5 types of antidepressants
Understanding your options for depression and anxiety treatment.
Key takeaways
- Antidepressants work by balancing neurotransmitters like serotonin and norepinephrine in your brain, which affect mood and emotions.
- The five main classes of antidepressants include SSRIs, SNRIs, Tricyclic antidepressants, MAOIs, and atypical antidepressants.
- Finding the right antidepressant may take time. Most people with depression notice improvement within a few weeks.
- Common side effects of antidepressants, like nausea or sleep changes, usually ease as your body adjusts.
- Nurx can evaluate your symptoms online, prescribe appropriate antidepressant medication when suitable, and deliver treatment to your door.
If you’re dealing with depression or an anxiety disorder, you’ve likely heard about antidepressants. But with so many different types of antidepressants available, it can feel a little overwhelming to know where to start—and whether or not these are even a good choice for your symptoms.
Fortunately, you don’t need to figure this out alone. Understanding the common types of antidepressants (and how they work) can help you have a more informed conversation with your provider about what might work best for you and your mental health.
Nurx offers prescription treatment for anxiety and depression for as little as $0 in copays or $25 per month without insurance.
What do antidepressants do?
Antidepressants help restore balance to the chemicals in your brain that regulate mood, sleep, and emotional well-being.
They don’t create artificial happiness or change who you are. Instead, they work by increasing the availability of neurotransmitters—chemical messengers that help brain cells communicate.
When depression or anxiety strikes, this communication system can get disrupted. Messages about feeling good, having energy, or enjoying life don’t get through the way they should. Antidepressants help these neurotransmitters, particularly serotonin and norepinephrine, stay active longer between nerve cells, gradually lifting mood and easing symptoms of depression.
How do antidepressants work?
Your brain cells communicate by releasing neurotransmitters into tiny gaps called synapses. Normally, these chemicals get reabsorbed quickly after delivering their message.
Antidepressants work by blocking this reabsorption, allowing mood-regulating chemicals to remain active longer.
Antidepressants usually take a few weeks to start working—typically a few weeks for full effects.
Some improvements in sleep or energy may appear sooner, so it’s important to take antidepressants consistently and stay in touch with your provider during this adjustment period.
5 common types of antidepressants explained
There are several different types of antidepressants, each working through slightly different mechanisms.
Here’s a breakdown of the main classes in simple terms.
1. SSRIs: Selective serotonin reuptake inhibitors
Selective serotonin reuptake inhibitors, or SSRIs, are the most commonly prescribed type of antidepressant and are often the first choice for depression treatment.
They are considered first-line treatments because they tend to be easier to tolerate than older medications.
They work by increasing serotonin levels in your brain—often called the “feel-good” chemical.
Your provider might recommend an SSRI if you’re dealing with depression, anxiety disorders, PMDD, or postpartum depression.
Popular options
Common SSRIs include sertraline (generic Zoloft®), fluoxetine (generic Prozac®), escitalopram (generic Lexapro®), and citalopram (generic Celexa®).
Side effects to watch for
While many people adjust well to SSRIs, some potential side effects may include:
- Nausea, vomiting, or digestive upset
- Headaches or dizziness
- Drowsiness or trouble sleeping (insomnia)
- Sexual side effects, such as lower libido or difficulty reaching orgasm
- Dry mouth
- Increased sweating or feeling agitated
2. SNRIs: Serotonin and norepinephrine reuptake inhibitors
SNRIs boost both serotonin and norepinephrine levels, providing a dual-action approach to treat depression and anxiety. The addition of norepinephrine can provide extra benefits for energy and focus.
These are often excellent alternatives if SSRIs alone haven’t given you the relief you need, and they can be particularly helpful if you have chronic pain alongside depression.
Popular options
Common SNRIs include venlafaxine XR capsule (generic Effexor®), duloxetine capsule (generic Cymbalta®), and desvenlafaxine capsule (generic Pristiq®).
Side effects to watch for
Because they work similarly to SSRIs, they share some side effects, but you might also experience:
- Nausea (especially when starting)
- Dry mouth and excessive sweating
- Dizziness or headaches
- Increases in blood pressure or heart rate
- Insomnia or fatigue
- Constipation
3. Tricyclic antidepressants
Tricyclic antidepressants are older medications named for their three-ring chemical structure. While they can be very effective, they affect multiple neurotransmitter systems at once.
This means they tend to come with more side effects than the newer options.
They are typically prescribed when other medications haven’t worked, or for specific issues like migraines or nerve pain.
Popular options
Medications like amitriptyline pill (generic Elavil®) and nortriptyline pill (generic Pamelor®) are frequently used options in this class.
Side effects to watch for
Tricyclics require a bit more monitoring than newer drugs. Potential side effects include:
- Dry mouth and blurred vision
- Constipation or urinary retention
- Drowsiness or dizziness, especially when standing up (orthostatic hypotension)
- Weight gain
- Heart rhythm changes (arrhythmias) or increased heart rate
4. MAOIs: Monoamine oxidase inhibitors
Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressants. They work by blocking an enzyme that breaks down serotonin, norepinephrine, and dopamine.
While effective for treatment-resistant depression, they are rarely a first choice today because they require strict dietary changes.
You have to avoid foods high in tyramine (like aged cheeses and cured meats) to prevent dangerous blood pressure spikes.
Popular options
Common MAOIs include phenelzine (Nardil®) and tranylcypromine (Parnate®). Nurx does not prescribe MAOIs. Please discuss with your primary care provider or psychiatrist to determine if MAOIs are appropriate for you.
Side effects to watch for
In addition to the need for dietary caution, side effects may include:
- Dizziness or lightheadedness
- Sleepiness or trouble sleeping
- Dry mouth, nausea, or upset stomach
- Weight gain
- Muscle cramps or jerks
- Hypotension (low blood pressure)
Nurx providers do not prescribe phenelzine (Nardil®) and tranylcypromine (Parnate®). If you think an MAOI may be appropriate for you, a primary care provider or psychiatrist can help evaluate your options and determine the best treatment for your needs.
5. Atypical antidepressants
Atypical antidepressants don’t fit neatly into the other boxes but offer valuable alternatives depending on your specific symptoms.
For example, some are energizing while others help with sleep, giving you and your provider more ways to tailor your treatment.
Popular options
- Bupropion pill (generic Wellbutrin®) affects dopamine and norepinephrine, making it a great option if you want to avoid sexual side effects.
- Trazodone pill (generic Desyrel®) is often used to help with sleep.
- Mirtazapine pill (generic Remeron®) can be helpful if you need to stimulate your appetite or improve sleep.
Side effects to watch for
Side effects vary quite a bit depending on which medication you take:
- For bupropion: May cause anxiety, dry mouth, insomnia, or headaches.
- For trazodone: Commonly causes significant drowsiness, dizziness, and dry mouth.
- For mirtazapine: Often causes increased appetite, weight gain, and sleepiness/sedation.
Antidepressant comparison chart
If you are just starting your research, this chart breaks down the key differences between the major classes of antidepressants to help you understand which options might align best with your symptoms and lifestyle.
| Drug class | Best suited for | Common trade-offs |
| SSRIs | First-time treatment. Often, the first choice for general depression and anxiety due to safety and tolerability. | Can cause lower libido or sexual difficulties. May cause initial nausea or jitteriness. |
| SNRIs | Fatigue or pain. Good for those who need more energy or focus, or have chronic pain conditions. | May increase blood pressure or heart rate. Sweating and dry mouth are common. |
| Atypicals | Avoiding sexual side effects. Often chosen to avoid sexual dysfunction common with other types. | Can cause anxiety or insomnia due to stimulating effects. Not for those with a seizure history. |
| Tricyclics (TCAs) | Pain & migraines. Typically reserved for cases involving nerve pain or migraine prevention. | Higher risk of drowsiness, weight gain, and dry mouth compared to newer drugs. |
| MAOIs | Resistant depression. Used when other treatments haven’t worked. | Requires a strict diet (low tyramine) to avoid dangerous blood pressure spikes. |
Serious side effects to watch for with an antidepressant drug
Although rare, some serious side effects require immediate attention, including signs of serotonin syndrome (agitation, rapid heartbeat, high temperature) or thoughts of self-harm.
Antidepressants carry a black box warning about an increased risk of suicidal thoughts in young people, particularly when first starting treatment. This is why regular check-ins with your provider matter, especially early on.
If you experience side effects that bother you, talk to your Nurx provider. They can adjust your dose or switch to a different antidepressant to help find what works for you.
Which antidepressant may be right for you?
Finding the right antidepressant involves several factors unique to your situation. Your provider will consider your specific symptoms, medical history, other health conditions, and previous treatment responses.
Some people prioritize avoiding certain possible side effects based on their lifestyle, while others prefer medications that also address co-occurring symptoms like insomnia.
Although antidepressants can help many people with depression, they work differently for different people—what’s effective for one person may not be the best fit for another.
If one antidepressant doesn’t help, there are many antidepressant options to explore.
Which antidepressants are considered first-line treatments for depression?
For patients diagnosed with depression, SSRIs are often the first medication prescribed.
According to the NHS, SSRIs are the most commonly used antidepressants because they cause side effects less frequently.
Antidepressants usually take a few weeks to show full benefit, so patience is important. If SSRIs don’t provide adequate relief, your Nurx provider may recommend trying an SNRI or another medication.
How to take antidepressants safely
When you take antidepressants, consistency matters. Take your medication at the same time daily. Never stop taking an antidepressant suddenly, as coming off antidepressants abruptly can cause withdrawal symptoms.
Always work with your provider if you want to stop or adjust your treatment.
Certain substances can interact with antidepressants. Alcohol can worsen depression symptoms and amplify medication effects.
Talk to your pharmacist about any concerns before starting new supplements or medications.
Can you get prescribed antidepressants online?
With Nurx, you can connect with a licensed provider from home, complete a comprehensive evaluation, and have antidepressant medication delivered to your door.
Your provider will create a personalized treatment plan and check in regularly. You can message the medical team anytime with questions.
If one antidepressant isn’t the right fit, your provider can discuss other options available through Nurx, including SNRIs, bupropion, and trazodone.
Take the next step for your mental health
Understanding the different types of antidepressants empowers you to make informed decisions about your care.
Whether SSRIs, SNRIs, or atypical antidepressants are right for you, effective treatment exists, and finding it takes patience and communication with your provider.
Start your online mental health evaluation with Nurx today!
Frequently asked questions (FAQs):
What are the top 10 antidepressant drugs?
The most commonly prescribed antidepressants include SSRIs like sertraline (Zoloft®), escitalopram (generic Lexapro®), fluoxetine (generic Prozac®), and citalopram (generic Celexa®), which are often first-line treatments due to fewer side effects. SNRIs such as duloxetine (generic Cymbalta®) and venlafaxine (generic Effexor®) also rank highly, along with atypical antidepressants like bupropion (generic Wellbutrin®), mirtazapine (generic Remeron®), trazodone (generic Desyrel®), and tranylcypromine (generic Parnate®).
What are the four classes of antidepressants?
The four main antidepressant classes are: selective serotonin reuptake inhibitors (SSRIs), which are the most widely prescribed; serotonin-norepinephrine reuptake inhibitors (SNRIs); tricyclic antidepressants (TCAs), an older class with more side effects; and monoamine oxidase inhibitors (MAOIs), now rarely used due to dietary restrictions.
What are the main types of antidepressants in simple terms?
The main types include SSRIs (boost serotonin), SNRIs (boost serotonin and norepinephrine), tricyclic antidepressants, MAOIs, and atypical antidepressants. SSRIs like sertraline and fluoxetine are typically first-line options because they’re effective with fewer side effects.
Can antidepressants cause migraines?
Yes, some antidepressants can trigger or worsen migraines, especially when starting treatment. Bupropion and certain SSRIs like escitalopram have shown higher associations with headaches initially. However, these same medications can sometimes help prevent migraines long-term once your body adjusts. If you experience migraines while on antidepressants, don’t stop your medication abruptly. Instead, connect with your healthcare provider to discuss adjusting your dose or switching medications.
How long do antidepressants take to work?
Antidepressants usually take a few weeks to show their full effect. You may notice small improvements in sleep and appetite within the first 1–2 weeks, while mood and interest take 4–6 weeks for most people. Keep taking your medication consistently and stay in touch with your provider during this time.
What are the common side effects by medication class?
SSRIs commonly cause nausea, sexual side effects, and insomnia, though these often improve after the first few weeks. SNRIs share similar effects but may also cause increased blood pressure and sweating. Tricyclics typically cause more bothersome side effects like dry mouth, constipation, and drowsiness. Atypical antidepressants vary in terms of side effects.
Are SSRIs first-line treatments, and how can I get evaluated?
SSRIs are indeed often prescribed as first-line treatments for depression and anxiety because they’re effective with generally manageable side effects. Online healthcare platforms like Nurx can evaluate your symptoms through detailed medical consultations, reviewing your health history to determine if antidepressants are appropriate.
What are the three most widely used depressants?
The three most commonly used depressants (substances that slow down the central nervous system) are alcohol, benzodiazepines, and GHB. It’s important to note that these “depressants” are different from antidepressants. Depressants slow brain activity, while antidepressants are medications that treat depression.
The information provided is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon this content for medical advice. If you have any questions or concerns, please talk to a medical professional. Nurx does not provide talk therapy or crisis management. If you’re experiencing a mental health crisis, please call 911 or go to your nearest emergency department.
Services not offered in every state. Medications prescribed only if clinically appropriate, based on completion of the required consultation. Individual results may vary.
Amitriptyline HCl tablets (10mg, 25mg, 50mg, 75mg, 100mg, & 150mg), Rx only, treats depression. Amitriptyline HCl may cause side effects, including fatigue, constipation, dry mouth, dry eyes, bleeding. If you would like to learn more ,see full prescribing information, here.
Bupropion HCl SR tablets (100mg, 150mg, & 200mg), Rx only, treats depression, seasonal affective disorder, and smoking cessation. Bupropion may also cause side effects including but not limited to nausea, constipation, headache, and dry mouth. Serious side effects may include increased risk of suicidal thoughts, hepatic dysfunction, and decreased seizure threshold. If you would like to learn more, see full prescribing information, here. Nurx providers screen for a history of seizures or eating disorders (like bulimia) before prescribing Bupropion, as these increase the risk.
Citalopram tablets (10mg, 20mg, & 40mg), Rx only, treats depression. Citalopram may also cause side effects including but not limited to nausea, diarrhea, drowsiness, dry mouth, sexual problems. If you would like to learn more, see full prescribing information, here.
Desvenlafaxine ER tablets (25mg, 50mg, & 100mg), Rx only, treats major depressive disorder. Desvenlafaxine ER may also cause side effects including but not limited to nausea, sweating, constipation, dizziness, and weight or appetite changes. If you would like to learn more, see full prescribing information, here.
Duloxetine DR capsules (20mg, 30mg, 40mg, & 60mg), Rx only, treats major depressive disorder, neuropathic pain associated with diabetic peripheral neuropathy, generalized anxiety disorder, fibromyalgia and chronic musculoskeletal pain. Duloxetine DR may also cause side effects including but not limited to nausea, dry mouth, drowsiness, headache, fatigue, weight loss. If you would like to learn more, see full prescribing information, here.
Escitalopram tablets (5mg, 10mg, & 20mg), Rx only, treats major depressive disorder. Escitalopram may cause side effects including but not limited to nausea, diarrhea, fatigue, headache, sexual problems, sleep problems. If you would like to learn more, see full prescribing information, here.
Fluoxetine tablets (10mg, 20mg, 40mg, 60mg), Rx only, treats depression and anxiety. This drug may cause side effects, including but not limited to nausea, diarrhea, dry mouth, headaches, decreased appetite, sexual problems. If you would like to learn more, see full prescribing information, here.
Mirtazapine tablets (7.5mg, 15mg, 30mg, 45mg), Rx only, treats major depressive disorder and panic disorder. This drug may cause side effects, including but not limited to drowsiness, constipation, dry mouth, weigh gain. If you would like to learn more, see full prescribing information, here.
Nortriptyline HCl capsules (10mg, 25mg, 50mg, 75mg), Rx only, treats depression. This drug may cause side effects, including but not limited to constipation, dry mouth, blurred vision, dizziness, drowsiness, low blood pressure. If you would like to learn more, see full prescribing information, here.
Sertraline HCl tablets (25mg, 50mg, 100mg), Rx only, treats depression, panic disorder, social anxiety disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and obsessive compulsive disorder (OCD. This drug may cause side effects, including but not limited to diarrhea, nausea, dry mouth, dizziness, drowsiness, fatigue, sleep problems, sexual problems. If you would like to learn more, see full prescribing information, here.
Trazodone HCl tablets (50mg, 100mg, 150mg, 300mg), Rx only, treats depression and insomnia. This drug may cause side effects, including but not limited to dizziness, drowsiness, nausea, dry mouth, headache, fatigue, blurred vision. If you would like to learn more, see full prescribing information, here.
Venlafaxine HCl ER capsules (37.5mg, 75mg, 150mg), Rx only, treats depression and anxiety. This drug may cause side effects, including but not limited to dizziness, drowsiness, insomnia, dry mouth, sweating, decreased appetite. If you would like to learn more, see full prescribing information, here.
Not all options discussed in the blog are available through Nurx. Please see Nurx.com for details. All product names, manufacturer or distributor names, logos, trademarks, and registered marks (“Product Marks”) are the property of their owners and are for identification purposes only. Product Marks do not imply any affiliation, endorsement, connection, or sponsorship by their owner(s) with Nurx.
