We now offer telemedicine Visits


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 DosageSide Effects*Special Uses/ Risks **
Anafranil
(Clomipramine)
25-75mg 3x/day with foodA, B, cD, O, Bld; possibly P, M,C
Cymbalta
(duloxetine)
20-100mgB, t, n, hD, Anx, C, ,P
Deseryl
(trazodone)
25- 600 mg/daya, b, cD, Anx, SP, M, C
Effexor
(venlafaxine)
25mg-125mg 3x/day with foodN, T, h, i, a, bD, Anx, P
May be useful in AD/HD
Active in serotonin and norepinephrine systems.
Elavil
(amitriptyline)
25-300 mg/dayA, B, CD, U, M, C, Bld
Ludiomil
(maprotiline)
25-225 mg/daya, b, cD, must raise dose slowly
Luvox
(fluvoxamine)
25-150mg 2x/daya, b, h ,nO, probably P, C, D
Nardil
(phenelzine)
15-105 mg/daya, b, cD, AD/HD, P, SP, Anx, C (MAO Inhibitor)
Norpramin
(desipramine)
25-350 mg/dayA, b, cD, AD/HD, Bld
Pamelor
(nortriptyline)
25-150 mg/dayA, b, cD, Bld (therapeutic window-level must be in specified range)
Parnate
(tranylcypromine)
10-90 mg/daya, cD–energizing; dietary restrictions (MAO Inhibitor)
Paxil
(paroxetine)
5-20 mg/daya, b, nD; probably O, SP, SOM, C, M
Pristiq50 mgA, b, C, NActive metabolite of Effexor-see above
Prozac
(fluoxetine)
5-80 mg/dayb, nD;  O, PMS
Serzone100-300 mg twice dailyN, a, b, cSoon to be approved. Fewer sexual side effects. D, possibly Anx.
Seroquel
(quetiapine)
25-800mgB, cFor Bipolar Depression
Sinequan
(doxepin)
25-300mg/dayA, B, CD, Anx, Bld, U, C, SOM
Surmontil
(trimipramine)
75-150 mg/dayA, B, CD, Anx.
Tofranil
(imipramine)
25-300 mg/dayA, B, CD, AD/HD, P, Anx, Bld; possibly useful in O, SP, SOM
Vivactil
(protriptyline)
5-15mg 3x per dayA, cD–Energizing; tolerated in patients with sleep apnea
Wellbutrin75-450 mg/day in divided dosesaD, AD/HD;no weight gain; increased risk of seizures in certain populations.
Zoloft25-200 mg/daybD; 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