Who ranks for “major depressive disorder medication”

Doctors commonly prescribe Selective Serotonin Reuptake Inhibitors (SSRIs) as the first medical treatment for major depressive disorder (MDD) because they generally cause fewer side effects than other options.

Antidepressants work by balancing natural chemicals in your brain that affect your mood and energy. It can take several weeks for these medicines to start working.

Main Medication Classes

1. SSRIs (Selective Serotonin Reuptake Inhibitors)

How they work: They increase the amount of serotonin, a brain chemical that helps control mood. Common examples:Sertraline (Zoloft) Fluoxetine (Prozac) Escitalopram (Lexapro) Citalopram (Celexa) Sertraline (Zoloft) Fluoxetine (Prozac) Escitalopram (Lexapro) Citalopram (Celexa)

2. SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)

How they work: They increase levels of two brain chemicals: serotonin and norepinephrine (which relates to the body's energy and stress response). Common examples:Venlafaxine (Effexor XR) Duloxetine (Cymbalta) Desvenlafaxine (Pristiq) Venlafaxine (Effexor XR) Duloxetine (Cymbalta) Desvenlafaxine (Pristiq)

3. Atypical Antidepressants

How they work: These medications do not fit into the other standard groups, but they still affect brain chemistry differently. Common examples:Bupropion (Wellbutrin) Mirtazapine (Remeron) Bupropion (Wellbutrin) Mirtazapine (Remeron)

4. Other or Older Types

Tricyclic Antidepressants (TCAs): Older medications like amitriptyline and nortriptyline. Doctors rarely use them first because they cause more side effects. Monoamine Oxidase Inhibitors (MAOIs): Older drugs like phenelzine (Nardil). Doctors only use these if other medicines fail, because they require strict food and drug rules.

Add-on Medications

If a single antidepressant does not help enough, a doctor may add a second medicine, such as a mood stabilizer or an add-on antipsychotic medicine like aripiprazole (Abilify) or quetiapine (Seroquel XR).