There are other antidepressants that do not fall into the three classes we have described. These are:
Effexor resembles the SSRIs, although it inhibits reuptake of both norepinephrine and serotonin. It has some of the same relatively mild side effects of TCAs and SSRIs. In drug trials, a small percentage of people stopped taking Effexor because of nausea, sleepiness or dizziness.
Trazodone inhibits serotonin reuptake, but it's chemically different from the SSRIs. It causes fewer side effects, such as cardiac difficulties, than the TCAs. Because it's extremely sedating, it's more appropriate for people whose depressive symptoms include agitation. One major drawback is that it's been known to cause priapism, or a painful, prolonged erection, that, in about one-third of the cases reported, has required surgical intervention.
Buproprion is believed to inhibit the reuptake of dopamine as well as serotonin and norepinephrine. It can cause seizures in people who are bulimic, have had head trauma or have a personal or family history of seizure disorders. The more common side effects include agitation, headache, nausea, vomiting, constipation, tremor and dry mouth.
Buproprion doesn't have the TCAs' sedating effect-in fact, it's been associated with insomnia-and it's been prescribed for people who don't respond to TCAs. It is often prescribed for people who have recurrent depressions with hypomania (mild manic depression).
Lithium carbonate, which is the drug commonly used for manic-depression, is
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