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          Depression MedicinesWomen's Health Topics Depression Medicines
  
  					From the FDA Office of Women's Health
	
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Do you feel depressed? Do not feel ashamed or alone. Women are more likely than men to feel depressed, although it is a major problem for both sexes.

**There is hope.**

Depression can be treated with medicine or counseling. Sometimes both are used. Talk to your healthcare provider to find out what will work best for you.

Use the following information to help you talk to your healthcare provider about medicines called **antidepressants**that can help treat depression. The medicine charts list FDA-approved products that are available to treat this condition. You will also find some general information to help you use your medicine wisely. Ask your healthcare provider to tell you about the risks of taking this type of medicine. The information provided only covers some of the risks. Also, it is important to tell your healthcare provider about any medicine that you are taking.

Signs of Depression

Everyone feels sad at times. People with **depression** feel sad most days. These feelings can get in the way of everyday life.
If you are depressed, you may:

Feel sad
	Feel tired all the time
	Sleep too little or all the time
	Cry a lot
	Lose interest in eating
	Eat too much
	Have trouble paying attention
	Feel nervous or cranky
	Think about death or trying to kill yourself
	Notice that things that used to make you happy do not make you happy anymore**Talk to your healthcare provider about your feelings if you have noticed these signs for at least 2 weeks or immediately if you have any dangerous thoughts or behaviors. Only your healthcare provider or counselor can tell you if you have depression.**

Depression and Pregnancy

Some women become depressed when they are pregnant or after they give birth. Other women notice that their depression gets worse during pregnancy.

No one knows the exact cause of depression during or after pregnancy. It may have something to do with:

Stress and sleep problems
	Hormones - after a woman has a baby, her hormone levels drop quickly
	Having depression before you get pregnant
	Lack of support from family and friends
	Young age – the younger you are when you have your baby the more likely you are to become depressed**Women should talk to their healthcare provider about the risks of taking antidepressants during pregnancy and after the baby’s birth.**

Depression can make it hard for a woman to take care of herself and her baby. It is important to talk to your healthcare provider about your feelings. Also, try to get some help from your family, friends, or a support group.

Ask a relative to watch your baby for a few hours.
	Join a group for new mothers.
	Ask a friend to cook a meal for your family or to help with chores.
 “The Baby Blues”

Having a baby can be a joyful time. However, some women cry a lot and feel sad right after they have a baby. This is called “the baby blues.” These feelings usually go away after about two weeks.

If you still feel sad after two weeks, go to your healthcare provider or clinic. You may be depressed. This type of depression is called **postpartum depression** because it starts after a woman has a baby. A woman can have this kind of depression up to one year after she has a baby.

Pregnancy Registry Main Image

Sign Up for a Pregnancy Registry

Pregnancy Exposure Registries are research studies that collect information from women who take prescription medicines or vaccines during pregnancy.

Pregnancy registries can help women and their doctors learn more about how depression medicines affect women during pregnancy.

The FDA does not run pregnancy studies, but it keeps a list of registries. **Check to see if there is a registry for your depression medicine or other medicines at: www.fda.gov/pregnancyregistries**

Medicine for Depression

There are different kinds of medicine for depression.

Selective Serotonin Reuptake Inhibitors (SSRI)
	Serotonin and Norepinephrine Reuptake Inhibitors (SNRI)
	Tricyclic and Tetracyclic Antidepressants
	Atypical Antidepressants
	Monoamine Oxidase Inhibitors (MAOIs)
	N-methyl D-aspartate (NMDA) Antagonist
	Neuroactive Steroid Gamma-Aminobutyric Acid (GABA)-A Receptor Positive ModulatorRead the following information to find out some general facts about the different kinds of medicine for depression.

Like all drugs, depression medicine may cause side effects. **Do not stop taking your medicine without first talking to your healthcare provider.** Tell your healthcare provider about any problems you are having, including thoughts about suicide. Your healthcare provider will help you find the medicine that is best for you.
  
Tell your healthcare provider about any medicine that you are taking. Do not forget about cold medicines, supplements, and herbals like St. John’s Wort. Some of these can interact with antidepressants and cause unwanted side effects.

Orderor Downloadour Free Medicine Record Keeper.

**Questions To Ask Your Healthcare Provider**

What medicine am I taking?
	What are the potential side effects?
	What other prescription medicine should I avoid while taking medicine for depression?
	What foods, herbs (like St. John’s Wort), or over-the-counter medicine should I avoid?
	When should I take each medicine?
	How many times per day do I take each medicine?
	Can I take my medicine if I am pregnant or nursing?Selective Serotonin Reuptake Inhibitors (SSRIs)

**Generic Name**
			**Brand Name**Celexa
			citalopramLexapro
			escitalopramPaxil, Paxil CR, Pexeva
			paroxetineProzac, Prozac Weekly
			fluoxetineTrintellix
			vortioxetineViibryd
			vilazodoneZoloft
			sertraline

**Warnings**

Do not take with these medicines: Monoamine Oxidase Inhibitors (MAOIs), and in some cases thioridazine or Orap (pimozide).
	Women should talk to their healthcare providers about the risks of taking these medicines during pregnancy.
	Use with caution if you have narrow-angle glaucoma.**Common Side Effects**

Nausea
	Tremor (shaking)
	Nervousness
	Problems sleeping
	Sexual problems
	Sweating
	Agitation
	Feeling tired**Less Common, but Serious, Side Effects**

Seizures
	Abnormal bleeding or bruising
	Withdrawal symptomsAsk your healthcare provider about **serotonin syndrome**.

For up-to-date information about the risks and side effects for each drug, check Drugs@FDA

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

**Brand Name**
			**Generic Name**Cymbalta
			duloxetineEffexor, Effexor XR
			venlafaxineFetzima
			levomilnacipranPristiq, Khedezla
			desvenlafaxine

**Warnings**

Do not take with MAOIs.
	Use with care if you have liver or kidney problems.
	Use with caution if you have narrow-angle glaucoma.**Common Side Effects**

Nausea
	Vomiting
	Dry mouth
	Constipation
	Fatigue
	Feeling drowsy
	Dizziness
	Sweating
	Sexual problems**Less Common, but Serious, Side Effects**

Increase in blood pressure
	Abnormal bleeding or bruising
	SeizuresAsk your healthcare provider about serotonin syndrome.

For up-to-date information about the risks and side effects for each drug, check Drugs@FDA

Tricyclic and Tetracyclic Antidepressants

**Brand Name**
			**Generic Name**Asendin
			amoxapineElavil
			amitriptylineLudiomil
			maprotiline*Norpramin
			desipraminePamelor
			nortriptylineSinequan
			doxepinSurmontil
			trimipramineTofranil
			imipramineVivactil
			protriptyline

**This is a tetracyclic. The others listed are tricyclic*.

**Warnings**

Do not take with MAOIs.
	Use with caution if you have narrow-angle glaucoma.**Common Side Effects**

Dry mouth
	Constipation
	Blurred vision
	Drowsiness
	Low blood pressure**Less Common, but Serious, Side Effects**

Problems urinating
	Confusion
	Fainting
	Seizures
	Life-threatening irregular heartbeatFor up-to-date information about the risks and side effects for each drug, check Drugs@FDA

Atypical Antidepressants

**Brand Name**
			**Generic Name**Desyrel
			trazodoneSerzone
			nefazodone

**Warnings**

Do not take with MAOIs, and, for nefazodone, if you are taking triazolam, alprazolam, pimozide, or carbamazepine.
	Cases of life-threatening liver failure have been reported in patients taking nefazodone.  Patients should be advised to be alert for signs and symptoms of liver dysfunction (jaundice, anorexia, gastrointestinal complaints, malaise, etc.) and to report them to their healthcare provider immediately if they occur.
	Use caution if you drink alcohol or take barbiturates while taking this medicine.**Common Side Effects**

Dry mouth
	Dizziness
	Blurred vision
	Feeling drowsy or sleepy
	Constipation**Less Common, but Serious, Side Effects**

Painful erection that lasts a long time
	Low blood pressure
	Fainting
	Confusion
	Liver failureFor up-to-date information about the risks and side effects for each drug, check Drugs@FDA

Atypical Antidepressants

**Brand Name**
			**Generic Name**Remeron
			mirtazapine

**Warnings**

Do not take with MAOIs.
	Use caution if you have a personal history or family history of heart disease or irregular heart rhythm.**Common Side Effects**

Feeling drowsy or sleepy
	Weight gain
	Dizziness**Less Common, but Serious, Side Effects**

Agranulocytosis (drop in white blood cell count)
	Increase in cholesterol
	Increase in liver enzymesAsk your healthcare provider about Serotonin Syndrome.

For up-to-date information about the risks and side effects for each drug, check Drugs@FDA

Atypical Antidepressants

**Brand Name**
			**Generic Name**Wellbutrin, Wellbutrin SR, Wellbutrin XL
			bupropion

**Warnings**

Use caution if you drink alcohol while taking this medicine.
	Use caution if you take levodopa.
	Use caution if you have seizures or take medicines that raise your chance of having a seizure.**Common Side Effects**

Dizziness
	Constipation
	Nausea
	Vomiting
	Blurred vision**Less Common, but Serious, Side Effects**

Seizures
	Blood pressure changesFor up-to-date information about the risks and side effects for each drug, check Drugs@FDA

Monoamine Oxidase Inhibitors (MAOIs)

**Brand Name**
			**Generic Name**Emsam (Skin Patch)
			selegilineMarplan
			isocarboxzaidNardil
			phenelzineParnate
			tranylcypromine

**Warnings**

Do not take MAOIs if you are also taking other medicines for depression or central nervous system stimulants or depressants.
	Do not eat certain foods like cheese, wine, protein foods that have been aged, or any food containing tyramine.
	Do not take cold pills or decongestants.**Common Side Effects**

Nausea
	Restlessness
	Problems sleeping
	Dizziness
	Drowsiness**Less Common, but Serious, Side Effects**

Headache
	Stroke
	Fainting
	Heart palpitations
	Blood pressure changesFor up-to-date information about the risks and side effects for each drug, check Drugs@FDA

N-methyl D-aspartate (NMDA) Antagonist

**Brand Name**
			**Generic Name**Spravato (nasal spray)
			esketamine

**Important Information:**

Esketamine must be taken with an oral antidepressant.
	Esketamine should be used only in patients who have tried other depression medicines that did not work for them.
	Patients may experience sedation (tiredness) and dissociation (difficulty with attention, judgment, and thinking) after administration.
	Because of these risks, esketamine is available only through a restricted program, called the Spravato REMS.
	Esketamine is a nasal spray that must be administered in a healthcare setting that is certified in the REMS program where the healthcare provider can monitor the patient for sedation and dissociation for two hours after each dose.**Warnings:**

Risk for temporary sedation (tiredness) and dissociation (difficulty with attention, judgment, and thinking) after administration.
	Esketamine is a federal controlled substance and has the potential to be misused and abused.
	May cause temporary difficulty with attention, judgment, thinking, reaction speed, and motor skills.
	Do not drive or operate machinery until the next day after a restful sleep.
	May harm an unborn baby. Patients should talk to their healthcare provider about the risks of taking this medicine during pregnancy.**Common Side Effects:**

Dissociation (difficulty with attention, judgment, and thinking))
	Dizziness
	Nausea
	Sleepiness
	Spinning sensation
	Decreased feeling or sensitivity
	Anxiety**Less Common, but Serious, Side Effects:**

Increase in blood pressureFor up-to-date information about the risks and side effects for each drug, check Drugs@FDA

Neuroactive Steroid Gamma-Aminobutyric Acid (GABA)-A Receptor Positive Modulator

**Brand Name**
			**Generic Name**Zulresso (This medicine is given as an intravenous infusion.)
			brexanolone

**Important Information:**

Brexanolone is approved for the treatment of postpartum depression (PPD) in adults.
	Brexanolone is given by continuous intravenous (IV) infusion over a total of 60 hours.
	Patients may experience excessive tiredness or sudden loss of consciousness or changes in their state of consciousness while brexanolone is being given.
	Because of these risks, brexanolone is available only through a restricted program called the Zulresso REMS. It can only be administered in a healthcare facility that is certified in the Zulresso REMS.
	Patients must be monitored while brexanolone is being given and report any signs and symptoms of excessive tiredness to a healthcare provider.
	Before starting brexanolone, tell your healthcare provider if you may be pregnant.**Warnings**:

Risk for sedation (tiredness) and sudden loss of consciousness.
	Brexanolone is a federal controlled substance and has the potential to be misused and abused.
	Taking brexanolone with opioids or certain other medicines called CNS depressants may increase the risks of tiredness or sudden loss of consciousness.
	Risk for suicidal thoughts and behaviors
	Brexanolone can be abused or lead to dependence.**Common Side Effects:**

Sedation (tiredness)
	Dry mouth
	Loss of consciousness
	Flushing**Less Common, but Serious, Side Effects:**

Suicidal thoughts and behaviorsDepression and Your Children

Like adults, children and teens can also feel depressed. You should watch your children for signs of depression. Talk to your children if you notice changes in their behavior. Talk to your child’s healthcare provider if you are still concerned.

Prozac (fluoxetine) is the only medicine that is approved by FDA for use in children with depression. Prozac (fluoxetine) and Lexapro (escitalopram) are the only FDA-approved medicines for teens with depression. Talk to your healthcare provider about important warnings for children and teens who take medicine for depression.

**Important Warnings**

**Some children and teens who take antidepressants may be more likely to think about hurting or killing themselves when starting treatment or when dose is changed.**

Call a healthcare provider or 911 if the person:

Tries to hurt or kill himself/herself
	Talks about specific ways they plan to hurt or kill himself/herself
	Talks about or tries to harm others**Call your healthcare provider right away if the person shows any of these signs:**

Talks about dying or suicide
	Starts acting very differently
	Is abnormally active
	Has severe problems sleeping
	Becomes violent or abnormally angry
	Becomes agitated or can't sit still

**Depression medicines and information is current as of September 2019. For the most up-to-date information about the risks and side effects of medicines for treatment of Depression, please see Drugs@FDA**


**To Learn More:**

National Institute of Mental Health (NIMH)
Web: www.nimh.nih.gov
Phone: 1-866-615-6464
TTY/TDD: 1-866-415-8051

Resources For You

Depression/HHS Office of Women's Health
	Free Publications For Women
	Women's Health Topics
	Office of Women's Health
	An Invitation to Collaborate

                                                                                  Content current as of:
      11/18/2019
              
              
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