Table 1. Commonly Prescribed Antidepressants in Primary Care
Generic NameUS Trade NameClass*Dosage FormsUsual FrequencyPregnancy Category†Breastfeeding Safety‡Generic AvailableRetail Available§Cost‖
AmitriptylineElavilTCATabletOnce a dayCNRYesYes$
BupropionWellbutrinNDRITabletThree times dailyCNRYesNo$$
Wellbutrin SRTwice a dayYesNo$$
Wellbutrin XLOnce a dayYesNo$$$
CitalopramCelexaSSRITablet, solutionOnce a dayCR:BYesYes$
DesvenlafaxinePristiqSNRITabletOnce a dayCNRNoNo$$$$
DuloxetineCymbaltaSNRICapsuleOnce a dayCNRNoNo$$$$
EscitalopramLexaproSSRITablet, solutionOnce a dayCR:BYesNo$$$
FluoxetineProzacSSRITablet, capsule, solutionOnce a dayCNRYesYes$
Prozac WeeklyCapsuleOnce a weekYesNo$$$
FluvoxamineLuvoxSSRITabletTwice a dayCR:BYesNo$$$
Luvox CRCapsuleOnce a dayNoNo$$$$
MilnacipranSavellaSNRITabletTwice a dayCNRNoNo$$$
MirtazapineRemeronNaSSATabletOnce a dayCR:BYesNo$
Remeron SolTabOral disintegrating tabletYesNo$$
Nefazodone**SerzoneSARITabletTwice a dayCNRYesNo$$
NortriptylinePamelorTCACapsule, solutionOnce a dayDNRYesYes$
ParoxetinePaxilSSRITablet, solutionOnce a dayDSafeYesYes$
Paxil CRTabletYesNo$$$
SertralineZoloftSSRITablet, solutionOnce a dayCSafeYesYes$
TrazodoneDesyrelSARITabletThree times dailyCR:BYesYes$
OleptroOnce a dayNoNo$$$
VenlafaxineEffexorSNRITabletTwice a dayCNRYesNo$$
Venlafaxine EROnce a dayYesNo$$$
Effexor XRCapsuleOnce a dayNoNo$$$$
Vilazodone††ViibrydSPARITabletOnce a dayCNRNoNo$$$$

  • ↵* TCA, tricyclic antidepressant; NDRI, norepinephrine dopamine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; SNRI, serotonin norepinephrine reuptake inhibitor; NaSSA, noradrenergic specific serotonergic antidepressant; SARI, serotonin antagonist reuptake inhibitor; SPARI, serotonin partial agonist reuptake inhibitor.

  • ↵† C, no adequate or well-controlled studies in humans; D, positive evidence of human fetal risk based on adverse reaction data or studies in humans.

  • ↵‡ NR, not recommended; R:B, weigh risk-benefit; safe, safe for nursing; based on Lexicomp Online Clinical Databases (http://online.lexi.com).

  • ↵§ Available for a low monthly cost through programs offered by large chain stores (e.g., Walmart, Kroger, Sam's Club, Target, Costco, CVS, Kmart, Walgreens).68

  • ↵‖ $ = <$50 per month; $$ = $50 to $100 per month; $$$ = $100 to $150 per month; $$$$ = >$150 per month; based on 2011 Consumer Reports Health Best Buy Drugs.68

  • ↵ In the United States, fluvoxamine is approved only for obsessive-compulsive disorder; milnacipran is approved only for fibromyalgia; both agents are used off-label to treat depression.19,24

  • ↵** Serzone, the brand name form of nefazodone, was discontinued in 2004 because of hepatotoxicity; generic nefazodone is available with a black box warning for liver failure.57

  • ↵†† Approved in 2011, vilazodone is the newest antidepressant in a novel therapeutic class; given that data is limited, it is not discussed in this article.