Antidepressants: Uses, most common brand names, and safety information

Medically reviewed by  Jamie Winn, PharmD

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Depression is a serious mental health condition that is the leading cause of disability in Americans aged 15-44. It is the second leading cause of death in the same age group. Depression can affect your mood and make you feel sad, fatigued, and hopeless. It can also cause a change in your sleep, appetite, and concentration.

It is estimated that in 2020, 8.4% of all adults (21 million) in the U.S. had at least 1 major depressive episode. Females (10.5%) were more likely to have an episode than males (6.2%). Depression is a condition that too commonly goes untreated. Two-thirds of people with depression are undiagnosed or do not receive proper treatment. Without adequate treatment, depression can lead to suicidal thoughts and behaviors. In the U.S. alone, there is a death by suicide every 12 minutes. With proper treatment, 80% of patients showed improvements in symptoms within 4 to 6 weeks of beginning therapy.

The list below includes the best antidepressants approved by the U.S. Food and Drug Administration (FDA) and their pricing:

List of Antidepressants

What are antidepressants?

Antidepressant medications are a wide-ranging class of drugs used to treat various conditions such as major depression, bipolar disorder, post-traumatic stress disorder (PTSD), chronic pain, and obsessive-compulsive disorder (OCD). They are also used to manage withdrawal symptoms, anxiety disorders, and seasonal affective disorder.

There are numerous different types of antidepressants and each type has a unique way they work to relieve symptoms of the condition being treated. The major classes of antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), Zoloft (sertraline), and Lexapro (escitalopram)
• Serotonin/norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta (duloxetine), Effexor XR (venlafaxine), and Pristiq (desvenlafaxine).
• Tricyclic antidepressants (TCAs) such as Tofranil (imipramine), Pamelor (nortriptyline), and Elavil (amitriptyline).
• Monoamine oxidase inhibitors (MAOI) such as Emsam (selegiline), Parnate (tranylcypromine), Marplan (isocarboxazid), and Nardil (phenelzine). Avoid foods with high levels of tyramine (cheese, cured meats, wine) as they can cause a fatal hypertensive crisis.
• Atypical antidepressants such as Wellbutrin (bupropion), Remeron (mirtazapine), and Desyrel (trazodone).

Your doctor may combine an antidepressant with an atypical antipsychotic such as Abilify (aripiprazole) or Seroquel (quetiapine).

How do antidepressants work?

Antidepressants represent a large class of medications. Each class of antidepressants works differently to treat symptoms of depression and other conditions. Antidepressants generally work by increasing the levels of certain neurotransmitters such as serotonin, dopamine, and norepinephrine (noradrenaline) in your brain. Increased levels of these neurotransmitters are associated with improved mood and concentration. Neurotransmitters can also alter the way nerves send pain signals, which may explain how antidepressants help reduce chronic pain.

Antidepressants can take time to work. You may see some improvements in the first week of therapy but it can take up to 8 weeks before you see the full effects. They are typically given along with other medications and cognitive or talk therapy.

What conditions are antidepressants used to treat?

Antidepressants are a class of medications used in the treatment of depression and other conditions such as:

• Obsessive-compulsive disorder (OCD)
• Generalized anxiety disorder (GAD)
• Post-traumatic stress disorder (PTSD)
• Social anxiety disorder (SAD)
• Chronic pain
• Premenstrual dysphoric disorder
• Panic attacks
• Fibromyalgia
• Migraines
• Eating disorders such as bulimia

Are antidepressants safe?

When taken as prescribed, antidepressants are relatively safe and effective. Your prescribing physician should be aware of your medical conditions, including:

• Cardiovascular disease
• Having suicidal thoughts
• Bipolar disorder
• Liver disease
• Kidney disease
• Glaucoma
• Bleeding disorder
• Seizures
• Diabetes
• Low sodium levels
• Are pregnant or plan on becoming pregnant as they may cause fetal harm and/or death

You should also make sure they are aware of all the medications you take, including prescription drugs, over-the-counter medications, and supplements, as they may cause drug interactions:

• Antidepressants, narcotic analgesics, St. John’s wort, and other medications that increase serotonin
• Medications that increase the QTc interval
• Anticoagulants such as Coumadin (warfarin)

Can you take antidepressants while you are pregnant or breastfeeding?

Taking antidepressants may slightly increase the risk of adverse effects on the fetus. But untreated depression can increase your risk of preterm birth or cause low birth weight as well. While most doctors think it is generally acceptable to use antidepressants during pregnancy, they can have an effect on the infant. Almost 30% of infants who are born to mothers taking SSRIs will experience withdrawal symptoms such as irritability, jitteriness, tremors, sleep disturbances, and trouble breathing.

Antidepressants may be passed to your infant through your breast milk at high enough levels that they might experience side effects.

You should always discuss the risks and benefits of any medication you need with your doctor if you are pregnant, plan on becoming pregnant, or are breastfeeding.

What are the common side effects of antidepressants?

Each class of antidepressants will have its own side effects. The newer antidepressants tend to have fewer side effects than the older ones.

Some common adverse effects of antidepressants include:

• Nausea
• Diarrhea
• Dry mouth
• Blurred vision
• Weight gain
• Weight loss
• Vomiting
• Drowsiness
• Sexual dysfunction
• Insomnia
• Agitation
• Headache
• Dizziness

Antidepressants can sometimes cause rare, severe adverse effects, including:

• Serotonin syndrome
• Hyponatremia (low sodium levels)
• Suicidal thoughts and behaviors, especially in children and young adults under 25 years of age
• Hyperglycemia (elevated blood sugars)
• Increased blood pressure

This is not a complete list of side effects and we encourage you to consult with your healthcare professional for medical advice about any possible side effects.

How much do antidepressants cost?

Antidepressants are very expensive with an average cost of around $5,000 per year for the brand-name medications. There are lower-cost generic alternatives available.

You can purchase antidepressants for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.

Related resources for antidepressants

• https://nndc.org/facts/
• https://www.nimh.nih.gov/health/statistics/major-depression
• https://medlineplus.gov/antidepressants.html
• https://www.ncbi.nlm.nih.gov/books/NBK538182/
• https://www.medicinenet.com/depression/article.htm#what_treatments_are_available_for_depression
• https://www.healthline.com/health/depression/medication-list
• https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/antidepressant-medications
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428540/