“What is the most dangerous antidepressant?”
I am a 32 year old male. I want to know what is the most dangerous antidepressant?
2 Answers
Although other classes can also be dangerous, generally the monoamine oxidase inhibitors (MAOIs) are regarded as the most dangerous class of antidepressants given their numerous, and potentially lethal, drug-drug and even drug-food interactions.
There are three major classes of antidepressants plus a couple of other drugs that don't fit into those classes. And some physicians prescribe drugs for depression that aren't antidepressants at all and may make depression worse. Briefly, the three classes are:
1. SRI (serotonin reuptake inhibitors) antidepressants are the safest and most commonly used. They work by increasing the amount of serotonin in the brain. They have relatively few side effects. Some can upset your stomach. Many can affect sexual function. Weight gain can be a problem, especially with the more sedating members of this class.
2. SNRI (serotonin-norepinephrine reuptake inhibitors) are very similar SRIs, but also increase norepinephrine levels in the brain. The major difference is SNRIs can reduce chronic pain, sometimes dramatically so.
3. Tricyclic antidepressants are an older class of antidepressants that are less often used because of risks and side effects. This class includes imipramine, amitriptyline, doxepin, nortriptyline, and desipramine. They are often highly effective at helping chronic pain or irritable bowel syndrome. They must be used cautiously or not at all in patients over age 65. This is the riskiest class of antidepressants, but I wouldn't call them "dangerous" if used properly. But I'd avoid prescribing them for simple depression.
Antidepressants not in these three classes include Remeron (mirtazipine) and Wellbutrin (bupropion). Both work well and are relatively safe, but each has its potential side effects. Warning: do NOT take benzodiazepines for depression, i.e., drugs like Valium, Ativan, or Xanax, and any antidepressant must be used cautiously in the elderly, although usually SRIs work well. Finally, there's a widespread impression that antidepressants are **DRUGS** that must be avoided at all costs. Wrong!! If you're really depressed, you won't be able to "snap out of it" just with willpower alone. And it's common for people who've been taking them for a few weeks to decide they no longer need them and stop taking them. Boom! The depression comes back with a vengeance.
1. SRI (serotonin reuptake inhibitors) antidepressants are the safest and most commonly used. They work by increasing the amount of serotonin in the brain. They have relatively few side effects. Some can upset your stomach. Many can affect sexual function. Weight gain can be a problem, especially with the more sedating members of this class.
2. SNRI (serotonin-norepinephrine reuptake inhibitors) are very similar SRIs, but also increase norepinephrine levels in the brain. The major difference is SNRIs can reduce chronic pain, sometimes dramatically so.
3. Tricyclic antidepressants are an older class of antidepressants that are less often used because of risks and side effects. This class includes imipramine, amitriptyline, doxepin, nortriptyline, and desipramine. They are often highly effective at helping chronic pain or irritable bowel syndrome. They must be used cautiously or not at all in patients over age 65. This is the riskiest class of antidepressants, but I wouldn't call them "dangerous" if used properly. But I'd avoid prescribing them for simple depression.
Antidepressants not in these three classes include Remeron (mirtazipine) and Wellbutrin (bupropion). Both work well and are relatively safe, but each has its potential side effects. Warning: do NOT take benzodiazepines for depression, i.e., drugs like Valium, Ativan, or Xanax, and any antidepressant must be used cautiously in the elderly, although usually SRIs work well. Finally, there's a widespread impression that antidepressants are **DRUGS** that must be avoided at all costs. Wrong!! If you're really depressed, you won't be able to "snap out of it" just with willpower alone. And it's common for people who've been taking them for a few weeks to decide they no longer need them and stop taking them. Boom! The depression comes back with a vengeance.
