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Atypical antidepressants
By Mayo Clinic staffAtypical antidepressants are called atypical because they don't fit into other classes of antidepressants. They are each unique medications that work in different ways from one another.
How atypical antidepressants work
Atypical antidepressants ease depression by affecting chemical messengers (neurotransmitters) used to communicate between brain cells. Most antidepressants work by changing the levels of one or more of these naturally occurring brain chemicals.
Like other types of antidepressants, atypical antidepressants affect neurotransmitters including dopamine (DOE-puh-mene), serotonin (ser-oh-TOE-nin) and norepinephrine (nor-ep-ih-NEF-rin). Changing the balance of these chemicals seems to help brain cells send and receive messages, which in turn boosts mood.
Atypical antidepressants approved to treat depression
Atypical antidepressants approved by the Food and Drug Administration to treat depression, with their generic names followed by brand names in parentheses, include:
- Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL)
- Mirtazapine (Remeron, Remeron SolTab)
- Nefazodone
- Trazodone (Oleptro)
Side effects of atypical antidepressants
Because each atypical antidepressant is unique, side effects and other characteristics of each one is different.
Bupropion can be a good choice for people who have low energy caused by depression. However, it causes or worsens anxiety in some people. It doesn't cause sexual side effects or weight gain as a number of other antidepressants do, and is sometimes prescribed to counter sexual side effects of another antidepressant. Bupropion may be a good antidepressant choice if you're trying to quit smoking. It's sometimes prescribed to ease nicotine cravings under the brand name Zyban. Side effects can include:
- Anxiety, restlessness or agitation
- Confusion
- Constipation
- Dry mouth
- Headache
- Increased, irregular heartbeat
- Insomnia
- Nausea
- Sore throat
- Tremor
Mirtazapine is generally taken before bed because it can make you sleepy. Like bupropion, mirtazapine may help counter sexual side effects caused by another antidepressant. Side effects can include:
- Constipation
- Dizziness or lightheadedness
- Dry mouth
- Increased appetite
- Increased cholesterol
- Increased or decreased blood pressure
- Low white blood cell count
- Sleepiness
- Weakness
- Weight gain
Nefazodone may help ease anxiety as well as depression. Nefazodone can make you sleepy. It seems less likely to cause sexual side effects than do some other antidepressants. Side effects can include:
- Blurred vision
- Confusion
- Constipation
- Dizziness or lightheadedness
- Dry mouth
- Headache
- Low blood pressure
- Nausea
- Sleepiness
- Weakness
Trazodone is a weak antidepressant that causes sleepiness and can help with anxiety. Like mirtazapine, it's usually taken at bedtime. It may be prescribed along with other antidepressants to help with sleep. Side effects can include:
- Sleepiness
- Headache
- Dry mouth
- Dizziness or lightheadedness
- Nausea
- Fatigue
- Diarrhea
- Constipation
- Insomnia
- Low blood pressure
- Confusion
- Blurred vision
- Irregular heartbeat
(1 of 2)
- Schatzberg AF, et al. Antidepressants: Introduction. In: Schatzberg AF, et al. Manual of Clinical Psychopharmacology. 7th ed. Arlington, Va.: American Psychiatric Publishing; 2010. http://www.psychiatryonline.com/content.aspx?aID=600624. Accessed Oct. 5, 2010.
- Fava M, et al. Antidepressants. In: Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa.: Mosby; 2008. http://www.mdconsult.com/das/book/body/221513496-3/0/1657/421.html?tocnode=57543329&fromURL=421.html#4-u1.0-B978-0-323-04743-2..50045-7_1104. Accessed Oct. 5, 2010.
- Hirsch MH, et al. Antidepressant medication in adults: MAO inhibitors and others. http://www.uptodate.com/home/index.html. Accessed Oct. 5, 2010.
- Wellbutrin (prescribing information). Greenville, N.C.: http://us.gsk.com/products/assets/us_wellbutrin_tablets.pdf.
- Mirtazapine (prescribing information). Montville, N.J.: Barr Laboratories. http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=5558. Accessed Oct. 5, 2010.
- Nefazodone hydrochloride (prescribing information). Jacksonville, Fla.: Ranbaxy Pharmaceuticals; 2008. http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=9323. Accessed Oct. 5, 2010.
- Trazodone hydrochloride (prescribing information). Pomona, N.Y.: Barr Laboratories; 2008. http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=7039. Accessed Oct. 5, 2010.
- Wang BC, et al. Antidepressant use during pregnancy. In: Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. Philadelphia, Pa.: Mosby; 2008. http://www.mdconsult.com/das/book/body/224591431-3/0/1657/308.html?tocnode=57543024&fromURL=308.html#4-u1.0-B978-0-323-04743-2..50033-0--cesec3_799. Accessed Oct. 5, 2010.
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