Class |
Examples |
Major adverse effects |
Selective serotonin reuptake inhibitors (SSRIs) (considered second generation) |
Citalopram Escitalopram Fluoxetine Paroxetine Sertraline |
Suicidal ideation, CNS, GI upset, weight gain, sexual dysfunction, hyponatremia, serotonin syndrome, bleeding risk (especially when combined with NSAIDs) |
Fluvoxamine (considered second generation) |
(belongs to SSRI class but is less commonly used for depression) |
SSRI adverse effects ± palpitations, tachycardia, malaise, sedation |
Serotonin-norepinephrine reuptake inhibitors (SNRIs) (considered second generation) |
Desvenlafaxine Duloxetine Venlafaxine |
GI, weight gain, CNS, sexual dysfunction, dermatologic |
Noradrenergic and specific serotonergic antidepressants (NaSSAs) (considered second generation) |
Mirtazapine |
Increased appetite, weight gain, postural hypotension, drowsiness |
Bupropion (considered second generation) |
GI, CNS, dermatologic | |
Tricyclic antidepressants (TCAs) (considered first generation) |
Amitriptyline Desipramine Imipramine Nortriptyline |
Arrhythmias, CNS, sedation, anticholinergic, endocrine, hyponatremia, GI, weight gain; high lethality with overdose |
Reversible inhibitors of monoamine oxidase A (RIMAs) (considered second generation) |
Moclobemide |
Sleep disturbances, CNS, GI, dermatologic |
Monoamine oxidase inhibitor (MAOI) (considered first generation) |
Phenelzine |
Postural hypotension, sleep disturbances, CNS, GI, fetal malformations; can cause hypertensive crisis when combined with certain foods and medications, in particular other antidepressants (eg, during tapering course) |
CNS, central nervous system; GI, gastrointestinal tract; NSAID, nonsteroidal anti-inflammatory drug. |