The best and most effective antidepressants in 2024

The modern rhythm of life leads people to a number of problems on the psychological spectrum - mood drops and emotional stress rises, they become apathetic and anxious, suffer from sleep and appetite disorders. Antidepressants, which have been used to treat depressive syndrome and the correction of other mental disorders since the 1950s, have been very successful in combating these problems.

In this article, we will tell you about the history of the emergence of antidepressants, their types, how these drugs work on the body, and what are the best and most effective antidepressants in 2024 on the medication market. We will also highlight their advantages and disadvantages, as well as much more.

History of appearance

Until the 19th century in medicine, for the treatment of depressive conditions, substances with a strong stimulating effect (various opiates, extracts of ginseng, valerian, caffeine, bromine salts) were actively used, which temporarily brought patients into a state of euphoria.

By the end of the 50s of the twentieth century, the use of the first antidepressants began to enter the practice. They were obtained through the synthesis of iproniazide, which was used for the complex treatment of tuberculosis. It was noticed that patients' mood rises over time and the emotional background evens out. However, the side effects were too great, and as a remedy for tuberculosis, it did not justify itself.

Around the same years, the German physician R. Kuhn discovered imipromine. He gave his patients various substances and watched the result. Thus, an increase in mood was observed from imipromine. The drug entered the official list of the World Health Organization and was the leader in sales, until the appearance of a new generation of drugs.

Today, the pharmaceutical industry offers more than 130 drugs to combat depression.

How antidepressants work

Our brain consists of a huge number of neurons, which are not connected directly, but through synaptic clefts (synapses). The exchange between neurons occurs through the release of special substances into synapses - mediators.

Biologists believe that one of the main causes of depression is a decrease in the concentration of certain neurotransmitters in the synapse. Currently, more than 30 mediators have been discovered, of which only three are associated with depressive disorders. This is a group of biogenic amines - norepinephrine, serotonin and dopamine. Their concentration is designed to control antidepressants, which allow you to adjust the brain and get rid of the disease.

Tranquilizers have a similar, stimulating or sedative effect on the body. However, antidepressants, due to the short duration of the courses (up to 1 year), do not cause strong dependence, than they differ from tranquilizers.

Classes and uses of antidepressants

The first classification divides stimulants into 4 main groups according to the principle of action:

1. Tricyclic antidepressants or tricyclics (TCAs)

This group includes preparations that are quite strong in effect, containing a triple carbon ring as their basis. The tricyclic was the first antidepressant developed by the multinational pharmaceutical company Ciba-Geigy, Imipramine. It is still used today due to its high efficiency. TCAs also include amyltriptyline, trazodone, clomipramine, maprotiline, mianserin, nortriptyline, and imipramine.

Tricyclics prevent the seizure of norepinephrine, dopamine, the “hormone of happiness” - serotonin, inhibit anticholinergic and antihistamine effects.

These drugs are prescribed for the treatment of anxiety, depression of various natures, suicidal tendencies, panic attacks, manic-depressive psychosis. They give a calming effect.

However, it should be noted that TCA is a group of drugs of the old generation. They have very strong and varied side effects, causing patients to refuse further treatment, in about a third of cases.

The spectrum of side effects is wide, but the most common are:

• Weight gain;
• Drowsiness;
• Constipation;
• Problems with urination;
• Tachycardia, impaired cardiac conduction;
• Drop in blood pressure;
• Problems with sexual function;
• Decreased appetite;
• Convulsions.

In light of these problems, TCAs cannot be purchased at a pharmacy without a doctor's prescription. Finding a drug suitable for a specific task is problematic, it is even more difficult to calculate the correct dosage that will help to cope with depression without much harm to the body.

In parallel with taking tricyclics, it is required to donate blood to control the amount of antidepressant, since an overdose is harmful to health.

The average price of medicines is from 300 to 500 rubles.

2. Monoamine oxidase inhibitors (MAOIs)

The action of this group of antidepressants is aimed at increasing the concentration of substances in the blood that are responsible for good mood. MAOIs provide inhibition of the breakdown of monoamine oxidase and an increase in the volume of hormones such as serotonin, norepinephrine, dopamine, tryptamine, phenylethylamine.

Thanks to this, efficiency increases, concentration of attention, improves mood and creates a stable emotional background.

The drugs of this group are used to treat attacks of panic, anxiety, various types of depression, vegetative-vascular dystonia, and schizophrenia. They are also used to eliminate pathological drowsiness (give vigor), to reduce weight in eating disorders and treat social phobia (give confidence, emancipation, sociability, reduce stiffness).

MAOIs are of both natural and synthetic origin.

There are three types of monoamine oxidase inhibitors that have their own characteristics:

1. Nonselective irreversible. In excess, there are contraindications and side effects. They differ in toxicity, the liver and heart suffer from them. The therapy is accompanied by constant nausea. A special diet is required that excludes alcohol, soy products, fish, dairy products, legumes, cabbage in any form, smoked meats, sweets, yeast products from the diet. These antidepressants are only taken for a short time;
2. Reversible selective. This type is used for depression, apathy, certain types of phobias, nervous disorders. Addictive - when the drug is discontinued, or, if the dosage is reduced, it worsens the patient's condition;
3. Irreversible, selective. Provides treatment for severe forms of diseases of the central nervous system (for example, Parkinson's disease, Alzheimer's). The main side effect is a decrease in blood pressure.

They all provide a stimulating effect. The most common side effect is addiction (MAOIs are similar to narcotic substances), as well as:

• For the first type - constipation, headache, dry mouth, blurred vision, swelling, sleep problems, convulsions, hallucinations, pressure surges;
• For the second and third type - problems with urination, heart palpitations, stomach pain, headache, sleep disturbances, anxiety, loss of appetite and libido, problems with ejaculation in men.

This group of drugs is also used exclusively as directed by a doctor. Taking MAOIs cannot be combined with many other medications (for colds, for weight loss, for immunity, diuretics, anthelmintics, amphetamines, and others), they are also contraindicated in diseases of the kidneys, liver, heart, alcoholism, mania and suicidal tendencies.

Entry and exit from therapy occurs at reduced doses. Positive effects usually appear in the second week of admission, when a sufficient concentration of the substance has accumulated. The course of treatment lasts 3-9 months, followed by maintenance therapy for up to 6 months.

3. Selective serotonin reuptake inhibitors (SSRIs)

This is a class of a new generation of antidepressants, and it is easiest for patients to take them - side effects are minimized. They are used to get rid of anxiety and depressive disorders, psychosomatic pains, phobias, eating disorders, PTSD, alcoholism and a number of other diseases - helping to control the emotional and mental state.

The principle of action is as follows - the inhibitor prevents the absorption of serotonin by the tissues of the brain, it is deposited on the receptors and prolongs the excitatory effects. This leads to increased mood.

This group of drugs is not addictive.

Side effects are less common, but the following problems may occur:

• Gastrointestinal disorders (from nausea and vomiting to constipation);
• Anxiety, sleep disturbance (from drowsiness to insomnia);
• Overexcitement, tremors;
• Migraine;
• Skin rash;
• Decreased sex drive;
• Apathy and emotional dullness;
• Puffiness.

Unlike the above groups, drugs of this class can be prescribed in adolescence and reduce the relevance of suicidal moods characteristic of this age. They are good both in the postpartum period and with menopause. The use of SSRIs is contraindicated in diseases of the kidneys, heart, liver, pregnant women, as well as adults who carry out activities that require concentration.

The first effect of the intake appears after 1-1.5 months, complete relief from depression occurs after 3 months. The course, on average, lasts from 4 months to six months. At the beginning and end of the intake, the concentration of medications should be reduced.

It is possible to buy a medication of this class without a doctor's prescription. In particular, non-prescription “light” antidepressants include: Maprotiline, Prozac, Paxil, Deprim, Azafen, Persen, Mianserin, Amitriptyline, Mirtazapine. However, long-term use of them can also cause negative effects and a build-up of symptoms against which they were directed. The situation will not do without addiction.

Below is a summary table showing the classes of antidepressants and their representatives.

Antidepressant class	Drugs
Tricycles (1st generation)	Azafen, Saroten Retard, Melipramine, Peopleomil
Monoamine oxidase inhibitors (2nd generation)	Nonselective irreversible - Iproniazide, Nialamide, Fenelzine, Tranylcypromine, Isocarboxazid; Reversible selective - Inkazan, Befol, Pyrazidol, Moclobemide; Irreversible selective - Selegilin, Razagilin, Pargilin
Selective serotonin reuptake inhibitors (3rd generation)	Fluoxetine (Prozac), Fluvoxamine (Fevarin), Paroxetine (Paxil), Escitalopram (Cipralex), Sertraline (Zoloft), Citalopram (Cipramil)

Note that there are other, safer drugs used for the prevention and treatment of depressive conditions. These are various tinctures - valerian, hawthorn, lemongrass, ginseng, leuzea. This also includes the herbal sedative - Novo-Passit.

You can find another type of classification of drugs into groups:

1. Timiretics - have a stimulating effect. Used to relieve depression, depression, and feelings of oppression.
2. Tymoleptics - have sedative, sedative properties. They are used if depression is accompanied by excitatory processes. This group includes TCA and IMAO.

Rating of quality and effective antidepressants

Consider the most popular drugs according to customer reviews, their key characteristics, and also find out how much each of them costs, which ones are better to buy in a given situation. This will help you understand how to choose the right medication that will bring the most benefits in the fight against depression and have the least effect on other bodily functions.

"Melipramine"

Cost - from 350 rubles.

The main active ingredient is imipramine, the drug belongs to the IMAO group. The drug is presented in the form of tablets, 50 pieces per package. It is indicated for depression of various etiology, panic disorder, OCD in children over 6 years old. Has clear sedative properties. The result is visible 2-4 weeks after you start taking the drug. Of the minuses, there is a violation of the heartbeat, the work of the gastrointestinal tract, the urinary system.

The required amount of the drug is determined by a specialist. On average, the dose starts from 25 mg (3 times a day), reaches 150-200 mg (per day) during the most intensive periods of therapy, after which it decreases to 50-100 mg.

The tablets are used only as directed by a doctor.

• Strong healing effect;
• Inexpensive pills;
• Can be taken by children;
• Insomnia goes away;
• Good quality raw materials;
• Calms the nervous system;
• Relieves headaches and sleep disorders.

• Severe side effects;
• Makes apathetic and drowsy;
• There are many contraindications;
• It is impossible during pregnancy.

"Paroxetine"

Cost - from 315 rubles.

Another drug with a high antidepressant effect and antiphobic effect. Belongs to the class of SSRIs. It is used in the treatment of various types of depression, obsessive-compulsive, anxiety and panic disorders, social phobia.

Available in tablets, 30 per pack. Take 1 tablet per day, during the first two weeks, in practice, the optimal individual dosage is determined. The maximum amount of active ingredient per day is 40 ml (2 tablets). The effect occurs 2-4 weeks after the start of the course.

It is dispensed only by prescription.

• Budget and effective tablets;
• Convenient form of the drug;
• Gives emotional stability;
• Does not cause drowsiness;
• Mild side effects;
• Reduces anxiety.

• Contraindicated in pregnant women, lactating women and children;
• Complex interactions with other medications;
• It is difficult to deal with withdrawal syndrome;
• A long course of treatment is required.

Doxepin

Cost - 800 rubles (30 tablets), 2,500 rubles (100 tablets).

The remedy is indicated for mild to moderate depression. Belongs to the TCA group. The drug has a sedative, anti-phobic effect, serves to improve mood and suppress apathy, anxiety. Indicated in the treatment of alcoholism. The result of therapy becomes visible in 2-3 weeks of taking the medicine.

At the start of the course, it is recommended to take 10-25 mg 3 times a day, the maximum amount is 300 mg / day. Even in case of overdose, the prognosis for the patient is relatively favorable.

Side effects rarely manifest themselves in the form of drowsiness, migraines, problems with the gastrointestinal tract and urination, swelling, decreased libido.

More effective complexes are formed when the drug is used together with Phezam.

• Can be taken by children over 12 years old;
• Relatively inexpensive tool;
• Gives a lasting effect;
• The effect of enlightenment in the first days of application;
• Improves the functioning of the nervous system;
• Enhances memory.

• Delayed effect;
• Difficult to find in pharmacies;
• Is addictive;
• Worsens the condition of the stomach.

"Persen"

Cost - 240 rubles (20 pieces), 360 rubles (40 pieces), 470 rubles (60 pieces).

It is an antidepressant of plant origin, in the composition - extracts of mint, valerian, lemon balm. Group - sedatives. Reduces the level of anxiety, irritability and nervous strain. The drug is used for mild depression.

Dose - 2-3 tablets 2-3 times a day, but up to 12 tablets a day. Overdose causes nausea, fatigue.

Side effects - allergies, constipation.

Released without a doctor's prescription.

• The result is felt almost immediately;
• Fights irritation;
• No addictive effect;
• Strongly soothes;
• Normalizes sleep;
• Ideal for fatigue;
• Stabilizes the nervous system;
• Natural ingredients in the composition.

• It turns out a little expensive, given the dosage;
• There is no accumulation effect, the intake ends - the symptoms return;
• Only suitable for children over 12 years old;
• Not suitable for diabetics.

Zooloft

Cost - 500 rubles (14 pieces of 50 mg each), 950 rubles (28 pieces of 50 mg each), 1250 rubles (28 pieces of 100 mg each).

The medicine is presented in pill form. Belongs to the class of SSRIs. Suitable for the treatment of mild to moderate depression, phobias, panic disorders, obsessive-compulsive disorder, PTSD.

The drug should not be combined with MAOIs, used during pregnancy, liver problems, underweight, in children under 6 years of age.

Dosage - in the first and last weeks of admission - half a tablet (25 mg / day), then a course - 1 tablet (50 mg / day). The effect appears in 2-4 weeks.

• No withdrawal syndrome;
• An effective remedy;
• There is a healing effect that does not disappear after cancellation;
• Relieves phobias;
• There is a feeling of lightness and happiness.

• Decreased libido;
• Causes insomnia;
• In the first days of taking, the brain refuses to think;
• Vision deteriorates;
• Affects hormonal levels;
• Weight increases.

So, we looked at the list of the best antidepressants of 2024 and got acquainted with how they work.

Keep in mind, however, that depression is not just a biochemical process in the brain. Healing is possible only with the involvement of one's own mental resources and professional psychotherapeutic help.

Only a specialist is able to objectively assess the state of the psyche, calculate the required dose and the drug that will relieve emotional overload, reduce anxiety and panic. The instruction contains information, but it must be understood that there are individual characteristics, portability of one or another means may arise, which makes it irrelevant.

A key ingredient to success in dealing with depression is adhering to your doctor's treatment plan.