Venlafaxine
Venlafaxine belongs to the group of selective serotonin and norepinephrine reuptake inhibitors (SSNRI). Depressive symptoms are thus reduced by an increased supply of the messenger substances serotonin and noradrenalin in the synaptic cleft. Besides depression, venlafaxine is also used in the treatment of anxiety disorders.
At the beginning of the intake of venlafaxine, side effects in the gastrointestinal tract (nausea, vomiting, loss of appetite, constipation) often occur. The occurrence of dizziness, agitation, nervousness and visual disturbances is also relatively common. Use during pregnancy and lactation is recommended if venlafaxine has been used before pregnancy. Reconfiguration during pregnancy should be made to a different, more tried and tested antidepressant.
Duloxetine
Like venlafaxine, duloxetine belongs to the SSNRI group. It is used to treat depression, anxiety disorders, polyneuropathy in diabetes and urinary incontinence. The possible side effects are similar to those of venlafaxine.
The side effects occur especially during the first days of taking it and then gradually decrease. As with venlafaxine, pregnancy and lactation can be treated if there has been previous therapy. Otherwise, another antidepressant should be used, for which more studies are available.
Mirtazapine
Mirtazapine, together with Mianserin, belongs to the small group of tetracyclic antidepressants. Mirtazapine interferes with the reuptake of serotonin and norepinephrine and probably also leads to an increased release of dopamine. The most common side effects of mirtazapine are fatigue and weight gain.
In patients suffering from pronounced sleep disorders in the context of depression, the attenuating effect can be used to improve night sleep. Mirtazapine is also used in low doses in some cases in patients who do not suffer from depression but who suffer from severe sleep disorders. However, this is an off-label use and the drug is not officially approved for this indication.
In pregnancy, there is no evidence of a damaging effect on the fertility of mirtazapine. If antidepressant treatment with mirtazapine already exists before pregnancy, it may be possible to continue this treatment. In order to start a new antidepressive therapy during pregnancy, better studied antidepressants (e.g. citalopram, sertraline, amitriptyline) are available. Tricyclic antidepressants SSRI (selective serotonin reuptake inhibitors) SNRI (selective noradrenalin reuptake inhibitors) SSNRI (selective serotonin and noradrenalin reuptake inhibitors) MAO inhibitors Other
- Amitriptyline
- Nortriptyline
- Opipramol
- Desipramine
- Trimipramine
- Doxepin
- Imipramine
- Clomipramine
- Citalopram
- Escitalopram
- Sertraline
- Fluoxetine
- Fluvoxamine
- Paroxetine
- Reboxetine
- Venlafaxine
- Duloxetine
- Tranylcipromin
- Moclobemide
- Mirtazapine
- Mianserin
