|Group Main Use||Medication
|Form||Dose Schedule||Dose Range||Most Common Side Effects for Group||Pros for Group||Cautions for Group|
(depression booster, sleep, and appetite increase)
15, 30, 45mg
|Once a day, evening||Child:7.5-30 mg
Adult 15-45 mg
|Sedation, often increases appetite. May be less sedation at higher doses.||Less GI or sexual side effects than SRI group. Helps sleep, agitation and anxiety. Combination of Norepinephrine and serotonin boost. May boost other meds. Few interactions. No Routine labs or EKG. May help GI. Generic||As with all antidepressants, avoid combinations or overlap with MAOI. Same time onset as SRI or TCA.|
|Given 2-3 times a
Start in the a.m.
SR 1-2 times a day.
XL once a day
Aplenzin once a day
|No significant sexual side
effects. No labs or EKG needed. Very few interactions.
May help Attention Deficit Hyperactivity Disorder.
Good for boosting other meds.
Approved to help stop smoking.
|Avoid if personal seizure
history. Caution if family seizure history. Avoid if bulimia. Probably less effective than SRI for severe anxiety.
Same time onset as SRI and TCA and all other antidepressants.
50mg, 100mg, 150mg, 300mg
|Sedation significant especially with Trazodone. Dizziness.||Excellent sleep aid. Often used to help sleep along with SRI or Wellbutrin. Not habit forming. Inexpensive generic.||One in 10,000 risk of priapism. Trazodone relatively weaker antidepressant and anti-anxiety medication.|
Serotonin and Norepinephrine Inhibitors
(depression, anxiety, panic, OCD, pain)
Savella (fibromyalgia, depression)
25, 37.5, 75, 100 mg
XR (extended release)
37.5, 75, 150 mg
50, 100 mg
or 3 times a day
XR once a day
Adoles: 75-300 mg
Adult: 150-450 mg
50 - < 400 mg
|Similar to SRI plus a bit more night sweat and constipation sometimes.||
and other SNRI's
increase both serotonin and norepinephrine thus affecting two important
neurotransmitter systems, unlike SRI's. May be
broader spectrum effect because of two transmitters increased.
Same as Effexor. Research shows some benefit against pain. FDA approval of Cymbalta for pain is a plus.
risk increased blood pressure at doses over 200 mg total a day. (less than
Discontinuation syndrome (nausea, dizziness, "flu-ish," "out of sorts" may occur if stopped suddenly without taper or skip on or several days. Not dangerous, but unpleasant. More likely with Paxil or Effexor, not with Prozac because it lasts longer. Can occur with SRI, SNRI, or TCA.
Cymbalta rare liver injury especially if alcohol abuse.
|once or twice a day||30-120 mg usually 60 mg for adults||Similar to
SRI and Effexor above.
Tends to increase energy and weight neutral.
Savella is an SNRI like others and approved in Europe for depression, it
is FDA approved so far only for Fibromyalgia.
Fetzima is approved for depression, not fibromyalgia. These 2 emphasize norepinephrine more than serotonin.
Both are brand only.
Because it is an SNRI avoid use with an SRI or other SNRI.
These 2 SNRI meds are very similar to other 3.
Newer in US.
12.5, 25, 50, 100mg
20, 40, 80, 120mg
Usually twice a day
Once a day
12.5 to 200mg
100mg is adult usual dose after building up slowly.
|Like other SNRIs. Can affect liver or urine flow. Nausea and constipation are most common. Little weight effect if any.|
All these medications should be taken 7 days a week to be effective. Simultaneous use of alcohol or cigarettes and especially street drugs should be avoided. All antidepressants may increase mania risk in persons with Bipolar (manic-depressive) disorder. All medications should be avoided if possible in pregnancy. This chart is intended to be a summary guide, not a full and complete list.