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Additional antidepressants for depression

These antidepressant medications do not fit well into any of the other medication categories. Like other medications they balance certain chemicals in the brain. When these chemicals are in proper balance, the symptoms of depression are relieved. In certain cases they may be as effective in treating depression as SSRIs.

Examples of these medications include:

  • bupropion hydrochloride (Wellbutrin)
  • mirtazapine (Remeron)
  • nefazodone hydrochloride (Serzone)
  • venlafaxine (Effexor)

There side effects are different from tricyclics/heterocyclics, or monoamine oxidase inhibitors (MAOIs). They have side effects similar to those of selective serotonin reuptake inhibitors (SSRIs). Sometimes certain SSRIs or other antidepressants can cause significant problems with sexual function and ability. When sexual dysfunction occurs, bupropion hydrochloride (Wellbutrin) may be prescribed instead to treat depression because it may be less likely to cause sexual dysfunction than other antidepressants (such as SSRIs).

The most common side effects of each of these medications include:

Bupropion possible side effects

  • Weight loss of more than 5 lbs.
  • Agitation, confusion, nervousness, and anxiety While rare, it is also possible that bupropion can cause other adverse affects, some of them serious, such as allergic reactions, dry mouth, headaches, heart palpitations, and seizures.

Mirtazapine possible side effects

  • Somnolence
  • Increased appetite
  • Weight gain
  • Dizziness

Nefazodone possible side effects

  • Dry mouth
  • Blurred vision
  • Constipation
  • Low blood pressure when standing Additional negative side effects of nefazodone are possible but rare. They include allergic reaction, nausea, ringing in the ears, headaches, insomnia, and possibly seizures.

Venlafaxine possible side effects

  • Constipation
  • Headaches
  • Weight loss
  • Dry mouth
  • Slight increase in cholesterol Other more serious side effects are rare but can include allergic reaction, fast heart rate, nausea, dizziness, anxiety, blurred vision, insomnia, increased blood pressure, and seizures.

When these medications are not used.

Bupropion

(Wellbutrin) should not be taken if you have had a previous allergic reaction to this medication or if you have taken a MAOI within the past two weeks (it may cause high blood pressure).

Nefazodone hydrochloride

(Serzone) should not be taken if you have had a previous allergic reaction to this medication. It should also not be used if you are taking an MAOI.

Venlafaxine

(Effexor) should not be taken if you have had an allergic reaction to this medication in the past or are currently taking an MAOI.

Additional facts about these medications.

  • These medications may take up to six weeks before they are effective in the treatment of depression.
  • These medications should not be used along with monoamine oxidase inhibitors (MAOIs) because serious, sometimes fatal, reactions can occur. To avoid serious reactions:
  • Wait at least 14 days after ending an MAOI treatment before beginning treatment with any one of these medications.
  • Wait at least 7 days after ending treatment with nefazodone or venlafaxine before beginning treatment with an MAOI.
  • Nefazodone should not be used along with:
    • Allergy medications (antihistamines) containing terfenadine (Seldane) and astemizole (Hismanal).
    • The antianxiety medication alprazolam (Xanax).