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Additional Antidepressants
For Depression

bupropion hydrochloride (Wellbutrin)
nefazodone hydrochloride (Serzone)
venlafaxine (Effexor)

Bupropion, nefazodone, and venlafaxine are antidepressant medications that do not fit well into any of the other medication categories. They are taken in tablet form (orally).

How It Works

Bupropion, nefazodone, and venlafaxine balance certain brain chemicals (neurotransmitters). When these brain chemicals are in proper balance, the symptoms of depression are relieved.

Why It Is Used

Bupropion, nefazodone, and venlafaxine are used to treat people with depression. These medications have different side effects than tricyclics/heterocyclics, or monoamine oxidase inhibitors (MAOIs). They have side effects similar to those of selective serotonin reuptake inhibitors (SSRIs).

Sometimes certain SSRIs or other antidepressants can cause significant problems with sexual function and ability. When sexual dysfunction occurs, bupropion hydrochloride (Wellbutrin) may be prescribed instead to treat depression. Bupropion (Wellbutrin) may be less likely to cause sexual dysfunction than other antidepressants (such as SSRIs).

When these drugs are not used

Bupropion (Wellbutrin) should not be taken if you have had a previous allergic reaction to this medication or if you have taken a MAOI within the past two weeks (it may cause high blood pressure).

Nefazodone hydrochloride (Serzone) should not be taken if you have had a previous allergic reaction to this medication. It should also not be used if you are taking an MAOI.

Venlafaxine (Effexor) should not be taken if you have had an allergic reaction to this medication in the past or are currently taking an MAOI.

How Well It Works

Bupropion, nefazodone, and venlafaxine are effective in treating depression. These antidepressants may be as effective in treating depression as SSRIs.

Side Effects

The most common side effects of each of these medications include the following:

Bupropion (Wellbutrin) possible side effects

• Weight loss of more than 5 lbs.
• Agitation, confusion, nervousness, and anxiety

While rare, it is also possible that bupropion can cause other adverse affects, some of them serious, such as allergic reactions, dry mouth, headaches, heart palpitations, and seizures.

Nefazodone (Serzone) possible side effects

• Dry mouth
• Blurred vision
• Constipation
• Low blood pressure when standing

Additional negative side effects of nefazodone are possible but rare. They include allergic reaction, nausea, ringing in the ears, headaches, insomnia, and possibly seizures.

Venlafaxine (Effexor) possible side effects

• Constipation
• Headaches
• Weight loss
• Dry mouth
• Slight increase in cholesterol

Other more serious side effects are rare but can include allergic reaction, fast heart rate, nausea, dizziness, anxiety, blurred vision, insomnia, increased blood pressure, and seizures.

See Drug Reference for a full list of side effects.

What to Think About

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These medications are effective in the treatment of depression, although it is possible they may take up to six weeks to begin working (usually less time is needed before they are effective).

These medications should not be used along with monoamine oxidase inhibitors (MAOIs) because serious, sometimes fatal, reactions can occur. To avoid serious reactions:

• Wait at least 14 days after ending an MAOI treatment before beginning treatment with any one of these medications.
• Wait at least 7 days after ending treatment with nefazodone or venlafaxine before beginning treatment with an MAOI.

Nefazodone should not be used along with:

• Allergy medications (antihistamines) containing terfenadine (Seldane) and astemizole (Hismanal).
• The antianxiety medication alprazolam (Xanax).

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