Options Other Than Doxepin
Many forms of psychotherapy, including some short-term therapies (10 to 20 weeks), can help people with depression. "Talk" therapies help patients gain insight into (and resolve) their problems through verbal exchange with the therapist and are sometimes combined with "homework" assignments between sessions. Behavioral therapists help patients learn how to obtain more satisfaction through their own actions and how to unlearn the behavioral patterns that contribute to or result from their depression.
Fortunately, there are many medications available to treat depression. These medications include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Monoamine oxidase inhibitors (MAOIs)
- Other tricyclic antidepressants
- Miscellaneous other antidepressants.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are usually very effective in treating depression and usually do not have many serious side effects. They work by increasing the level of serotonin available for cells of the brain. These antidepressant medications include:
- Citalopram (Celexa®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Fluvoxamine (Luvox®, Luvox® CR)
- Paroxetine (Paxil®, Paxil CR®, Pexeva™, Brisdelle™)
- Sertraline (Zoloft®).
Serotonin-Norepinephrine Reuptake Inhibitors
These antidepressants are very similar to SSRIs, except that they also affect norepinephrine (another chemical in the brain). SNRIs used to treat depression include:
- Desvenlafaxine (Pristiq™)
- Duloxetine (Cymbalta®)
- Levomilnacipran (Fetzima™)
- Venlafaxine (Effexor®, Effexor XR®).
Milnacipran (Savella™) is an SNRI that is not approved for the treatment of depression (although it may be used off-label for this purpose).
Monoamine Oxidase Inhibitors (MAOIs)
Monoamine oxidase inhibitors are a class of older medications used for treating depression. There are many serious food and drug interactions with MAOIs. Because of this, MAOIs are usually used only if other medications for depression have not been effective. Examples of MAOI types of depression medication include:
- Isocarboxazid (Marplan®)
- Phenelzine (Nardil®)
- Selegiline (Eldepryl®, Emsam®, Zelapar®)
- Tranylcypromine (Parnate®).
Tricyclic antidepressants are another older class of antidepressants. Doxepin is a tricyclic antidepressant. Due to certain side effects, this type of drug is generally not recommended for elderly people. In addition to doxepin, tricyclic types of depression medicine include:
- Amitriptyline (Elavil®)
- Amoxapine (Asendin®)
- Clomipramine (Anafranil®)
- Desipramine (Norpramin®)
- Imipramine (Tofranil®, Tofranil PM®)
- Maprotiline (Ludiomil®)
- Nortriptyline (Pamelor®)
- Protriptyline (Vivactil®)
- Trimipramine (Surmontil®).
There are several other antidepressants available, including:
- Bupropion (Aplenzin™, Budeprion SR®, Budeprion XL®, Buproban®, Forfivo™ XL, Wellbutrin®, Wellbutrin SR®, Wellbutrin XL®, Zyban®), a norepinephrine-dopamine reuptake inhibitor
- Mirtazapine (Remeron®)
- Nefazodone (Serzone®)
- Trazodone (Desyrel®) or trazodone ER (Oleptro™)
Sometimes, stimulant medications such as methylphenidate (Ritalin®) are used to treat depression when other medications have not helped, although stimulants are not approved for this use.