Table 1.
Classification, mechanisms of action, and side effects of antidepressant drugs.
| Classification | Mechanism of Action | Half-Life | Side Effects/Toxicity |
|---|---|---|---|
| SSRIs (Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline) |
SERT inhibition, enhancement of serotonergic transmission | 1–4 days | Cognitive impairment, nausea, prolonged QT interval, serotonin syndrome, sexual dysfunction, suicidal thoughts, xerostomia |
| SNRIs (Desvenlafaxine, Duloxetine, Levomilnacipran, Milnacipran, Venlafaxine) |
SERT and NET inhibition | 8–14 hours | Constipation, high diastolic blood pressure, nausea, serotonin syndrome, sexual dysfunction, suicidal thoughts |
| TCAs (Amitriptyline, Amoxapine, Clomipramine, Desipramine, Doxepin, Imipramine, Maprotiline, Nortriptyline, Protriptyline, Trimipramine) |
Inhibition of SERT, NET, α1, α2, M1 and H1 receptors. | 1–3 days | Blurred vision, constipation, orthostatic hypertension, seizures, sexual disfunction, suicidal thoughts, tachycardia, weight gain |
| MAOIs (Isocarboxazid, Phenelzine, Selegiline, Tranylcypromine) |
MAOA and MAOB inhibition, increase of 5-HT, histamine, DA, NE and epinephrine levels | 2–12 hours | Headache, insomnia, serotonin syndrome, sexual dysfunction, weight gain |
| Atypical Antidepressants (Bupropion, Mirtazapine, Trazodone, Vilazodone, Vortioxetine) |
DAT inhibition, antagonism of α1, 5-HT2 and 5-HT3 receptors | 1–3 days | Abnormal bleeding, agitation, dry mouth, headache, insomnia, nausea, seizures, sexual dysfunction |
SSRIs: selective serotonin reuptake inhibitors; SNRIs: serotonin-norepinephrine reuptake inhibitors; TCAs: tricyclic antidepressants; MAOIs: monoamine oxidase inhibitors; SERT: serotonin transporter; NET: norepinephrine transporter; DAT: dopamine transporter; MAO: monoamine oxidase; DA: dopamine; NE: norepinephrine, 5-HT: 5-hydroxytryptamine; M1: muscarinic acetylcholine receptor M1; H1: histamine receptor H1; α1: alpha-1 adrenergic receptor; α2: alpha-2 adrenergic receptors.