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MAOIs | AD Topic Index | Common and not-so common uses of Antidepressants

1.  What Does That Leave Us?

Finally we have the antidepressants that are in small classes, sometimes with a membership all their own, and accepted treatment options for depression that aren’t medications.

2.  Other Reuptake Inhibitors

While serotonin reuptake inhibitors (SSRIs) and serotonin & norepinephrine reuptake inhibitors (SNRIs) are the current standard for antidepressants, we also have the norepinephrine and dopamine reuptake inhibitor bupropion. It comes in several flavors:

There are some others under development, available only overseas, or used off-label to treat depression. These include:

  • Radafaxine - one of Wellbutrin’s active metabolites
  • Triple reuptake inhibitors (TRIs), like putting Lexapro and Wellbutrin in one pill. Unfortunately…
    • Just like Meridia (sibutramine), tesofensine works as well, if not better as an anti-obesity med. There’s a lot more money in obesity than depression.
    • Similarly bicifadine is testing well as an analgesic, so it might follow Savella’s (milnacipran) path as a pain treatment, where there’s still more money than there is in depression.
    • There are several other TRIs in the works, but they haven’t made it to the point where they have generic names. Like PRC200-SS.
  • There are also dopamine-selective reuptake inhibitors in the works, but I doubt any of them will see the light of day in the US.

3.  Serotonin Antagonist and Reuptake Inhibitors (SARIs)

An interesting and effective class of antidepressants that are unfortunately hampered by a couple of drawbacks. Serzone (nefazodone HCl) can make your liver explode, which is why you won’t find brand Serzone anywhere and few doctors will prescribe it. Trazodone, rarely, if ever, prescribed by brand, is almost always prescribed off-label as a sleep aid. It can be an effective antidepressant, but usually at its highest dosages. And when added to something else. And with that short half-life it would probably work better if taken three times a day, which most people can’t deal with.

4.  Antidepressant and Antipsychotic combinations

You can add Abilify to most modern antidepressants with the FDA’s blessing. Since depression is far more socially acceptable than bipolar disorder and schizophrenia, BMS is really pushing Abilify as an antidepressant. Symbyax is the most recent two-in-one pill, but the combination has been around for a long, long time.

  • Abilify (aripiprazole)
  • Etrafon/Triavil (amitriptyline HCl and perphenazine)
  • Symbyax (olanzapine and fluoxetine)
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5.  Everything else

5.1  Medications

  • Brintellix (vortioxetine) - the most atypical AD around.
  • Valdoxan (agomelatine)
  • Viibryd (vilazodone) - although Viibryd is really nothing more than a potent SSRI with the added bonus of being a partial 5-HT1A agonist. In English: It’s like taking Paxil and BuSpar.
  • Stablon (tianeptine) - technically not a medication in the US.

5.2  Not Medications

  • FDA-approved treatments for depression-spectrum disorders
    • Electroconvulsive therapy (ECT)
    • Repetitive Transcranial Magnetic Stimulation (rTMS)
    • Vagal Nerve Stimulator (VNS)
  • Non-drug treatments generally accepted to be effective in treating depression-spectrum disorders
    • Cognitive Behavioral Therapy (CBT) - the only form of talk therapy recognized by most psychopharmacologists and psychiatric researchers to be as effective as meds. While somewhat narrow-minded of them, at least there is a form of talk therapy that the psychiatric community says is as good as any drug, if not better than a few of them.
    • Lovaza (omega-3-acid ethyl esters) - AKA prescription-strength omega-3 fish oil. Treating depression is an off-label application, and practically everyone buys decent fish oil from a supplements retailer, so Lovaza itself is rarely used to treat depression. I have it here because for the PI sheet, with all of those side effects. As we’ve written all over this site, if something is going to work, it’s going to have side effects. 300–1,200 mg a day of the EPA component is generally accepted to be an effective antidepressant, either by itself for mild-to-moderate depression, or as an add-on for MDD and other serious depression-spectrum disorders.
    • S-Adenosyl methionine (SAM-e) another supplement recognized as being effective, although it’s not as accepted as EPA.
    • Light Therapy. This one is specific to seasonal affective depression.
      • Yes, there really is such a thing as Dark Therapy. Great for weirdos like me and my pharmacist, whose symptoms are worse during daylight hours; or who are more susceptible to depression and/or anxiety when there is more sunlight instead of less. Usually cheaper and more eco-friendly than Light Therapy.

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MAOIs | AD Topic Index | Common and not-so common uses of Antidepressants

Miscellaneous Treatment Options for Depression by Jerod Poore is copyright © 2010 Jerod Poore

Last modified on Friday, 15 April, 2016 at 20:19:49 by JerodPoorePage Author: Jerod PooreDate created: 26 November 2010

All drug names are the trademarks of someone else. Look on the appropriate PI sheets or ask Google who the owners are. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.

Page design and explanatory material by Jerod Poore, copyright © 2003 - 2016. All rights reserved.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, and 2016 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
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All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
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Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
Crazymeds now uses a secure server, but it is not so secure that you can discuss anything having to do with nuclear power facilities, air traffic control systems, aircraft navigation systems, weapons control systems, or any other system requiring failsafe operation whose failure could lead to injury, death or environmental damage. Just so you know. So if you’re mentally interesting and have a job that deals with that sort of thing, talk about said job elsewhere. Otherwise feel free to discuss your meds and brain cooties.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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