Dual action antidepressants and some important considerations

Aust N Z J Psychiatry. 2003 Apr;37(2):190-5. doi: 10.1046/j.1440-1614.2003.01169.x.

Abstract

Objective: To review controlled studies of long-term treatment and their side-effects with newer dual action antidepressants following an acute episode of major depression.

Method: A literature review (MedLine) was undertaken and references were selected for their relevance and methodology in describing their contribution to the examination of our objective.

Result and conclusion: Three dual action antidepressants are identified: venlafaxine, mirtazapine and milnacipran. These are more effective and better tolerated than the older tricyclic antidepressants in the treatment of an acute episode of depression and in the prevention of relapse. They also offer advantages in that they lack autonomic side-effects of the tricyclics. However, sedation, nausea and sexual side-effects may occur with venlafaxine, and weight gain with mirtazapine.

Publication types

  • Review

MeSH terms

  • Adrenergic alpha-Antagonists / adverse effects
  • Adrenergic alpha-Antagonists / pharmacology*
  • Adrenergic alpha-Antagonists / therapeutic use*
  • Antidepressive Agents, Second-Generation / adverse effects
  • Antidepressive Agents, Second-Generation / pharmacology*
  • Antidepressive Agents, Second-Generation / therapeutic use*
  • Cyclohexanols / adverse effects
  • Cyclohexanols / pharmacology*
  • Cyclohexanols / therapeutic use*
  • Cyclopropanes / adverse effects
  • Cyclopropanes / pharmacology*
  • Cyclopropanes / therapeutic use*
  • Depressive Disorder, Major / drug therapy*
  • Histamine H1 Antagonists / adverse effects
  • Histamine H1 Antagonists / pharmacology*
  • Histamine H1 Antagonists / therapeutic use*
  • Humans
  • Mianserin / adverse effects
  • Mianserin / analogs & derivatives
  • Mianserin / pharmacology*
  • Mianserin / therapeutic use*
  • Milnacipran
  • Mirtazapine
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / pharmacology*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Sexual Dysfunction, Physiological / chemically induced
  • Venlafaxine Hydrochloride
  • Weight Gain / drug effects*

Substances

  • Adrenergic alpha-Antagonists
  • Antidepressive Agents, Second-Generation
  • Cyclohexanols
  • Cyclopropanes
  • Histamine H1 Antagonists
  • Serotonin Uptake Inhibitors
  • Mianserin
  • Venlafaxine Hydrochloride
  • Mirtazapine
  • Milnacipran