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Table of Contents
ATYPICAL ANTIDEPRESSANT COMPARISON
| Drug
|
Dose/day
|
Liver
Enzyme Inhibition*
|
Class
|
Common Adverse Effects |
Fluoxetine
(Prozac®)
|
10-80mg
|
CYP 2D6
(significant)
|
SSRI
|
Drowsiness
Dizziness
Hypotension,
GI Distress (>30%)
Headache
Dry Mouth
Tremor
Sexual dysfunction 30-50%
Weight gain (with chronic use)
(Fluvoxamine is most sedating SSRI)
|
Paroxetine
(Paxil®)
|
10-50mg
|
CYP 2D6
(significant)
|
Sertraline
(Zoloft®)
|
25-200mg
|
CYP 2C19 (weak)
|
| Fluvoxamine
(Luvox®)
|
50-300mg
|
CYP 1A2
(significant)
|
| Citalopram (Celexa®) |
10-60mg
|
Weak
(few drug interactions
|
| Nefazodone
(Serzone®)
|
100-600mg
in 2 doses
|
CPY
3A4**
(significant)
|
SARI
|
As per SSRI except
Sexual
dysfunction 10%
Minimal weight gain or tremor
|
| Venlafaxine
(Effexor®)
|
37.5-375mg
|
Weak
(few drug
interactions) |
SNRI
|
As per SSRI
except
Sexual dysfunction10-30%
Sweating Minimal weight gain or tremor |
| Bupropion
SR
(Wellbutrin SR®)
|
150-300mg
in 2 doses
|
CYP
2D6
(moderate)
|
NDRI
|
Dizziness,
Insomnia, GI distress, Constipation, Dry mouth, Tremor, Headache, Sexual
Dysfunction 10% (May promote weight loss) |
|
Mirtazapine (Remeron®)
|
15-45mg
|
Weak
(few drug
interactions) |
NaSSA
|
Sedation (>30%)
Dry Mouth, Constipation,
Weight gain (>4kg in 15% of patients)
(Less
nausea, sexual dysfunction and sweating compared to SSRIs) |
SSRI = selective serononin reuptake inhibitor; SARI =
serotonin 2 antagonist/reuptake inhibitor;
SNRI = serotonin norepinephrine reuptake inhibitor; NDRI = norepinephrine
dopamine reuptake inhibitor;
NaSSA = noradrenergic/specific serotonergic antidepressant
*Cytochrome p450 isoenzymes inhibited by drug
**multiple drug interactions via CYP 3A4 including grapefruit juice
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