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Some common types of medications for depression:

• Monoamine oxidase inhibitors (MAOIs): these depression medications have been around for years. They aren’t used as often as the newer medications, but still have a place in the treatment of resistant depression. They are generally inexpensive as they are generic. There are new forms of these medications such as skin patches that are available as brand name drugs. The use of MAOIs requires dietary restrictions and overdose can be deadly. They interact with many over-the-counter preparations, causing dangerous increases in blood pressure. Reversible MAOIs are now available with less need for dietary restrictions and less concern for drug interactions.
• Tricyclic Antidepressants (TCAs): also older medications, useful for chronic pain management and to help with sleep. Sometimes these drugs are useful if the newer ones are unaffordable or cause too many side effects. Larger doses may cause significant sedation, heart arrhythmias and weight gain. They are generally inexpensive.
• Selective Serotonin Reuptake Inhibitors (SSRIs): newer depression medications that generally have fewer and less severe side effects. At this writing, all but one are available as generics. This makes them more affordable. Some can be effective for pain management. Main side effects include loss of sexual interest, and some cause weight gain.
• Serotonin-Norepinephrine Reuptake Inhibitors(SNRIs): These drugs seem to have the advantage of better anxiety management, and can be helpful in chronic pain There are two main medications in this category.
• Serotonin Dopamine Reuptake Inhibitors (SDRIs): Available as generic, unlikely to cause weight gain or sexual side effects, sometimes causes increased irritability.
• Other depression medications: there are other medications that are available that don’t fit into any of the above categories that are used in special situations.

Factors affecting the choice of depression medication:

• Age:Children, adults and elderly people all have unique metabolic responses to depression medication. Some medications are approved for adults, but not for children and adolescents. For this reason, it is important to consult someone with expertise in your age group. Dosing may vary by age group even if the drug is generally used across groups.
• Sex Some drugs act differently on women than on men. Research studies traditionally were done with male subjects, and only recently have women been studied separately. Results found with men will not necessarily be reproduced in women.
• Body size: Medication can be absorbed and distributed differently in the body depending on the amount of body fat. Overall weight may determine the amount of depression medication needed to get the desired effect.
• Body chemistry: Fluid and electrolyte balance, hormonal activity, and other differences in individual body chemistry affect the action of medications.
• Physical illnesses: Diabetes, cancer, high blood pressure and other physical conditions can impact the body’s response to medication.
• Medical treatments: Medications used for other illnesses, radiation therapy, acupuncture and other alternative treatments all need to be considered in the choice of antidepressant medication used.
• Diet, tobacco, alcohol and other substance use: Your prescriber needs to have information about your habits, diet and activity level in order to make an informed recommendation for depression medication.

Karen Grisham is a mental health nurse practitioner, maintaining a private practice since 1996. She has authored books on grief and suicide bereavement. She is owner of Comfort Your Heart, your online source for accurate and timely mental health information, suicide facts and support for survivors, and general grief support and encouragement.

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