Drugs for the Treatment of Depression

, stress and suicidal thoughts.

Depression can be the result of more or less serious pathologies (e.g. alcoholism, renal alterations, hypothyroidism and hyperparathyroidism, Hashimoto's disease, Alzheimer's and Parkinson's diseases, premenstrual syndrome, tumors), but often it is a consequence of psychological / emotional discomfort originating from work / sentimental disappointments, social isolation, stress, self-neglect.

, appearance of unexplained physical problems (back pain and headache), difficulty concentrating, insomnia / hypersomnia, lack of sexual desire, thoughts of death, loss of general interest, tendency to cry, sadness.

Below are some of the classes of drugs most used in therapy against depression; however, it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the type and severity of the disease, the state of health of the patient and his or her response to treatment.

Tricyclic antidepressants

Tricyclic antidepressants are useful for the treatment of medium and severe depression, possibly associated with physical pathologies. These drugs are not indicated for the treatment of mild acute depression. Still, tricyclics are widely used in therapy for depression associated with altered appetite, insomnia, hypersomnia and related disorders. Most of the time, the very first symptom of recovery is an improvement in the quality of sleep, clearly altered by depression.

Among the active ingredients belonging to this class that can be used, we remember:

L "amitriptyline;
The nortriptyline;
Clomipramine;
Dosulepin.

Selective Serotonin Reuptake Inhibitors

Selective serotonin reuptake inhibitors (SSRIs), whenever possible, are preferred over tricyclic antidepressants, as they have fewer side effects. In fact, SSRIs lack the cholinergic action, which is instead implicated in the manifestation of the secondary effects of tricyclics.

Among the active ingredients belonging to this class of antidepressants that can be used in therapy, we remember:

Fluoxetine;
Sertraline;
The citalopram;
L "escitalopram.

Noradrenaline and Dopamine Reuptake Inhibitors

Bupropion belongs to this class of drugs. It is a selective inhibitor of dopamine reuptake (DA) at the presynaptic level and also has a mild action against the reuptake of serotonin (5-HT) and noradrenaline (NA).

Serotonin and Noradrenaline Reuptake Inhibitors

These antidepressants work by inhibiting the reuptake of both serotonin and norepinephrine. Active ingredients such as duloxetine and venlafaxine belong to this class of drugs.

Monoamine Oxidase Inhibitors (MAOIs)

These antidepressants work by inhibiting the monoamine oxidase enzymes responsible for the metabolism of monoamines. Active ingredients such as tranicylpromin and moclobemide belong to this class of drugs. However, as of today (January 2021), in Italy, medicines containing these active ingredients are no longer marketed.

For further information: Antidepressant drugs