Fortunately, many medications are available to treat depression. These include:
- Other selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants
- Miscellaneous other antidepressants.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Prozac is an SSRI. SSRIs are usually quite effective at treating depression and usually do not have many serious side effects. They work by increasing the level of serotonin available for cells of the brain. In addition to Prozac, these medications include:
- Citalopram (Celexa®)
- Escitalopram (Lexapro®)
- Fluvoxamine (Luvox®, Luvox® CR)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®, Brisdelle™)
- Sertraline (Zoloft®).
Serotonin-Norepinephrine Reuptake Inhibitors
These antidepressants are similar to SSRIs, except that they also affect norepinephrine (another chemical in the brain). SNRIs used to treat depression include:
- Desvenlafaxine (Pristiq™)
- Duloxetine (Cymbalta®)
- Levomilnacipran (Fetzima™)
- Venlafaxine (Effexor®, Effexor XR®).
Milnacipran (Savella™) is an SNRI that is not approved for the treatment of depression, although it may be used off-label for this purpose.
Monoamine Oxidase Inhibitors (MAOIs)
Monoamine oxidase inhibitors are a class of older medications used for treating depression. There are many serious food and drug interactions with MAOIs. Because of this, these drugs are usually used only if other medications for depression have not been effective. Examples of MAOIs used as Prozac alternatives include:
- Isocarboxazid (Marplan®)
- Phenelzine (Nardil®)
- Selegiline (Eldepryl®, Emsam®, Zelapar®)
- Tranylcypromine (Parnate®).
Tricyclic antidepressants are another older class of antidepressants. Due to certain side effects, they are generally not recommended for elderly people. Medicines in this category include:
- Amitriptyline (Elavil®)
- Amoxapine (Asendin®)
- Clomipramine (Anafranil®)
- Desipramine (Norpramin®)
- Doxepin (Sinequan®)
- Imipramine (Tofranil®)
- Maprotiline (Ludiomil®)
- Nortriptyline (Pamelor®)
- Protriptyline (Vivactil®)
- Trimipramine (Surmontil®).
Several other antidepressants can be used as an alternative to Prozac, including:
- Bupropion (Aplenzin™, Budeprion SR®, Budeprion XL®, Buproban®, Forfivo™ XL, Wellbutrin®, Wellbutrin SR®, Wellbutrin XL®, Zyban®), a norepinephrine-dopamine reuptake inhibitor
- Mirtazapine (Remeron®)
- Nefazodone (Serzone®)
- Trazodone (Desyrel®) or trazodone ER (Oleptro™)
Sometimes, stimulant medications such as methylphenidate (Ritalin®) are used to treat depression when other medications have not helped, although stimulants are not approved for this use.