Drug | Recommended dose (mg/day) | CYT P450 enzymes involved in metabolism | Contraindications; all antidepressants are contraindicated in patients with a history of hypersensitivity to any component | Accessory effects | Half-life |
---|---|---|---|---|---|
Amitriptyline | 10–300 | 1A2, 2C9, 2C19, 2D6, 3A4 | Cardiac arrhythmias, myocardial infarction, glaucoma, urinary retention, prostatic hypertrophy, use of MAOI in the past 14 days | Pain, appetite stimulant | 10–50 |
Nortriptyline | 25–150 | Sedative, anxiety, pain, insomnia | 20–100 | ||
Doxepin | 10–300 | 17 h | |||
Imipramine | 25–200 | 11–25 h | |||
Fluoxetine | 20–80 | 2C9, 2C19, 2D6, 3A4 | Concomitant use of MAOIs, liver impairment | Anxiety, insomnia, borderline personality disorder | 1–4 days |
Sertraline | 50–100 | 2B6, 2C9, 2C19, 2D6, 3A4 | Anxiety, post-traumatic stress disorder | 26 h | |
Escitalopram | 10–20 | 2C19, 2D6, 3A4 | Anxiety | 27–32 h | |
Citalopram | 20–60 | 35 h | |||
Paroxetine | 20–60 | 2D6, 3A4 | Anxiety, post-traumatic stress disorder | 21 h | |
Duloxetine | 30–120 | 2D6, 1A2 | Concomitant use of MAOIs or SSRIs, for duloxetine: chronic alcohol use or liver disease | Pain, hot flushes, fibromyalgia | 8–17 h |
Venlafaxine | 37.5–225 | 2D6 | Anxiety, hot flushes | 2.5–7.3 h | |
Milnacipran | 50–100 | None | Pain, fibromyalgia | 8 h | |
Trazodone | 150–375 | 3A4 | None | Insomnia, anxiety | 3–9 h |
Mirtazapine | 15–45 | 2D6/1A2, 3A4 | Concomitant use of MAOIs | Hypnotic, antiemetic, appetite stimulant | 20–40 h |
Tianeptine | 37.5 | IIIA3 | Concomitant use of MAOIs | Anxiety, erectile dysfunction | 2.5 h |
Bupropion | 100–450 | 2B6 | History of epilepsy, active brain tumours, anorexia nervosa, bulimia, alcohol or benzodiazepine withdrawal | Stop smoking | 12–30 h |
Agomelatine | 25–50 | 1A2/2C9 | Liver impairment | Insomnia | 2.3 h |
h, hours; MAOI, monoamine oxidase inhibitor; SSRI, selective serotonin reuptake inhibitor.