What are the different types of depression and anxiety meds?

The types I know of are:

depression:
SSRI
SNRI
DRI
MAOI

anxiety:
benzodiazepines
beta-blockers

SSRIs are the initial antidepressants of choice for uncomplicated depression because of their minimal anticholinergic effects. Many SSRIs are also approved to treat various anxiety disorders including generalized anxiety disorder, OCD, panic disorder, and social anxiety disorder.They have the advantage of ease of dosing and low toxicity in overdose. SSRIs are greatly preferred over the other classes of antidepressants for the treatment of children and adolescents, and these agents are also the first-line medications for late-onset depression, due to their superior tolerability and comparatively more benign safety profile. Because the adverse-effect profile of SSRIs is less prominent than other agents, improved compliance is promoted. Common adverse effects of SSRIs include gastrointestinal upset, sexual dysfunction, bleeding, emotional blunting, cognitive dysfunction, and changes in energy level (ie, fatigue, restlessness). Examples include Celexa (citalopram), Lexapro, Cipralex (escitalopram), Luvox (fluvoxamine), Paxil (paroxetine hydrochloride), Prozac (fluoxetine), and Zoloft (sertraline). SSRIs act on serotonin alone by inhibiting its reuptake therefore increasing serotonin levels resulting in increased binding at receptor sites.

SNRIs can be used as first-line agents, particularly in patients with significant fatigue or pain syndromes associated with the episode of depression. The SNRIs also have an important role as second-line agents in patients who have not responded to SSRIs. SNRIs are also approved to treat various anxiety disorders. SNRIs act on serotonin and norepinephrine and increase their levels in much the same way SSRIs work. Examples include Cymbalta (duloxetine), Effexor (venlafaxine), Effexor XR (venlafaxine extended-release), and Pristiq (desvenlafaxine).

A DRI is a type of drug that acts as a reuptake inhibitor for the neurotransmitter dopamine by blocking the action of the dopamine transporter (DAT). The only antidepressant in this class is Wellbutrin (bupropion hydrochloride). Wellbutrin is typically not typically used for anxiety, it is limited to treated depression and smoking cessation. Wellbutrin has fairly stimulating properties and does not cause many of the side effects of SSRIs and SNRIs.

Monoamine oxidase inhibitors (MAOIs) were the first antidepressants discovered, in the early 1950s. They are widely effective in a broad range of affective and anxiety disorders. They are also used in the treatment of Parkinsons Disease. MAOIs irreversibly block monoamine oxidase (MAO). MAO breaks down serotonin, norepinephrine, and dopamine. By inhibiting the break down of MAO, neurotransmitter levels are increased. MOAIs are not considered first-line treatment for depression because of the side effects, drug-drug interactions, and dietary restrictions. Patients on these medications must follow a low-tyramine diet. Examples include Nardil (phenelzine), Parnate (tranylcypromine), Eldepryl (selegiline), Azilect (rasagiline), Emsam (selegiline transdermal system), and Marplan (isocarboxazid).

Benzodiazepines often are used with antidepressants as adjunct treatment. They are especially useful in the management of acute situational anxiety disorder and adjustment disorder where the duration of pharmacotherapy is anticipated to be 6 weeks or less and for the rapid control of panic attacks. Long-term use of benzodiazepine use is ideally avoided but when it is indicated it can be associated with tolerance, addiction, and withdrawal. However, addiction is actually very uncommon although up to 25-30% of patients on long-term benzodiazepines do become physically dependent (which alone is not addiction). Benzodiazepines are also used to treat insomnia, convulsive disorders, for sedation, in anesthesia, for alcohol withdrawal, and many other conditions. Examples include Xanax (alprazolam), Ativan (lorazepam), Klonopin, Rivotril (clonazepam), Valium (diazepam), Serax (oxazepam), Librium (chlordiazepoxide), Restoril (temazepam), Halcion (triazolam), and Versed (midazolam).

Beta-blockers are primarily used for hypertension and none are approved to treat anxiety in either Canada or The United States, they may be useful for the circumscribed treatment of situational/performance anxiety on an as-needed basis. They may also be effective for certain forms of treatment resistant anxiety. However overall they are not very effective for treating anxiety disorders. Examples used to treat anxiety include Inderal (propranolol), Tenormin (atenolol), Lopressor (metoprolol tartrate), Corgard (nadolol), and Visken (pindolol).

One Response to “What are the different types of depression and anxiety meds?”

  • Mathieu says:

    SSRIs are the initial antidepressants of choice for uncomplicated depression because of their minimal anticholinergic effects. Many SSRIs are also approved to treat various anxiety disorders including generalized anxiety disorder, OCD, panic disorder, and social anxiety disorder.They have the advantage of ease of dosing and low toxicity in overdose. SSRIs are greatly preferred over the other classes of antidepressants for the treatment of children and adolescents, and these agents are also the first-line medications for late-onset depression, due to their superior tolerability and comparatively more benign safety profile. Because the adverse-effect profile of SSRIs is less prominent than other agents, improved compliance is promoted. Common adverse effects of SSRIs include gastrointestinal upset, sexual dysfunction, bleeding, emotional blunting, cognitive dysfunction, and changes in energy level (ie, fatigue, restlessness). Examples include Celexa (citalopram), Lexapro, Cipralex (escitalopram), Luvox (fluvoxamine), Paxil (paroxetine hydrochloride), Prozac (fluoxetine), and Zoloft (sertraline). SSRIs act on serotonin alone by inhibiting its reuptake therefore increasing serotonin levels resulting in increased binding at receptor sites.

    SNRIs can be used as first-line agents, particularly in patients with significant fatigue or pain syndromes associated with the episode of depression. The SNRIs also have an important role as second-line agents in patients who have not responded to SSRIs. SNRIs are also approved to treat various anxiety disorders. SNRIs act on serotonin and norepinephrine and increase their levels in much the same way SSRIs work. Examples include Cymbalta (duloxetine), Effexor (venlafaxine), Effexor XR (venlafaxine extended-release), and Pristiq (desvenlafaxine).

    A DRI is a type of drug that acts as a reuptake inhibitor for the neurotransmitter dopamine by blocking the action of the dopamine transporter (DAT). The only antidepressant in this class is Wellbutrin (bupropion hydrochloride). Wellbutrin is typically not typically used for anxiety, it is limited to treated depression and smoking cessation. Wellbutrin has fairly stimulating properties and does not cause many of the side effects of SSRIs and SNRIs.

    Monoamine oxidase inhibitors (MAOIs) were the first antidepressants discovered, in the early 1950s. They are widely effective in a broad range of affective and anxiety disorders. They are also used in the treatment of Parkinsons Disease. MAOIs irreversibly block monoamine oxidase (MAO). MAO breaks down serotonin, norepinephrine, and dopamine. By inhibiting the break down of MAO, neurotransmitter levels are increased. MOAIs are not considered first-line treatment for depression because of the side effects, drug-drug interactions, and dietary restrictions. Patients on these medications must follow a low-tyramine diet. Examples include Nardil (phenelzine), Parnate (tranylcypromine), Eldepryl (selegiline), Azilect (rasagiline), Emsam (selegiline transdermal system), and Marplan (isocarboxazid).

    Benzodiazepines often are used with antidepressants as adjunct treatment. They are especially useful in the management of acute situational anxiety disorder and adjustment disorder where the duration of pharmacotherapy is anticipated to be 6 weeks or less and for the rapid control of panic attacks. Long-term use of benzodiazepine use is ideally avoided but when it is indicated it can be associated with tolerance, addiction, and withdrawal. However, addiction is actually very uncommon although up to 25-30% of patients on long-term benzodiazepines do become physically dependent (which alone is not addiction). Benzodiazepines are also used to treat insomnia, convulsive disorders, for sedation, in anesthesia, for alcohol withdrawal, and many other conditions. Examples include Xanax (alprazolam), Ativan (lorazepam), Klonopin, Rivotril (clonazepam), Valium (diazepam), Serax (oxazepam), Librium (chlordiazepoxide), Restoril (temazepam), Halcion (triazolam), and Versed (midazolam).

    Beta-blockers are primarily used for hypertension and none are approved to treat anxiety in either Canada or The United States, they may be useful for the circumscribed treatment of situational/performance anxiety on an as-needed basis. They may also be effective for certain forms of treatment resistant anxiety. However overall they are not very effective for treating anxiety disorders. Examples used to treat anxiety include Inderal (propranolol), Tenormin (atenolol), Lopressor (metoprolol tartrate), Corgard (nadolol), and Visken (pindolol).
    References :
    M.D., C.M. psychiatry, internal medicine (Qu├ębec)
    Hons. BSc pharmacology

    Medscape Reference

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