Tricyclic antidepressants

Secondary amines: Nortriptyline, desimipramine and lofepramine

Tertiary amines: Amitriptyline, imipramine, trimipramine, chlorimipramine, dothiepine and butriptyline.

Monoamine oxidase inhibitors

Irreversible non-selective monoamine oxidase inhibitors: Tranylcypromine

MAO type A-Inhibitors: Moclobemide

MAO type B-Inhibitors: Selegiline(deprenil) and rasagiline

Selective serotonin re-uptake inhibitors(SSRIs)

Flouxetine, paroxetine, fluvoxamine, sertraline, citalopram and escitalopram

           Serotonin-Noradrenalin re-uptake inhibitors(SNRIs)

Venlafaxine and duloxetine 

Selective Noradrenalin re-uptake inhibitors(NARIs)

Reboxetine

Tetracyclic and unicyclic antidepressants

Tetracyclic: Mianserin and mirtazapine

Unicyclic: Bupropion

5-HT₂ modulators

Trazodone and vortioxetine

Circadian Rhythm regulators

Agomelatine

2. Most of them increase the concentration of 5-HT and NE.
3. It takes 3-5 weeks until Antidepressants target our DNA, in particular the genes that code for the serotonin transporter. They make these genes less active, so fewer serotonin transporter molecules are available in the brain and thus it takes longer for the clinical effect to be seen.
4. EFFICACY

TADs are serotonin-noradrenalin re-uptake inhibitors and thus they are less specific and less efficacious as antidepressants.

SSRIs are specific for the serotonin receptors and thus they are more efficacious as antidepressants.

SIDE EFFECTS

TADs

H1 blockade leads to sedation and weight gain. Sympathomimetic effects e.g tachycardia and agitation. Anticholinergic effects such as blurred vision and constipation. Cardiovascular effects such as orthostatic hypotension. Psychosis and mania as well as convulsions.

SSRIs

Insomnia, tremors, GIT disturbances, headache, decreased libido, sexual dysfunction, anxiety(acute) and withdrawal syndrome.

SAFETY

The side effect profile of TADs is very severe and broad and thus TADs are relatively unsafe. SSRIs are relatively safe based on their side effect profile with certain doses and only become unsafe at excessively high doses or when used with drugs like MAOIs.

5. -    Mirtazepine blocks the alpha-2, 5-HT_2A, and the 5-HT₃ receptors. Mirtazepine also blocks the H₁ and the alpha-1 receptors.

• Venlafaxine inhibits NE and 5-HT re-uptake
• Agomelatine is an agonist on the MT1/MT2 receptors and an antagonist on the 5-HT_2C receptors.