The most common treatments for depression are medications and psychotherapy. Medications include three broad classes of antidepressant drugs:

• SSRIs: Selective serotonin reuptake inhibitors work by increasing the activity of a neurotransmitter called serotonin. These drugs are usually the first to be prescribed if depression is suspected because they have the least bothersome side-effects. They include fluoxetine (Prozac, Sarafem), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa) and escitalopram (Lexapro). Related dugs include the SNRIs — such as venlafaxine (Effexor) — that increase the activity of both serotonin and another neurotransmitter called norepinephrine; the NDRIs — such as Bupropion (Wellbutrin) — which increase brain levels of norepinephrine and another neurotransmitter called dopamine.


• TCAs: The tricyclic antidepressants have been around longer than the SSRIs but they are still commonly prescribed. They work by increasing the levels of serotonin, norepinephrine and dopamine in the brain. Because they tend to have more troublesome side effects, TCAs are usually a secondary choice that may be prescribed if the SSRIs do not provide relief from symptoms. Examples of TCAs include: amitriptyline (Elavil) and imipramine (Tofranil).


• MAOIs: The monoamine oxidase inhibitors are rarely prescribed unless other edications have failed, in part because they interact with many other medications and with certain foods. They work by inhibiting an enzyme that breaks down serotonin, norepinephrine, and dopamine, thus increasing their levels in the brain. Examples include phenelzine (Nardil) and isocarboxazid (Marplan). The FDA recently approved selegiline (Emsam) which is an MAOI applied as a patch to the skin, a method of administration with fewer side effects.

Several herbal remedies for depression are on the market, some of which have proved to be effective in controlled studies and many others that have not. Talk to a doctor or a trusted health care professional before trying these treatments. All herbs and supplements carry a risk of interaction with other drugs so it is important to let your doctor know what you are taking and in what amount.

Psychotherapy, alone or in combination with medications, has been shown to help many people with depression. Psychotherapy or “talk therapy” is a general term for treatment that is focused on talking about your condition and related issues in your life with a mental health professional such as a counselor, psychiatrist, or clinical psychologist. The goal is to help you gain insight into your own feelings so you can better understand them and perhaps make changes in your life to feel empowered or find more effective ways to cope with stress. There are several different types of psychotherapy so talk to a mental health professional about which one might be right for you.