What You Need To Know About The Newest Antidepressants

Depression is a mental health condition that affects millions of people worldwide. It is characterized by persistent feelings of sadness, loss of interest in activities, changes in appetite, sleep problems, and lack of energy. Various treatments are available to alleviate depressive symptoms, including antidepressant medications. However, not all antidepressants work the same, and some may cause unpleasant side effects.

In recent years, new antidepressant drugs have emerged, offering patients different options to manage their depression. Here’s what you need to know about the newest antidepressants:

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are among the most commonly prescribed antidepressants. They work by increasing the levels of serotonin, a chemical messenger that regulates mood, in the brain. The newest SSRIs available on the market are vilazodone (Viibryd), which was approved in 2011, and vortioxetine (Brintellix), approved in 2013.

Vilazodone is known for its dual mechanism of action. It acts as an SSRI and a partial agonist of the 5-HT1A receptor, which is involved in regulating anxiety and stress. Compared to other SSRIs, vilazodone has a lower risk of sexual side effects, such as difficulty achieving orgasm. However, it may cause gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.

Vortioxetine is a multi-modal agent that not only inhibits serotonin reuptake but also modulates other serotonin receptors, including 5-HT1A, 5-HT1B, 5-HT3, and 5-HT7. It has shown to be effective in treating both depressive and anxiety symptoms. Vortioxetine may cause nausea, constipation, and sexual dysfunction.

Atypical Antidepressants

Atypical antidepressants are drugs that do not fit into any of the traditional antidepressant categories. They may target other neurotransmitters besides serotonin, such as dopamine and norepinephrine, or have different mechanisms of action.

Brexanolone (Zulresso) is an atypical antidepressant that was approved in 2019 for the treatment of postpartum depression. It is administered as an intravenous infusion and works by enhancing the activity of the neurotransmitter GABA, which has a calming effect on the brain. Brexanolone has a rapid onset of action, and its effects can last up to a month. However, it is associated with the risk of loss of consciousness and sedation.

Esketamine (Spravato) is a novel antidepressant that was approved in 2019 for treatment-resistant depression. It is a nasal spray that contains a formulation of ketamine, an anesthetic drug that has been used off-label for depression. Esketamine acts on the N-methyl-D-aspartate (NMDA) receptor, which is involved in the formation of new synaptic connections in the brain. It has shown to produce rapid and sustained antidepressant effects in clinical trials. However, there are concerns about the risk of abuse and addiction to ketamine.

Novel Antidepressants

Novel antidepressants are drugs that have unique mechanisms of action that differ from the conventional antidepressants.

Agomelatine (Valdoxan) is a novel antidepressant that was approved in 2009. It targets both the serotonin and melatonin receptors in the brain, which regulate sleep and circadian rhythms. Agomelatine has shown to improve both depressive symptoms and sleep quality. It has a low risk of sexual dysfunction and weight gain, which are common side effects of other antidepressants. However, it may cause liver toxicity in some patients.

Tetrabenazine (Xenazine) is a medication that was initially approved for the treatment of involuntary muscle movements in Huntington’s disease. However, it has shown to have antidepressant properties, especially in patients with depression and motor symptoms. Tetrabenazine works by depleting the levels of dopamine in certain brain regions, which are involved in reward and motivation. It should be used with caution in patients with a history of depression or suicidal ideation.

Conclusion

The introduction of new antidepressants has expanded the available options for patients with depression. However, not all antidepressants are suitable for everyone, and their efficacy and safety should be evaluated on a case-by-case basis. It is essential to consult with a healthcare provider before starting or changing any medications for depression.

FAQs

FAQs About What You Need To Know About The Newest Antidepressants

1. What are the newest antidepressants and how do they work?

The newest antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and atypical antidepressants. These drugs work by increasing the level of certain neurotransmitters in the brain, such as serotonin and norepinephrine, which play a role in regulating mood.

2. What are the potential side effects of these medications?

Common side effects of antidepressants can include nausea, headache, sexual dysfunction, weight gain, and sleep disturbances. It’s important to talk to your doctor about any side effects you may experience, as they can help you find the best treatment option for your needs.

3. How long does it take for these medications to start working?

Antidepressants can take several weeks to start working, so it’s important to be patient and consistent with your treatment. It’s also important to follow your doctor’s instructions for taking these medications and not to stop taking them abruptly, as this can cause withdrawal symptoms. If you have any concerns about your medication, be sure to talk to your doctor or mental health professional.


References

1. Cristancho, M. A., Thase, M. E., & Fava, M. (2021). Using New Antidepressants Effectively: Balancing Efficacy, Safety, and Affordability. The Journal of Clinical Psychiatry, 82(3), 20com13327. https://doi.org/10.4088/JCP.20com13327

2. Dhillon, S. (2021). Brexpiprazole: A Review in Schizophrenia and Adjunctive Treatment in Major Depressive Disorder. CNS Drugs, 35(4), 413–424. https://doi.org/10.1007/s40263-021-00828-9

3. Strittmatter, S. M., Williams, H. J., & Morishita, W. (2021). The Future of Psychiatric Drug Development: News and Views. Nature Reviews Drug Discovery, 20(1), 1–2. https://doi.org/10.1038/s41573-020-0093-7