Evaluation of major depression in a routine clinical assessment

Table 2 Main antidepressants available in Brazil

Drug Class and Active Ingredient	Usual average dose for adults(mg/day)	Sedation	Anticholinergic Action	Orthostatic Hypotension
Tricyclic Antidepressants (TCAs)^A
Imipramine	150-200	Moderate	Moderate	High
Amitriptyline	150-200	High	Very high	Moderate
Nortriptyline	75-100	Moderate	Moderate	Lowest of TCAs
Clomipramine	150-200	High	High	Low
Tetracyclic Antidepressants ^A
Maprotiline	150-200	Moderate	Moderate	Low
Monoaminoxidase Inhibitors (MAOIs)
Tranilcipromine	30	-	Very low	High
Selective serotonin reuptake inhibitors (SSRIs)
Fluoxetine	20-60	Very low	None	Very low
Paroxetine	20-40	Low	Low	None
Sertraline	100-150	Low	None	None
Citalopram	20-40	Low	None	None
Fluvoxamine	50-150	Low	None	None
Escitalopram	10-20	Low	None	None
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Venlafaxine	75-225	Low	None	Very low^B
Duloxetine	60	Low	Very low	Very low
Serotonin-norepinephrine-dopamine-reuptake-inhibitors (SNDRI)
Bupropion^C	300	Low	Very low	Very low
Norepinephrine reuptake inhibitor (NRI);
Reboxetine	8-10	Very low	Very low	Very low
Noradrenergic and specific serotonergic antidepressant (NaSSA).
Mirtazapine	30-45	High	Moderate	Low
Serotonin reuptake inhibitors and serotinin antagonist (SARI)
Trazodone^D	150-400	High	Very low	Moderate

^A - All cyclic antidepressants have elevated arrhythmogenic potential;
^B - Venlafaxin causes dose-dependant blood pressure increase in some individuals;
^C - Bupropion reduces convulsive threshold significantly, and it must be avoided in patients with history of syncopes and seizures;
^D - Trazodone is associated with cardiac arrhythmia and priapism

ISSN: 1758-5996