Note: Medscape articles require prior but free registration
 

Links to brand name information were always disappearing so instead I have a page of places where you can do your own  drug searches Whenever possible, I have linked the generic name to the monograph at WWW.Mentalhealth.Com Definitions for SSRI's ,TCA's and MAOI's are from About.com. bipolar glossary

Side Effects( this site)

Nefazadone (Serzone) is being withdrawn from the Canadian Market effective Nov. 27, 2003 because of reports of liver toxicity

The activating antidepressants include: the SSRI's (Prozac, etc), Wellbutrin, Effexor, protryptyline, and the MAOIs. The sedating antidepressants include: Serzone, Trazodone, Remeron, amitriptyline, doxepin, and trimipramine.

 

SSRI's Selective Serotonin Reuptake Inhibitors

Selective Serotonin Reuptake Inhibitor - a class of drugs which work by preventing the movement of the neurohormone Serotonin into nerve endings thus forcing the Serotonin to remain actively working

Generic Name	Brand Name/Names	Comments
Fluoxetine	Prozac.com Pharmaceutical site	as Sarafem for PMS
Paroxetine Focus on Paroxetine(medscape)	Paxil  pdf 8 pages of in depth information Pharmaceutical site	(FDA) approved for the treatment of Social Anxiety Disorder and Generalized Anxiety Disorder  Paxil - Seroxat Heaven Sent or Hell Bent
Sertraline	Zoloft.com pharmaceutical site	FDA approved for OCD , Panic disorders &PTSD May also be effective for PTSD and in relieving PMS symptoms
Fluvoxamine	Luvox	Only approved for OCD
Citalopram	Celexa  pharmaceutical site	oral solution approved

Addressing Both the Emotional and Physical Symptoms in Depression Medscape CME April 2003 In 1998, Stephen Stahl^[16] theorized that all 3 neurotransmitters -- dopamine, norepinephrine, and serotonin -- affected mood, and that both norepinephrine and serotonin affected anxiety. But he believed that dopamine may preferentially regulate motivation, pleasure, and reward; serotonin may preferentially regulate obsessions and compulsions; and norepinephrine may preferentially regulate alertness and energy. Showing the symptom domains of serotonin and norepinephrine, Stahl placed mood, emotion, anxiety, pain, irritability, and cognitive function in the domain of both neurotransmitters. Vigilance and motivation are in the domain of norepinephrine; and the serotonin domain includes impulsivity, sex, appetite, and aggression

A survey of prescribing practices in the treatment of depression abstract Progress in Neuro-Psychopharmacology & Biological Psychiatry Jan, 2002

JournalClub Review - Differences in Efficacy Among Currently Available SSRI's 

Merck Manual Antidepressants Includes dosage info and precautions

Antidepressant treatment of other conditions (this site)

SSRI Discontinuation Syndrome about.com Mar.11,2002 short  but descriptive article
ABCNEWS.com SSRI Withdrawal Effects Underdiscussed Article includes short section on how to properly stop taking SSRI's under a doctor's supervision.

Questions Remain About Cardiac Effects of SSRIs Psychiatric news Dec.1,2000 the researchers said, as long-term maintenance therapy becomes the standard in the treatment of major depression, it is important to monitor the cardiovascular side effects of newer antidepressants over longer intervals.

DG DISPATCH - ECNP: Some SSRIs May Impair Vigilance And Long-Term Memory The antidepressants paroxetine and sertraline may have adverse effects on cognitive skills such as memory and vigilance, according to researchers. 

Tricyclic Antidepressants May Increase Risk Of Heart Attack January 12, 2000 doctor's guide

Clinical Psychiatry News Weight Gain Varies With Antidepressants Carl Sherman, Contributing Writer Bipolarworld 

Safer Antidepressants Do Not Prevent Self-Harm December 28 5:26 Br J Psychiatry 2000;177:551-556 Significantly more DSH events occurred following the prescription of an SSRI than that of a TCA BJP -- Search

Mind-Body - Serotonin Syndrome

Removing Roadblocks to Full Recovery Washington Post Feb 29,2000 Article on the importance of addressing anti-depressant side effects. (paid archives)

Antidepressants Found To Alter Brain Cells in Rats Mar 7, 2000 Study used extremely high doses

Sexual Side Effects

SSRIs Relatively Safe While Nursing medscape May 2003 small study 23 women  5 ssri's found no significant blood levels in baby's blood.

Drug fear endangers pregnant women Many aren't taking medicine they need 

Antidepressant Benefits Outweigh Risks During Pregnancy And Breastfeeding Doctor's Guide Feb.5, 2001

Safety of Antidepressant Medications During Pregnancy

Sertraline Use Probably Safe During Breastfeeding

Gender May Affect Antidepressant Response Psychiatric News Sept 15,2000

Sustained use of anti-depressants increases cell growth and protects cells in the brain  EurekAlert Journal of Neuroscience 15 December 2000 Antidepressants used in study were tranlcypromine (MAOI), fluoxetine (SSRI) and Reboxetine (atypical)

Sildenafil Effective in Antidepressant-Related Sexual Dysfunction Medscape Dec 2002 Viagra Pfizer, Inc., supported this study 54.5% of patients receiving sildenafil and 4.4% of patients receiving placebo reported being much or very much improved

Venlafaxine associated sexual dysfunction treated with sildenafil a case report Psychiatry online

:Sexual Dysfunction Less Likely In Depressed Patients Taking Moclobemide

(From Reuters) Use of the serotonin antagonist mianserin reverses sexual dysfunction in women caused by SSRIs, Israeli researchers report in the November-December issue of Clinical Neuropharmacology.  An earlier study found the drug also worked for men.

Management of and Counseling for Psychotropic Drug-Induced Sexual Dysfunction Medscape 1999 Bupropion (Wellbutrin), Remeron ( Mirtazapine) and Nefazodone( Serzone) are the 3 antidepressants that do not have sexual side effects

Treatment of Antidepressant-Induced Sexual Dysfunction Medscape 1998

Antidepressants Linked to Sexual Dysfunction More Often Than Expected medscape Reuters 37% reported problems Compared with bupropion SR (Wellbutrin), sexual problems were six times more likely to be reported by subjects on venlafazine XR (Effexor), five times more likely in patients on paroxetine (Paxil) or sertraline (Zoloft), and four times more common in patients on fluoxetine (Prozac

Wonderful Wellbutrin? Most antidepressants suppress sex drive, but some new evidence suggests this one might be different

WASHINGTON (Reuters Health) Oct 12 - The US Food and Drug Administration (FDA) has approved Eon Labs Manufacturing's generic version of Glaxo Wellcome's antidepressant Wellbutrin (bupropion) tablets.
Invamed, Mylan, Novopharm and Teva had previously received FDA approval for their respective generic formulations of Wellbutrin

Antismoking drug comes under scrutiny after deaths BMJ Feb 2001 18 deaths were linked with suspected adverse drug reactions It is important to note that suspected reports are not necessarily caused by the drug and may relate to other factors such as other illnesses, other medicines or more importantly smoking itself," said a spokeswoman for GlaxoSmithKline

FDA Approves Mylan's Generic Bupropion Tablet Apr.20,2000

Links not checked from this point to end of page on April, 2003 . They may  or may not be still working

New Kind of Drug Holds Promise for Depression (reboxetine)Mediconsult

Pharmacia & Upjohn, Janssen To Copromote Antidepressant Drug medscape
Janssen Pharmaceutica, a subsidiary of Johnson & Johnson, will copromote Pharmacia & Upjohn's new antidepressant reboxetine mesylate (Vestra) in the US

Reboxetine Effective In Treating Depression Symptoms, PSL Group

Effexor More Effective Than Prozac In Achieving Remission In Depression  

Study Shows Venlafaxine is More Effective Than Prozac in Treating Depression and Achieving Remission medscape February 16, 2000
Effexor More Effective Than Prozac In Achieving Remission In Depression same study Doctor's Guide 8 week study: full remission Effexor 37%, Prozac 22%, placebo 18%

Venlafaxine more effective than SSRIs PsycPort March 1,2001 overall venlafaxine remission rates were 45 percent, compared to 35 percent for SSRIs, and 25 percent for placebo

Focus On Venlafaxine

News - Antidepressant, Celexa (Citalopram), Produces Less Weight Gain Than Paxil (Paroxetine) Doctor's Guide

Citalopram in Child and Adolescent Depression With Anxiety

Citalopram Use in Pregnancy Not Associated With Major Teratogenic Risk Reuters Medscape 2005 among 108 women exposed to citalopram during the first trimester, only one baby (0.9%) was born with a major malformation

Paroxetine Safer For Patients With Rheumatoid Arthritis Than Amitriptyline medscape Reuter's news Jan.19, 2001

Withdrawal from paroxetine can be severe warns FDA  BMJ 2002;324:260 ( 2 February )

Paroxetine Use During Late Pregnancy Associated With Neonatal Complications medscape May,2002 More so than other similar antidepressants, paroxetine (Paxil) use late in pregnancy seems to be associated with higher rates of neonatal complications
 

Paroxetine Can Cause an Increase in LDL Cholesterol

Should Antidepressant Serzone Be Banned WebMd Oct. 2003 ...there will be one case of liver failure for every 250,000 patients who take the drug for one year. Since 1994, 11 million people worldwide have taken Serzone.......it's impossible to tell which patients will get liver damage from Serzone. So while a given patient has a very low risk of liver failure, those who do get liver failure may not see any warning signs until it's too late.

Nefazadone (Serzone) is being withdrawn from the Canadian Market effective Nov. 27, 2003 because of reports of liver toxicity

Mirtazapine Effective And Well-Tolerated Anti-Depressant Jan. 8, 2001 The most frequent adverse effects were somnolence, increased appetite and weight gain

FDA Approves Remeron SolTab (Mirtazapine) For Depression  Doctor's Guide Jan.12, 2000 dissolvable tablet 

Sertraline Safe, Effective in Patients With Recent MI, Angina Medscape Aug.2002

In the works

Escitalopram, New Generation Selective Serotonin Reuptake Inhibitor, Promising In Major Depressive Disorder Doctor's Guide Dec.13,2000 isomer of citalopram 
Adverse Event Rate Lower With Escitalopram Than Citalopram for Depression medscape July5, 2001

Phase I Data Positive on CRF Receptor Antagonist for Depression, Anxiety medscape Reuters Mar. 8,2000   drug blocks stress responses medicated by corticotropin realeasing factor (CRF) resulting in anti-anxiety and anti-depressant effects

On the Horizon: New Antidepressants Martin L. Korn MD  May, 2002  There is also increasing evidence that the glutamate system is involved in depression and therefore offers another pathway to intervene in the system

Duloxetine Significantly Reduces Symptoms of DepressionNov,2001 medscape medwire Duloxetine 60 mg/day statistically significantly reduced overall pain by the second week and back pain by the first week of active therapy
 Daily Duloxetine Effective Against Major Depressive Disorder medscape May 10, 2002   The study...does suggest that a dual-action antidepressant such as duloxetine, affecting both serotonin and norepinephrine neurotransmission, may be particularly efficacious in treating both depression and painful physical symptoms among major depressive disorder patients

Experts Debate New Clinical Data on Duloxetine medscape 2002

Bipolar and Antidepressants

Use Antidepressants Cautiously For Bipolar Depression
The management of bipolar depression remains a thorny issue, with several 'reasonable' therapeutic choices but none of unquestioned superiority for all patients.

Use of Antidepressants in Treating Bipolar Disorder BPSO discussion and links on the topic of the use of antidepressants in bipolar clients

Adjunctive Antidepressant  As Effective As Second  Mood Stabilizer  For Bipolar Depression  For patients with bipolar disorder, addition of an antidepressant to a mood stabilizer is just as effective as addition of a second mood stabilizer in the treatment of moderate depression, Canadian researchers have found.

Antidepressants Overused in Bipolar Treatment by Arline Kaplan

News briefs on anti-depressants

St. John's Wort May Set Off Switch [into mania] Bruce Jancin
 

 befloxatone-reversible monoamine oxidase inhibitor
   Cymbalta

Substance P Antagonist
isocarboxazid (Marplan)
 

Substance P Antagonists (SPAs)- New Class of Drugs Show Promise in Treating Depression Medscape April 2003 Sixty percent of them [patients with depression] get better and another 30 to 40 percent clearly need another option

Bipolar Disorder Research Pages
Copyright © 2000 All rights reserved.
Revised: January 08, 2006 .