|
Generic Name |
Brand name |
Dosage |
Side-effects |
Comments |
|
venlafaxine hydrochloride |
Effexor Effexor XR |
75 mg up to a maximum of
375 mg per day, usually given in a bid or tid dosage. Effexor XR starts at 37.5 mg once daily up
to 225 mg once a day |
GI symptoms with nausea,
vomiting with decreased appetite, constipation, central nervous system
side-effects with sedation, dizziness, insomnia, dryness of the mouth,
sweating, problems with ejaculation problems and impotence in men,
with sexual dysfunction problems in both males and females |
Use cautiously in patients
who are on other medications that affect the central nervous system.
Also there may be some increased levels of Effexor when combined
with Tagamet (cimetidine) and therefore caution is advised |
|
paroxetine hydrochloride |
Paxil |
10 to 50 mg daily usually
given in a single dosage in the morning |
Weakness, sweating, GI
symptoms with nausea, constipation, diarrhea, dryness of the mouth,
sedation with dizziness, insomnia, problems with sexual function including
ejaculation and impotence |
This is one of the group
of antidepressants called selective serotonin reuptake inhibitors
which appear to work by increasing the level and activity of serotonin
in the brain. It is useful
in depression and panic disorder as well as obsessive-compulsive states. The dosage may have to be adjusted in the
face of Tagamet (cimetidine). It
is not approved for use in pregnancy |
|
doxepin hydrochloride |
Sinequan |
25 to 325 mg daily either
once a day or in divided dosages |
Sedation which may lessen
with usage over time, decreased blood pressure, dryness of the mouth,
blurring of the vision, urinary retention with problems emptying bladder,
constipation, gastrointestinal symptoms with nausea and vomiting |
There may be withdrawal
symptoms if the medicine is abruptly stopped and thus it is better
to taper it down. One needs
to use caution when using this in combination with Tagamet (cimetidine)
which may change the blood levels of the Sinequan.
Since it may cause sedation, patients should not be operating
a motor vehicle when they first start taking this medication.
This antidepressant is often helpful with patients who are
having problems sleeping as well as depression. This drug is not approved
for use in pregnancy. |
|
mirtazapine |
Remeron |
15 mg up to 45 mg usually
given at bedtime |
Dryness of the mouth, weight
gain, sedation, dizziness, increased appetite, constipation |
Rare cases of decreased
white blood count with this medicine and thus need to observe for
this. Remeron is not approved in pregnant females.
It may cause problems in a patient with any renal disease since
it is excreted by the kidney and thus care should be used in patients
over 65 in particular especially if renal function is a problem |
|
nefazodone hydrochloride |
Serzone |
50 to 100 mg bid initially,
increasing up to 600 mg per day |
Liver toxicity including
rare cases of liver failure may occur. |
Patients with underlying
severe liver disease are not good candidates for this medication due
to the potential for liver toxicity, including actual liver failure.
Patients taking this drug need to be regularly monitored with liver
function tests to make sure that they are not experiencing any side
effects involving the liver. |
|
bupropion hydrochloride |
Wellbutrin, Wellbutrin SR |
Wellbutrin 100 mg bid increasing
to a total dose of 300 mg per day. Wellbutrin SR initially 150 mg once daily in the morning may increase
to 150 mg twice a day or with Wellbutrin SR 100 two tablets bid as
a maximum dose |
Headaches, dryness of the
mouth with nausea, constipation, skin rash, agitated feeling |
This is indicated in depression.
It also works very well with patients with chronic fatigue
in association with fibromyalgia (the Wellbutrin works as an energizer).
It is the same exact medication as Zyban which is used to help
patients quit smoking. It
is not approved for pregnant females or in females who are breast
feeding. It should be avoided if the patient has a
known seizure disorder. |
|
citalopram hydropromide |
Celexa |
20 mg tablets once daily
increasing to 40 mg per day, if necessary |
Sedation, nausea, dryness
of the mouth, sweating, problems with ejaculation |
A highly selective serotonin
reuptake inhibitor used in depression |
|
fluoxetine hydrochloride |
Prozac |
10 mg up to 80 mg per day
usually given as a single dose in the morning |
Nausea, decreased appetite,
dryness of the mouth, fatigue, insomnia, anxiety, nervousness, sedation,
sweating |
Might impair thinking and
thus when first starting this medicine should be used with caution
if driving a motor vehicle. Need
to monitor pro-time carefully in patients on Coumadin. Not approved in pregnancy |
|
sertraline hydrochloride |
Zoloft |
25 to 200 mg daily usually
given once a day in the morning |
Sedation, headache, dizziness,
tremor, dry mouth, increased sweating, problems with sexual dysfunction
with ejaculation, nausea, diarrhea, loss of appetite, fatigue, insomnia,
nervousness, agitation |
This is another of the
serotonin reuptake inhibitors which has been used as part of the treatment
program in fibromyalgia and in depression secondary to other rheumatic
diseases. Not approved in
pregnancy |
|
amitriptyline hydrochloride |
Elavil |
10 mg up to 150 mg daily
usually given at bedtime |
Sedation, confusion, decreased
blood pressure, problems with emptying urinary bladder, constipation,
blurring of the vision, dryness of the mouth, some patients with weight
gain, other patients with weight loss |
This is an older type of
medicine for depression which is in a group called the tricyclic antidepressants.
It helps some patients who have trouble with insomnia and has
been shown to be of benefit in fibromyalgia patients.
Unfortunately, some patients cannot tolerate some of its side-effects.
The newer group of serotonin reuptake inhibitors have fewer
of some of these side-effects and therefore are better tolerated.
This drug is not approved for use in pregnancy. |