Thursday 18 May, 2006

Two minute overview of antidepressants

Posted in Emergency Dept., General Practice, May Su, Psychiatry, Wards at 17:59 by May Su

Original article by: May Su :: Printer friendly

Happy pills…

The most commonly used antidepressants are the SSRIs (selective serotonin re-uptake inhibitors), venlafaxine and mirtazapine. These antidepressants are generally the first line agents. This is mainly because of their lower side effect profile and safety in overdose.

TCAs are dangerous in overdose, with severe anticholingeric effects, confusion, and significant cardiac toxicity with tachycardia and conduction abnormalities. However you may still find older patients or resistant patients on these medications. They are also used commonly as an adjunct for chronic pain conditions.

MAOI are more rarely prescribed due to stringent dietary restrictions (anything with tyramine – “the good stuff” such as wine, chocolate and cheese). Usually they are prescribed in patients with severe depression where other antidepressants have been used unsuccessfully. Although RIMAs are much better tolerated, they are not usually first line therapy and have been found to be relatively less effective as antidepressants.

Antidepressants and their trade names available in Australia:


  1. Ann James said,

    I am on 20mg lexapro the last 5 years and starting to have more frequent episodes of anxiety, really worried about switching to something else and still be able to work. What’s the short amount of time to switch to another drup

  2. Terri said,

    I am taking 150mg of venlafaxine and am switching to 20mg of lexapro. My doc wean me off the venlafaxine by just having me take the same dose but every other day for 2 weeks and take the lexapro (starting with just 10mg) every that I don’t take the venlafaxine. Is this acceptable? Please answer with a yes or no and why. Thank you:)

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