Anti-depressant medications have short term and long-term side effects. While the short term side effects are annoying (dry mouth, dizziness, nausea, headache are common), the long term side effects are of greater concern (weight gain, insulin resistance, sexual dysfunction) because they can lead to additional problems such as diabetes, osteoporosis, heart disease and relationship problems. In recognition of this fact, I wrote the Antidepressant Survival Guide and Program (Crown Publishing). Using the The Center for Whole Psychiatry + Brain Recovery approach, medication can often be avoided, reduced or at the least made more effective. As a result of this approach, the side effects are reduced and the long-term consequences of these medications can be avoided, even if they have to be used.
Table: The Antidepressant Medications (listed alphabetically)
| Brand Name (Generic Name) | Daily Dosage | Side Effects* | Special Uses/ Risks ** |
|---|---|---|---|
| Anafranil (Clomipramine) | 25-75mg 3x/day with food | A, B, c | D, O, Bld; possibly P, M,C |
| Cymbalta (duloxetine) | 20-100mg | B, t, n, h | D, Anx, C, ,P |
| Deseryl (trazodone) | 25- 600 mg/day | a, b, c | D, Anx, SP, M, C |
| Effexor (venlafaxine) | 25mg-125mg 3x/day with food | N, T, h, i, a, b | D, Anx, P May be useful in AD/HD Active in serotonin and norepinephrine systems. |
| Elavil (amitriptyline) | 25-300 mg/day | A, B, C | D, U, M, C, Bld |
| Ludiomil (maprotiline) | 25-225 mg/day | a, b, c | D, must raise dose slowly |
| Luvox (fluvoxamine) | 25-150mg 2x/day | a, b, h ,n | O, probably P, C, D |
| Nardil (phenelzine) | 15-105 mg/day | a, b, c | D, AD/HD, P, SP, Anx, C (MAO Inhibitor) |
| Norpramin (desipramine) | 25-350 mg/day | A, b, c | D, AD/HD, Bld |
| Pamelor (nortriptyline) | 25-150 mg/day | A, b, c | D, Bld (therapeutic window-level must be in specified range) |
| Parnate (tranylcypromine) | 10-90 mg/day | a, c | D–energizing; dietary restrictions (MAO Inhibitor) |
| Paxil (paroxetine) | 5-20 mg/day | a, b, n | D; probably O, SP, SOM, C, M |
| Pristiq | 50 mg | A, b, C, N | Active metabolite of Effexor-see above |
| Prozac (fluoxetine) | 5-80 mg/day | b, n | D; O, PMS |
| Serzone | 100-300 mg twice daily | N, a, b, c | Soon to be approved. Fewer sexual side effects. D, possibly Anx. |
| Seroquel (quetiapine) | 25-800mg | B, c | For Bipolar Depression |
| Sinequan (doxepin) | 25-300mg/day | A, B, C | D, Anx, Bld, U, C, SOM |
| Surmontil (trimipramine) | 75-150 mg/day | A, B, C | D, Anx. |
| Tofranil (imipramine) | 25-300 mg/day | A, B, C | D, AD/HD, P, Anx, Bld; possibly useful in O, SP, SOM |
| Vivactil (protriptyline) | 5-15mg 3x per day | A, c | D–Energizing; tolerated in patients with sleep apnea |
| Wellbutrin | 75-450 mg/day in divided doses | a | D, AD/HD;no weight gain; increased risk of seizures in certain populations. |
| Zoloft | 25-200 mg/day | b | D; possibly useful in O, Anx, S, C |
Key
Upper case – significant effect; Lower case – minor effect
- A, a – Dry Mouth, Constipation, Blurry Vision.
- B, b – Sedation
- C, c – Dizziness on Standing
- N, n – Nausea
- H, h – Headache
- I, i – Insomnia
- T, t – Hypertension
- D – Depression
- AD/HD – Attention Deficit Disorder
- Anx – Anxiety
- Bld – Monitoring of the level of medication in the patient’s blood is necessary.
- C – Chronic Pain
- M – Migraine
- O – Obsessive Compulsive Disorder
- P – Panic Disorder
- SP – Social Phobia
- U – Ulcers
- SOM – Somatization Disorder