Selecting the Best Antidepressant for Depression and Anxiety 

Best antidepressants

 

Anxiety and depression are the most common mental health problems affecting people today. Half of the people who have depression are also diagnosed with having an anxiety disorder.

People with either depression or anxiety go to great lengths to relieve their distress, whether using medication or trying different natural remedies.

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For depression and anxiety, antidepressants are among the most commonly prescribed medications.

In general, this class of drug is considered to be effective in treating depression and anxiety.

People must seek the best options for medications, especially if they suffer from depression or anxiety.

Using antidepressants for relieving these conditions can empower you to achieve your goals and dreams minus the pain and frustrations.

This is a comprehensive guide to arm you with knowledge about the best antidepressants for treating depression and anxiety.

By the end of this expose, you will be able to make an informed, educated discussion with your doctor regarding your antidepressant medication choices.

 

1. What are Antidepressants?

What do antidepressants do, and how do they work? Before examining the best antidepressants for anxiety and depression, it is essential to understand what they are.

Antidepressants refer to a class of medication that targets to stabilize chemical imbalances responsible for mood and behavior changes linked to malfunctioning neurotransmitters in the brain.

As you may already know, depression is a brutal mental state to live with. It has the potential to upend lives and negatively impact relationships. Thankfully, antidepressants can be (and have been) very effective in alleviating symptoms of depression.

Antidepressants are used to treat several conditions, including post-traumatic stress disorder (PTSD) and severe phobias like agoraphobia or social phobia.

The use of antidepressants has steadily increased over the past 20 years. CDC data shows that 12.7% of Americans above the age of 12 took antidepressants in 1999-2002. Each year, this number increases.

 

Best Antidepressants
Best Antidepressants for Adults

 

  • What Do Antidepressants Do?

The medications relieve depression by causing the brain’s chemical neurotransmitters to become more active.

In treating depression and anxiety, the neurotransmitters serotonin, norepinephrine, and dopamine are a critical part of the mix.  The brain is a highly complex organ, so the exact reason these drugs work isn’t entirely understood.

Most people who use these drugs often report relief from depression and anxiety symptoms. There is an even greater chance of success with these prescriptions when people use the second type of antidepressant if they do not find relief with the first one.

 

  • Do Antidepressants Induce Euphoria?

Antidepressants don’t make you feel “high” or euphoric. They simply help restore realistic balance to your emotional responses.

Once you’ve started taking antidepressants, you will suddenly notice how minor things which may have normally bothered you a little bit to a significant degree aren’t affecting you anymore.

This is because the chemicals in these types of medications combat hypersensitivity and anxiety. Therefore, the drugs can improve your perceptions of others and allow for a better relationship due to feeling less “overly bothered” by everyday social triggers.

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  • Effectiveness Of Antidepressants

The effectiveness of antidepressants remains the same whether one has anxiety or depression.

For depression to be treated successfully with medication, a combination of therapy and antidepressants is usually the best method.

It has been found that 40% to 60% of individuals who take an antidepressant for depression respond positively to the treatment. 

In contrast, only 25% to 30% of placebo-treated patients respond positively. In other words, individuals taking antidepressants for moderate or severe depression tend to get better quicker than those taking a placebo.

 

2. Types of Antidepressants

Antidepressants fall into several classes or types.  Regardless of category, they work by recalibrating neurotransmitters, such as serotonin and norepinephrine.

Antidepressants affect these neurotransmitters differently depending on the type (class) they belong to.

While all antidepressants generally work well for relieving depression and anxiety, researchers have shown that some antidepressants may be more effective at alleviating symptoms than other brands.

Your doctor may have to try a few options before identifying a formula that works best for you.

Therefore it’s important to remember that it takes time to get an entire idea of how a medication will impact you, just as it takes time for your body to adjust and react accordingly.

For instance, some medicines need to build up in your system before they can take effect. In that case, your doctor will have to wait a few days before deciding to switch to another class, brand, or dosage.

By seeking treatment with antidepressants, you have taken a bold and wise step towards wellness.

Don’t get discouraged if it’s still hard because each individual gets a different experience with these medications. The results and side effects vary from person to person.

 

Antidepressant types
Common Types of Antidepressants

 

Below is an overview of various antidepressants and their efficacy.

 

  • Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors are a commonly prescribed class of antidepressants. Taking these drugs doesn’t cause significant side effects, even at higher dosages. They can help to alleviate mild to moderate depression.

Selective serotonin reuptake inhibitors, or SSRIs as they’re commonly referred to, target only serotonin. These antidepressants prevent serotonin from getting absorbed back into neurons.

Consequently, this increases the brain’s supply of available serotonin, enhancing a person’s mood and outlook on life.

The effect of SSRIs on anxiety is often described as “turning down the volume” on anxious thoughts.

It may have similar or higher effects to practicing mindfulness and participating in psychotherapy.

Apart from reducing physiological symptoms of depression and anxiety (sleep problems, muscle tension, headaches), SSRIs may also reduce psychological symptoms.

 

  • Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs)

SNRIs work like SSRIs. The overall outlook is that they are more potent than SSRIs. There is, however, no concrete evidence to support their superiority over SSRIs. Ultimately, individual responses may vary.

SNRIs prevent the brain from reabsorbing (reuptake of) neurotransmitters serotonin and norepinephrine. Such drugs are effective against depression.

Additionally, SNRIs can be used for several other conditions, including anxiety disorders and chronic pain, especially nerve pain.

Many people dealing with depression experience pain and aches. People who suffer from depression and pain could benefit from medication like SNRIs.

Broadly speaking, SNRI combines two drugs – a serotonin receptor inhibitor and a norepinephrine reuptake inhibitor. They work by reducing the rate of the reuptake of these brain chemicals.

By not allowing these neurotransmitters to be absorbed as fast as they would normally be, the medications prolong their presence in your brain and offer longer-lasting relief from anxiety and panic attacks, as well as depression symptoms.

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  • Noradrenaline and Specific Serotonergic Antidepressants (NaSSAs)

Because completely new drugs take a long time to be developed – which doesn’t happen very often – there needs to be a way for people to find alternative options.

In these cases, a small modification of an existing drug may provide the solution. NaSSAs are a modification of SNRIS.

When needed, Noradrenaline and Specific Serotonergic Antidepressants are used for different illnesses that affect similar biological systems in the body. 

Specifically, NaSSA stimulates an increased release of norepinephrine, serotonin, and dopamine in the synaptic clefts (the spaces between neurons where neurotransmitters communicate).

Typically, NaSSAs also serve as a treatment for anxiety, depression, and obsessional-compulsive disorder (OCD).

 

  • Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are not a doctors’ favorite because of their frequency for causing unpleasant side effects and potentially lethal overdoses. Nonetheless, medical experts may issue their prescription if other medications fail to relieve depression in patients.

TCAs are mainly prescribed to treat severe depression, but they can treat other conditions like:

TCAs increase noradrenaline and serotonin levels in the brain.

Various types of TCAs produce different side effects and interact with different drugs in different ways. Some people are more susceptible to specific side effects or interactions than others.

In general, amitriptyline tends to increase sleepiness and weight gain.

If you are suffering from the side effects of any particular medication such as insomnia- Click the button below to get our licensed professional’s opinion and guidance.

 

  • Monoamine oxidase inhibitors (MAOIs)

Monoamine oxidase inhibitors (MAOIs) used to be commonly prescribed antidepressants. They were eventually taken off the market and aren’t as frequently used today as other antidepressants.

There have been cases of severe side effects with this kind of antidepressant, so one should never take them without consulting a doctor first. Only a specialist is legally allowed to prescribe them.

MAOIs block the enzymes that break down serotonin, noradrenaline, and dopamine. Consequently, optimal brain hormone levels are maintained, which helps sustain positive moods.

Beware, though, MAOIs are known to interact with certain medications and foods, including:

  • Aged cheese
  • Cured meat
  • Fava beans

Also, taking an MAOI and eating high-tyramine foods increases your blood pressure (and heightens your risk of stroke) if you consume tyramine-rich foods.

Typically MAOIs are only prescribed if there is no other effective antidepressant available. MAOIs should not be used by patients who have high blood pressure or heart problems.

 

3. The Best Antidepressants for Depression

Studies have proven that antidepressants can help to treat depression. However, some people react better to certain types than others.

There are a variety of antidepressants available to meet each patient’s unique needs and requirements, and it is often on a case-by-case basis when deciding which ones will work best for individual needs and circumstances.

Choosing the right one from the many medications available for depression can be difficult.

The following sections will discuss antidepressants that are considered the best for depression based on public and scientific research—the list of pick-ups that will make understanding your doctor’s recommendations easier.

Also, keep in mind that depression medications aren’t restricted to these.

Also, different drugs have different effects, ranging from mild sleep disturbances to severe cramps and sexual dysfunction. In this case, your physician is likely to explore several antidepressants until they find one you are comfortable with.

 

Best antidepressants

How to Achieve the Best Results from an Antidepressant?

 

  • Effexor (Venlafaxine)

Effexor X.R. is a serotonin-norepinephrine reuptake inhibitor or SNRI.  Clinical trials have proven that Effexor X.R. can effectively relieve symptoms associated with severe forms of depression.

Results were generally good for adults who had either an inadequate response to previous medications.

Overall, most participants in the clinical trial felt their symptoms had improved after taking Effexor X.R.

The most common side effects of this medication include:

  • Insomnia
  • Constipation
  • Dry mouth
  • Tremors

 

  • Prozac (Fluoxetine)

Prozac is a selective serotonin reuptake inhibitor (SSRI) that boosts serotonin levels in the brain. It’s thought to be an excellent choice for young people who are suffering from depression.

New research suggests Prozac could be more effective than other options for treating major depressive disorder (MDD).

One study involved an examination of 83 children between the ages of six and 17 found improvement in children’s depression after using Fluoxetine to treat their major depressive episodes.

Results showed greater improvement after one week than those who received treatment with placebo, the “sugar pill” control group.

A total of 1,056 ratings have been submitted for Prozac on the drug review website, resulting in an average rating of 7.2. 65% of reviewers said that the drug had a positive effect, while 20% complained that it had a negative impact.

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  • Celexa (Citalopram)

Celexa is one of the most popular antidepressants on the market. It’s been around since 1993 and has often been said to be effective. Experts concur that it causes fewer side effects than many other SSRIs (although not all).

One of its downsides may be minor weight gain (1 to 5 pounds) and heart palpitations if you take a higher than the recommended dose.

Please note that other antidepressants like Lexapro might be more effective than Celexa for patients with anxiety and depression.

Data from clinical trials conducted in the U.S. were used to study Celexa’s effectiveness as a depression medication. Researchers concluded that this medication is very effective.

This antidepressant also has similar efficacy to other SSRIs and tricyclic antidepressants. At therapeutic doses, it is well-tolerated and safe.

There have been 789 reviews of Celexa on Drugs.com. Its average rating is 7.3 out of 10. Another 15 % of users reported a negative effect, while another 65% reported a positive impact.

 

  • Zoloft (Sertraline)

Zoloft is also an SSRI. One of the benefits of Zoloft is that it causes less sleepiness than other antidepressants.

Zoloft is proven to be effective for treating major depression without causing significant side effects and significant reductions in treatment discontinuation, thanks to its powerful effects on quality of life.

Zoloft is commonly prescribed to help people with mental health issues related to their depression. Based on 1,570 reviews, the average rating for Zoloft is 7.2. 63% of reviewers had a positive experience, while 18% had a negative experience.

 

  • Cymbalta (Duloxetine)

Duloxetine is used for treating anxiety and depression. Additionally, Duloxetine can help relieve peripheral neuropathy (nerve pain) caused by diabetes, fibromyalgia (a disorder that causes widespread pain), arthritis, or chronic back pain.

You may experience mood, sleep, appetite, energy level, and nervousness improvements while taking Duloxetine. Additionally, it may reduce pain caused by certain medical conditions.

It restores the natural balance of substances in the brain–norepinephrine and serotonin.

There is evidence that Duloxetine is effective in treating MDD in both the short- and long term. In addition, Cymbalta is an attractive option for people who suffer from painful physical symptoms related to MDD.

The average rating for Cymbalta on Drugs.com is 6.2 out of 10 based on 1,564 reviews. In addition, 54% of users reported positive effects, and 29% reported adverse effects.

 

Best antidepressant
Factors to Consider When Choosing an Antidepressant

 

Brand name Generic name Average rating Prominent features
Effexor Venlafaxine 6.6 out of 10 This medication is well-tolerated and effective at treating severe depression.
Prozac Fluoxetine 7.2 out of 10 Excellent medication for young people with depression.
Celexa Citalopram 7.3 out of 10 It is less side-effect-prone than other antidepressants.
Zoloft Sertraline 7.2 out of 10 Reduces drowsiness compared to other SSRIs and improves quality of life significantly.
Cymbalta Duloxetine 6.2 out of 10 A short- and long-term treatment model that is effective for treating adult patients with MDD. In addition, it offers a viable option for patients who suffer from pain associated with MDD.

                                                   

4. The Best Antidepressants for Anxiety

There are different symptoms associated with anxiety disorders. Psychotherapy, exercise, and medications are all options that can benefit patients depending on their symptoms.

The combination of these three elements and the sequence in which they are required may differ from person to person.

When it comes to antidepressants, Serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs) are the most commonly used medication for anxiety disorders. 

In this section, we will list our picks for the best anxiety medications. With the help of your healthcare provider, you can make the right decision about anxiety medication.

 

The best antidepressants for anxiety are:

 

  • Paxil (paroxetine)

Paxil (paroxetine) is an antidepressant that belongs to the selective serotonin reuptake inhibitors (SSRIs) class of medications.

Paroxetine affects neurochemicals that may be out of equilibrium in people suffering from anxiety, depression, or other mental disorders.

Follow your doctor’s instructions when taking Paxil.

Read all drug guidelines or instruction sheets and follow the recommendations on your prescription label. Your dose may need to be adjusted periodically by your physician.

The extended-release pills of Paxil C.R. should not be chewed, crushed, or broken. Swallow them whole.

When using this antidepressant for the first time, some young individuals develop suicidal thoughts.

On the course of treatment, experts recommend regular doctor visits so they can assess your development. Your family or other carers may also help to detect changes in your moods or symptoms.

Beware: Taking an SSRI antidepressant like Paxil while pregnant can lead to severe lung issues and other health problems in the infant. If you become pregnant, call your doctor straight away.

Do not start or stop using this medication without consulting your doctor.

 

  • Lexapro (Escitalopram)

Apart from Prozac, Lexapro is the only other anti-anxiety SSRI approved by the FDA for teenagers.  Based on a recent survey, the prescription rate for Lexapro is approximately 8%.

Take Lexapro once a day, with or without a meal, morning or evening, as directed by your doctor.

Your health condition determines the dose, response to therapy, age, and acceptable drug combinations. Please make a list of all the medicinal products you use and provide it to your physician and pharmacist.

If you have a citalopram allergy or take pimozide or citalopram, do not use this medication. You should not use escitalopram for 14 days before or after using an MAO inhibitor. The resultant interactions may be detrimental to your health.

 

  • Prozac (Fluoxetine)

Prozac remains one of the most commonly prescribed SSRIs in the United States. It’s among the few that the FDA has authorized for usage by children and teens. In a 2017 antidepressant usage survey, little over 11% of respondents said they were using Prozac for depression.

As of 1987, Fluoxetine was approved by the U.S. Food and Drug Administration (FDA). Prozac is the brand name for this medication.

What is the essential information regarding Prozac (Fluoxetine) that I should know?

If you are allergic to Fluoxetine or are on pimozide or thioridazine, please don’t take it.

If you’ve taken an MAO inhibitor in the last 14 days, don’t take Fluoxetine.

A hazardous medication interaction may occur. Selegiline, rasagiline, isocarboxazid, linezolid, phenelzine, methylene blue injection, and tranylcypromine are all MAO inhibitors.

Before using Fluoxetine, you must stay at least 14 days after discontinuing an MAO inhibitor. After stopping Fluoxetine, you should wait five weeks until taking thioridazine or an MAO.

Tell your doctor if you are taking any other antidepressants, including :

  • Celexa
  • Viibryd
  • Cymbalta
  • Desyrel
  • Lexapro
  • Effexor
  • Luvox
  • Oleptro
  • Pexeva
  • Paxil
  • Symbyax
  • Zoloft

 

  • Zoloft (Sertraline)

Although Zoloft is very efficient. In a 2017 survey of antidepressant use, 17% of respondents reported taking the drug.

Don’t use Zoloft if you are allergic to it or if you are also taking pimozide. If you’re taking disulfiram, don’t take the liquid version of sertraline.

Sertraline should not be used 14 days before or after an MAO inhibitor. A hazardous medication interaction may occur.

 

  • Venlafaxine (Oral)

Venlafaxine is an oral antidepressant that treats severe anxiety and panic attacks in adults.

It is safe and highly tolerable, and effective. Nonetheless,  it can cause nausea and vomiting, and the patients’ blood pressure and heart rate may rise with its use.

This medication shouldn’t be used by patients with uncontrolled narrow-angle glaucoma or allergic to venlafaxine or desvenlafaxine (Pristiq).

Do not take venlafaxine if you’ve taken an MAO inhibitor like linezolid, isocarboxazid, blue injection, phenelzine, or tranylcypromine in the last seven days or 14 days.

 

Brand name Generic name Average rating Prominent features
Zoloft Sertraline 7.2 out of 10 Effective against depression, panic attacks, OCD, PTSD, social anxiety disorder (social phobia), and a severe form of the premenstrual dysphoric disorder.
Lexapro  Escitalopram 8.2 out of 10 Improves energy level and feelings of well-being. Decrease nervousness.
Effexor XR Venlafaxine 6.6 out of 10 Decreases fear, anxiety, unwanted thoughts, and the frequency of panic attacks.
Paxil, Pexeva Paroxetine 7.1 out of 10 Improves mood, sleep, appetite, and energy levels. It helps to restore the joy of life.

 

5. The Best Antidepressants for Treating Comorbid Depression and Anxiety?

Most people suffer from both anxiety and depression. They are also more likely to struggle with the comorbidities of the two conditions.

When both anxiety and depression are present, the quality of life, functional impairment, and treatment outcomes tend to be poorer.

The following explores the medications considered to be best suited to treating anxiety and depression.

Apart from medications, patients with anxiety disorder and depression also require psychotherapy, support groups, and other non-pharmacological treatment methods.

Further, it is crucial to manage both acute and chronic symptoms of these disorders. Reducing anxiety symptoms can often lead to easing depression symptoms.

Antidepressants are also used for relaxation as well as treating depression.

 

  • List of the Best Antidepressants for Depression and Anxiety

SSRIs and SNRIs can treat both anxiety and depression.

They typically include the following:

  • Venlafaxine (SNRI)
  • Bupropion (SNRI)
  • Paroxetine (SSRI)
  • Mirtazapine (SNRI)
  • Sertraline (SSRI)
  • Escitalopram (SSRI)
  • Fluoxetine (SSRI)

Due to concern over safety and tolerability and potential somatic symptoms, tricyclic antidepressants (TCAs) often come as an afterthought.

TCAs used to treat depression and anxiety are:

  • Amitriptyline
  • Imipramine

Schedule your appointment with a mental health professional to get the most suitable treatment for anxiety or depression.

 

6. How To Know Which Antidepressant Is Best for You?

When your doctor prescribes any medication, be it an antidepressant or another type of medicine, there are several considerations behind the decision.

The selection criteria are extensively diverse,  given that antidepressants can have varying effects on different patients.

Below are some of the factors that can help shape the decision of your physician.

 

  • Multipurpose Prescriptions

You might sleep more if you take some antidepressants, and you might gain weight when taking some.

Sometimes, doctors use these effects to their patients’ advantage. As an example, assume that due to your depression or anxiety, you have not eaten and lost weight.

You might be prescribed a weight-gaining antidepressant in that case. Your doctor can also prescribe a depression pill that induces sleep before bed if you are experiencing sleep deprivation.

 

  • On and Off Label Uses

The “off-label” use of an approved drug is used to treat a condition that it is not intended for. Physicians who prescribe a medication that the FDA has approved for a given condition are considered to be using it “on-label.”

Some doctors are more likely to prescribe off-label medications than others. Your doctor will try to find one with the fewest side effects. Remember that Off-label does not mean that medication will not be helpful.

 

  • The Severity of Side Effects

During a consultation with your doctor, you will be asked whether you experienced any side effects while using antidepressants in the past.

A doctor also strives to select one with the fewest side effects if you take any other medicine with side effects that you can’t stand. You may have to try a few before finding the right one.

 

  • Pregnancy or Breastfeeding

Antidepressants have been known to cause adverse effects in babies, so your doctor will caution you against using them.

When you are pregnant, planning to become pregnant, or breastfeeding, you and your doctor will need to figure out how to deal with depression.

 

  • Other Conditions or Medications

Some medications can interact with antidepressants, so your doctor will need to know what other medicines you’re taking – including over-the-counter drugs, prescription medications, vitamins, or supplements – before prescribing a drug to treat depression.

In addition, your doctor will consider if you have any other conditions that may react or counteract the prescriptions. Some antidepressants might aggravate existing conditions such as Type 1 or Type 2 diabetes, cardiovascular disease, or liver problems.

 

  • Your Particular Symptoms         

The symptoms of depression vary greatly, and it can be challenging to understand which type you are experiencing. One medication may have more of an effect on one sign than another.

For example, some drugs are designed for people with problems sleeping or with anxiety, while others more specifically treat weight loss, trouble focusing, etc.

 

  • Cost and Health Insurance Coverage

Considering that some antidepressants are pretty expensive, it is vital to determine if a generic alternative exists and explore its efficacy. Make sure you know whether your health insurance plan covers antidepressants, and if so, what types.

 

Antidepressants
Effects of an Antidepressant

 

7. Frequently Asked Questions Regarding Antidepressants

 

  • Are There Antidepressants With the Fewest Side Effects That Are Effective?

Yes. In contrast to other antidepressants, SSRI drugs have fewer side effects. There are, therefore, fewer withdrawal symptoms associated with higher levels of treatment.

 

  • Are Antidepressants Addictive?

Addiction to antidepressants is not a commonly occurring concern. Symptoms may worsen when you stop or decrease the dosage, but that doesn’t mean antidepressants are addictive.

 

  • What Happens if You Don’t Respond to One Antidepressant?

It’s tough for many people to find the proper medication, and some never respond to standard antidepressants. It’s estimated that only 30 to 35 percent of people will respond well to their first antidepressants. 

A range of different antidepressants is available to treat depression. Some medications may work, and others may not. In that case, changing remedies could be beneficial.

 

  • Do Antidepressants Have Any Long-term Risks if You Stay on Them?

Psychologists recommend that patients stay on the medication for six months to a year after feeling better. You should check on your response after three weeks and between three and six months.

Despite the potential for side effects of antidepressants, there are no well-known side effects on long-term usage.

In essence, you should discuss with your doctor when you want to stop antidepressants. This is a clinical decision that depends on the severity and length of your depression.

 

  • What if You Still Experience Depression Symptoms?

Has it been six weeks, and you are still depressed after taking an antidepressant? You might want to take a more potent dose or switch to another medicine. Whenever you experience symptoms, speak with your doctor to see if it’s time to change.

 

  • What Are the Possible Side Effects of Antidepressants?

Some people may experience sexual side effects such as decreased libido or delayed or less powerful orgasm, sleepiness, and weight gain.

Others may experience common side effects such as:

It takes about a week for most of the initial side effects to subside.

Contact your doctor if you experience side effects for a long time. You can ask your clinician for assistance in finding the right drug for you from among the many choices.

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Final Words

People with depression and anxiety can benefit significantly from antidepressant medications. Even so, you should consult with your doctor before making a decision.

It is necessary to get the type of treatment you need and prefer according to your specific health situation for a better outcome. The licensed professionals at EZCare Clinic make sure to provide you with the best treatment plan for depression or anxiety. 

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