Medication for Depression and Anxiety
| Generic Name | Trade Name | Available Forms | Dosing | Duration | Peak Effect | FDA Indication | Side Effects | Comments |
|---|---|---|---|---|---|---|---|---|
| citalopram | Celexa | Tablets:10, 20, 40 mg Solution: 10mg/5ml |
Starting with 10mg every morning Dose range: 10-40mg daily |
24 hours | 4-6 weeks | MDD (A) | Common: nausea, dry mouth, somnolence, insomnia, tremor, ejaculatory dysfunction, dyspepsia, decreased libido Serious: seretonin syndrome, increased suicidality, worsening depression, mania |
Good side effect profile. Does not usually cause |
| escitalopram | Lexapro | Tablets:5, 10, 20 mg Solution: 5mg/5ml |
Starting with 5mg (or less) every morning Dose range: 5-40mg daily |
24 hours | 4-6 weeks | MDD (12-17 yo) & GAD (A) | " " | S-isomer of citalopram |
| fluvoxamine | Luvox | Tablets:25, 50, 100 mg | Starting with 25mg at bedtime; doses above 50mg should be divided Dose Range:50-300mg daily |
24 hours | 4-6 weeks | OCD (Child & Adolescent) | " " | Luvox brand discontinued in US |
| paroxetine | Paxil / Paxil CR | Tablets:10, 20, 30, 40 mg Solution: 10mg/ CR tab:12.5, 25, 37.5 mg ER |
Starting with 10mg (12.5mg if CR) daily. (may be given at night) Dose range: 10-50mg (12.5-37.5mg if CR)daily |
24 hours | 4-6 weeks | Paxil: MDD, OCD, panic, SAD, GAD, PTSD(A) Paxil CR: MDD, panic, PMDD (premenstrual), SAD(A) |
" " | Increased risk of withdrawal symptoms if discontinued abruptly |
| fluoxetine | Prozac | Tablets:10, 20, 40 mg Solution: 20mg/5ml |
8-11 yo: Start 5-10mg every morning 12 and older: Start 10mg every morning Dose range: 5-20mg in children under 12 yo and 5-40mg (to 80 in some cases) in children over 12 yo |
24 hours | 4-6 weeks | MDD, OCD, Bulemia Nervosa, panic, PMDD (A) MDD (8-17 yo), OCD (7-17 yo) | " " | Weekly form available. Long half life prevents withdrawal symptoms if dose is missed/td> |
| sertraline | Zoloft | Tablets:25, 50, 100 mg Solution: 20mg/5ml |
Starting with 12.5mg per day Dose range: 50-200mg daily |
24 hours | 4-6 weeks | MDD, OCD, panic, PTSD, PMDD, SAD(A), OCD (6-17 yo) | " " | |
| venlafaxine | Effexor / Effexor XR | Tablets:25, 37.5, 50, 75, 100 mg XR capsules (extended release) 37.5, 75, 150 mg |
Starting with 75mg/day in divided doses; XR form can be used once daily Dose range: 75-225mg (225 mg max per FDA indications; however in adults max frequently up to 375mg) |
8-12 hours XR: 24 hours |
4-6 weeks | MDD (A) XR: MDD, GAD, Panic, SAD (A) | common: nausea, dry mouth, somnolence, insomnia, tremor, ejaculatory dysfunction, dyspepsia, decreased libido serious: seretonin syndrome, increased suicidality/worsening depression, mania, HTN, seizures |
monitor BP closely |
| duloxetine | Cymbalta | Capsules:20, 30, 60 mg | Starting dose 30mg/day for 2 weeks before considering and increase to 60mg Dose range: 30-120mg/day 7-17 yo Adults: 40-60 mg/day for MDD up to 120 for GAD |
24 hours | 4-6 weeks | MDD, diabetic neuropathy, GAD | common: nausea, dry mouth, somnolence, insomnia, tremor, ejaculatory dysfunction, dyspepsia, decreased libido, HTN serious: seretonin syndrome, increased suicidality/worsening depression, mania, hepatotoxicity, Steven-Johnson Syndrome, seizures |
|
| bupropion | Wellbutrin | Tablets: 75, 100 mg | Starting with 75mg given twice per day Dose range: 37.5-450mg/day in 2-3 divided doses |
12 hours | 4-6 weeks | MDD (A) | common:insomnia, irritability, dry mouth, headaches, stomach upset, agitation, muscle aches, appetite suppression and weight loss, constipation or diarrhea Less Common:Steven-Johnson Syndrome, erythema multiforme, seizures, mania, psychosis, increased heart rate, liver failure, severe hypertension, migraines, worsened depression, suicial thoughts |
|
| bupropion | Wellbutrin SR | Tablets: 100, 150 mg | Starting with 100mg PO QAM, increase 100 mg/day QWK, divide dose BID Max: 400 mg/day Info: avoid/minimize alcohol use; do not cut/crush/chew |
12-24 hours | 4-6 weeks | MDD (A) | " " | |
| bupropion | Wellbutrin XL | Tablets: 150, 300 mg | Start with 150 mg PO QAM, increase after 7 days to 300 mg/day Max: 450 mg/day Info: avoid/minimize alcohol use; do not cut/crush/chew |
24 hours | 4-6 weeks | MDD & SAD (A) | " " |