TABLE 1. Organization of Antidepressant Agents into Eight Classes by Punative Mechanism of Actiona
Serotonin and norepinephrine reuptake inhibition with effects on multiple receptor systems and sodium conductance.
(e.g., amitriptyline, imipramine)
Selective serotonin reuptake inhibitorsb
(e.g., fluoxetine, sertraline, paroxetine, fluxamine)
Selective norepinephrine reuptake inhibitorsb
(e.g., desiptamine, maprotiline)
Serotonin and norepinephrine reuptake inhibitors
(e.g., venlafaxine)
Serotonin (5-HT2A) receptor blockade with serotonin reuptake inhibition
(e.g., nefazodone)c
Serotonin (5-HT2A and 2C) receptor blockade with norepinephrine (alpha-2) receptor blockade
(e.g., mirtazipine)c
Dopamine and norepinephrine reuptake inhibition
(e.g., bupropion)
Monoamine oxidase inhibitors
(e.g., tranycypromine, phenelzine, isocarboxazid)d

a Although the pathophysiology of depression remains unclear, drugs are classified by prominent mechanism(s) of action believed to mediate antidepressant efficacy.

b The selectivity may be obscured at doses higher than those recommended for routine treatment of depression.

c Both nefazodone and mirazipine have additional non-antidepressant mechanisms of action which are engaged at concentrations that occur under clinically relevant dosing guidelines.

d Only irreversible/nonselective monoamine oxidase inhibitors (MAOIs) are marketed in the United States, but reversible/selective MAOIs are marketed elsewhere in the world and are in development.

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published 2000