Overview The seven available agents in the selective serotonin reuptake inhibitor class are citalopram (Lund-beck’s Cipramil, Forest Laboratories’ Celexa, generics) and its single enan-tiomer, escitalopram (Lundbeck’s Cipralex, Forest’s Lexapro); paroxetine (GSK’s Paxil/Seroxat, Novartis’s Frosinor, generics); the controlled-release version of paroxetine…
Depression
Triple Reuptake Inhibitors
Overview A novel mechanism for the treatment of depression that has attracted much attention is triple reuptake inhibition. Given their additional mechanism of action on dopamine, the triple reuptake inhibitors pose a potential threat to the clinical use and commercial…
Serotonin-Norepinephrine Reuptake Inhibitors
Overview Several antidepressants have dual action at both serotonergic and noradrenergic receptors. The most notable are the serotonin/norepinephrine reuptake inhibitors, particularly extended-release venlafaxine (Wyeth’s Effexor XR) and milnacipran (bioMerieux-Pierre Fabre’s Ixel/Dalcipran, Asahi Kasei/Janssen-Kyowa’s Toledomin; available only in France and Japan).…
Dopaminergic/Noradrenergic Agents
Overview Bupropion (GSK’s Wellbutrin/Wellbutrin XR) acts on the noradren-ergic and dopaminergic system by inhibiting reuptake of norepinephrine and dopamine. Because bupropion does not affect the serotonergic system, this drug has become a common alternative or adjunct therapy for patients unable…
Tricyclic Antidepressants
Overview tricyclic antidepressants entered the market in the 1960s after the Monoamine Oxidase Inhibitors but quickly lost their popularity when the selective serotonin reuptake inhibitors entered the market. Although tricyclic antidepressants are as effective as the selective serotonin reuptake inhibitors…
Minor Depression
Etiology and Pathophysiology Minor depression is only a proposed diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and there are no International Classification of Diseases codes to categorize it. The proposed diagnostic category for minor depression…