastrointestinal issues, sexual dysfunction, and irregular heart rhythm. In addition to treating depression, SSRIs are also sometimes used to treat [anxiety disorders](https://www.verywellmind.com/anxiety-disorder-2510539), [eating disorders](https://www.verywellmind.com/eating-disorders-4157252), [autism spectrum disorders](https://www.verywellmind.com/autism-signs-symptoms-5194920), and [premenstrual dysmorphic disorder](https://www.verywellmind.com/premenstrual-dysphoric-disorder-4767096). They have also proved helpful during stroke recovery. ## Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) [Serotonin and norepinephrine reuptake inhibitors](https://www.verywellmind.com/norepinephrine-380039) (SNRIs) work in a similar way to SSRIs except that they inhibit the reuptake of both norepinephrine and serotonin. The first SNRI was FDA-approved in December of 1993. Increasing norepinephrine levels in tandem with serotonin levels can be particularly useful for people with [psychomotor retardation](https://www.verywellmind.com/psychomotor-retardation-380166) (the slowing of physical movement and thought). Examples of SNRIs include: - Cymbalta (duloxetine) - Effexor (venlafaxine) - Fetzima (levomilnacipran) - Pristiq (desvenlafaxine) - Savella (milnacipran) ### SNRI Side Effects Common side effects of SNRIs include nausea, drowsiness, fatigue, constipation, and dry mouth. Some SNRIs, like Cymbalta, can also be used to [treat chronic pain](https://www.verywellmind.com/psychological-based-strategies-for-chronic-pain-management-5205535), a condition closely linked to the development of depression. They have also proven useful in treating generalized anxiety, [post-traumatic stress disorder](https://www.verywellmind.com/ptsd-in-the-dsm-5-2797324) (PTSD), [social anxiety disorder](https://www.verywellmind.com/social-anxiety-disorder-4157220) (SAD), [panic disorder](https://www.verywellmind.com/what-is-a-panic-disorder-2795468), and nerve pain associated with fibromyalgia. ## Tricyclic Antidepressants (TCAs) [Tricyclic antidepressants](https://www.verywellmind.com/tricyclic-antidepressants-379652) (TCAs) are an older class of drugs first designed in the 1950s. They were named after their chemical structure, which is composed of three interconnected rings of atoms. TCAs work similarly to reuptake inhibitors in that they block the absorption of serotonin and norepinephrine into nerve cells, as well as another neurotransmitter known as acetylcholine (which helps regulate the movement of skeletal muscles). Examples of TCAs include: - Anafranil (clomipramine) - Asendin (amoxapine) - Elavil (amitriptyline) - Norpramin (desipramine) - Pamelor (nortriptyline) - Sinequan (doxepin) - Surmontil (trimipramine) - Tofranil (imipramine) - Vivactil (protriptyline) Ludiomil (maprotiline) belongs to the same class of drugs. However, it is more appropriately described as a tetracyclic antidepressant (TeCA) due to its fourth atomic ring. ### TCA Side Effects Common side effects of TCAs include constipation, dry mouth, blurry vision, drowsiness, dizziness, and weight gain. In some cases, irregular heartbeat, low blood pressure, and seizures can also occur. In addition to their use in depression, tricyclic antidepressants can help treat chronic pain. They were also once commonly used in [children with attention deficit hyperactivity disorder](https://www.verywellmind.com/adhd-in-children-20844) (ADHD) but have since been replaced with more effective drug agents with fewer side effects. ## Monoamine Oxidase Inhibitors (MAOIs) One of the first types of antidepressants developed was [monoamine oxidase inhibitors](https://www.verywellmind.com/monoamine-oxidase-inhibitors-maois-2584303) (MAOIs). This antidepressant class, first discovered in the 1950s, inhibits the action of an enzyme called monoamine oxidase, whose role is to break down monoamines. By blocking this effect, more neurotransmitters are available for mood regulation. Examples of MAOIs include: - Emsam (selegiline) - Marplan (isocarboxazid) - Nardil (phenelzine) - Parnate (tranylcypromine) ### MAOI Side Effects MAOIs are less commonly used due to potentially severe reactions with [foods high in tyramine](https://www.verywellmind.com/foods-to-avoid-when-taking-maois-4136871), potentially triggering critical increases in blood pressure. To avoid this, MAOI treatment usually involves dietary restrictions. Other side effects include nausea, dizziness, drowsiness, dry mouth, and insomnia. Despite the risks, MAOIs have proven useful in treating agoraphobia, social phobia, bulimia, PTSD, [borderline personality disorder](https://www.verywellmind.com/what-is-borderline-personality-disorder-bpd-425487), and bipolar depression. Even so, its use is usually reserved for when other antidepressant options have failed. ## Atypical Antidepressants There are also other fairly new types of antidepressants that do not fit into any of the above-listed categories. Broadly described as atypical antidepressants, they affect serotonin, norepinephrine, and dopamine levels in unique ways. Examples include: - Oleptro (trazodone) and Brintellix (vortioxetine): Serotonin antagonist and reuptake inhibitors(SARIs) used for major depression that both inhibits serotonin reuptake and block adrenergic receptors - Remeron (mirtazapine): A noradrenergic antagonistused for major depression, that blocks receptors of the stress hormone epinephrine (adrenaline) on the brain - Symbax: Combines the SSRI fluoxetine with the antipsychotic drug olanzapine to treat bipolar depression or treatment-resistant depression - Wellbutrin (bupropion): Classified as a dopamine reuptake inhibitor, used to treat depression and seasonal affective disorder as well as a smoking cessation aid ### Atypical Antidepressant Side Effects Side effects can vary by drug type but may include dizziness, dry mouth, insomnia, nausea, vomiting, constipation, blurry vision, weight gain, and [sexual dysfunction](https://www.verywellmind.com/how-to-reduce-sexual-side-effects-1067490). ## Antidepressant Effectiveness Antidepressants are effective in treating depression, although individual responses may vary. One 2018 review of 21 different types of antidepressants found that all of these medications were more effective at treating depression than placebo. However, a 2020 meta-analysis concluded that for many people, the treatment effects of antidepressants were relatively small. So which type of antidepressant is the most effective? According to the 2018 review, the five most effective antidepressants that people were least likely to stop taking were: - Lexapro (escitalopram) - Paxil (paroxetine) - Zoloft (sertraline) - Valdoxan/Thymanax (agomelatine) - Remeron (mirtazapine) In general, SSRIs are the most commonly prescribed, primarily because they are effective, well-tolerated, and produce relatively few side effects. Wellbutrin and SNRIs also typically have fewer side effects and good efficacy. All types of antidepressants take a few weeks to begin working. For many people, this means it may take up to eight weeks to feel the full effects of an antidepressant medication. ## Choosing the Right Antidepressant There are several factors that go into [choosing the right antidepressant](https://www.verywellmind.com/how-doctors-choose-the-best-antidepressant-for-you-1065501). Chief among them is tolerability. Because many different types of antidepressants are equally effective in treating depression, a greater emphasis is placed on prescribing the drugs with the fewest short- and long-term side effects. This is especially true with nausea and [weight gain](https://www.verywellmind.com/antidepressant-and-weight-1067613). Both of these effects can impact a person's quality of life and lead to the premature discontinuation of treatment. Antidepressants are most effective when [used in conjunction with psychotherapy](https://www.verywellmind.com/psychotherapy-4157172), self-help strategies, social support, and the treatment of co-existing conditions (such as chronic pain, anxiety, bipolar disorder, and personality disorders). ### Natural Antidepressants In addition to the different types of prescription antidepressants, some people opt to try [natural antidepressant options](https://www.verywellmind.com/natural-antidepressants-for-depression-5270480). Options include herbs and supplements that may have a beneficial effect on mood, such as [St. John's wort](https://www.verywellmind.com/st-johns-wort-a2-89959). Some people may find that alternative therapies such as brain stimulation therapy and acupuncture can be helpful. Even natural options can have side effects, may come with risks, and can interact with other medications you are taking. Always talk to your healthcare provider before trying a natural antidepressant. Lifestyle modifications can also play an important role in depression treatment and augment medication and therapy. Exercise, nutrition, social support, and [spending time in nature](https://www.verywellmind.com/how-nature-therapy-helps-your-mental-health-5210448) are just a few things you can do to feel better. ## Antidepressant Risks and Considerations Antidepressants are sometimes used in combination with other drugs to treat a variety of conditions. In some cases, the combined use of drugs that both exert serotonergic action can lead to [serotonin syndrome](https://www.verywellmind.com/what-is-serotonin-syndrome-379651). This is the toxic accumulation of serotonin that can trigger a cascade of potentially dangerous physical and psychiatric symptoms. To avoid this, always advise your physician about any and all drugs you are taking, including prescription drugs, over-the-counter medication, nutritional supplements, or herbal remedies. Antidepressants should only be used as prescribed and may take up to eight weeks before the benefits are fully felt. It is important never to stop, interrupt, decrease, or increase doses without first speaking with your physician. Stopping abruptly can lead to disruptive and often debilitating [withdrawal symptoms](https://www.verywellmind.com/antidepressant-withdrawal-4172110), including nausea, vomiting, tremors, nightmares, dizziness, depression, and electrical shock sensations. This can be avoided by gradually [tapering the dose](https://www.verywellmind.com/how-to-taper-off-your-antidepressant-1067626), preferably under the direction of a medical professional. Antidepressants should be used with extreme caution in children, teens, and younger adults. In 2007, the FDA issued a black box warning about the increased risk of suicidal thoughts and actions in people under 24 on antidepressants of any type. Antidepressants should only be used in children, teens, and younger adults when absolutely needed and only after weighing the potential benefits of treatment against the potential risks.
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