What is the best antidepressant for anxiety and depression? (3+ Options)
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In this blog post, we are going to answer the question, “What is the best antidepressant for anxiety and depression?”. Antidepressants are one of the most commonly prescribed medications nowadays, because of the widespread depression and other mental health conditions.
However, these antidepressants can also be used for the management and treatment of anxiety disorders. This blog will cover those antidepressants which can be used for both depression and anxiety.
What is the best antidepressant for anxiety and depression?
The best antidepressants for the treatment of both anxiety and depression include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SSRIs)
- Tricyclic antidepressants (TCAs)
- Monoaminoxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are one of the most commonly prescribed antidepressants for the management and treatment of both anxiety and depression. These drugs are very well tolerated and can significantly help restore your mental health.
For severe anxiety and depression, some doctors prescribe two SSRIs in combination, mostly Sertraline and Escitalopram, to help relieve the disturbing symptoms associated with persistent depression. However, for mild cases, monotherapy is enough.
SSRIs basically inhibit the reuptake of serotonin by blocking serotonin transporters (SERT). This way, more active serotonin is available to bind to its respective receptors. Serotonin is one of the main neurotransmitters that are closely related to depression and anxiety.
It is this chemical whose deficiency triggers depression in the first place. This is why SSRIs work in the best possible way to counteract such depression symptoms. Most commonly prescribed antidepressants include:
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
- Citalopram (Celexa)
Among antidepressants, Sertraline is one of the most commonly prescribed antidepressants and it can actively help you recover from anxiety, depression, and related symptoms. Some common side effects associated with the use of SSRIs include
- Nausea
- Vomiting
- Diarrhoea or Constipation
- Acid reflux or heartburn
- Abdominal pain
- Loss of appetite
- Weight gain or loss
- Excessive sweating or night sweating (nocturnal/night hyperhidrosis)
- Frequent urination
- Polydipsia or excessive thirst
- Tremors
- Muscle twitching and pain
- Drowsiness
- Dizziness
- Excessive tiredness or fatigue
- Insomnia or inability to fall asleep
- Xerostomia or dry mouth
- Dysmenorrhea or heavy periods
- Flu-like symptoms including irritation in eyes and runny nose
- Sexual side effects
Serotonin-norepinephrine reuptake inhibitors (SSRIs)
SNRIs are also used for the treatment and management of anxiety and depression. SNRIs are approved by the Food and Drug Administration (FDA) for the management and treatment of anxiety and depression.
SNRIs work by inhibiting the reuptake of two excitatory monoamine neurotransmitters; serotonin and norepinephrine. This way, more amounts of serotonin and norepinephrine are available to bind to the respective receptors.
High doses of SNRIs can also be used in some patients, but only in those who can tolerate the drug well. For those who can not bear the effects caused by the higher doses, two antidepressants are paired together.
For treating anxiety and depression, SNRIs can be paired with SSRIs, another SNRI, Bupropion, or Mirtazapine. Some of these combinations hold great importance and can successfully manage the most severe kinds of depression.
Studies suggest that several case studies showed good responses to the combination treatment of Bupropion and SNRIs. However, the combination of Venlafaxine and Bupropion stands out from the rest of them.
Research shows that these two together can be used for the treatment and management of persistent depression and anxiety. Some of the common SNRIs include:
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
- Milnacipran (Ixel)
- Levomilnacipran (Fetzima)
They are considered good and effective antidepressants, but they also possess some risks. Some of the common side effects associated with the use of SNRIs include
- Drowsiness
- Fatigue
- Sleepiness or hypersomnia
- Decreased salivation leading to dry mouth
- Vertigo
- Loss of appetite
- Excessive sweating
- Constipation or diarrhoea
- Weight gain or loss
- Abdominal pain
- Bloating
- Flatulence
- Headache
- Muscular pain
Tricyclic antidepressants (TCAs)
Tricyclic antidepressants (TCAs) are also used for the treatment and management of both anxiety and depression. However, these meds are not used as the first line of therapy and may not be used until they become absolutely necessary.
TCAs were the drugs of choice during the early days, but people could not bear them. These meds work by inhibiting the reuptake of serotonin and norepinephrine, but they do bind to a number of other receptors which is the leading cause of the side effects. Some of the TCAs include
- Elavil (Amitriptyline)
- Pamelor (Nortriptyline)
- Tofranil (Imipramine)
Some of the side effects associated with the use of TCAs include:
- Painful urination
- Dry mouth or xerostomia
- Gastrointestinal side effects, including nausea and vomiting
- Weight gain
- Vertigo
- Drowsiness or extreme fatigue
- Constipation
- Abdominal pain
- Enlarged breasts
- Heartburn
- Excessive sweating
Monoaminoxidase inhibitors (MAOIs)
Monoaminoxidase inhibitors (MAOIs) are those antidepressants which are always used alone, but they actively work to counteract the symptoms associated with both anxiety and depression. They can not be paired with other antidepressants because of their mechanism of action.
They work by inhibiting the enzyme monoaminoxidase which is responsible for the breakdown and metabolism of serotonin and norepinephrine.
If they are paired with any other antidepressant, the drastic effects that are caused by the combination can give rise to a number of complications.
This is because the combination of MAOIs with any other antidepressant can excessively increase the amount of active serotonin in your body. Common MAOIs include
- Nardil (Phenelzine)
- Marplan (Isocarboxazid)
- Emsam (Selegiline)
- Parnate (Tranylcypromine)
Antidepressant dosing chart
| Antidepressants | Class | Recommended doses |
| Sertraline (Zoloft) | SSRI | 50 mg – 200 mg /day |
| Escitalopram (Lexapro) | SSRI | 10 mg – 20 mg /day |
| Citalopram (Celexa) | SSRI | 20 mg – 40 mg /day |
| Paroxetine (Paxil) | SSRI | 10 mg – 60 mg /day |
| Fluoxetine (Prozac) | SSRI | 20 mg – 80 mg /day |
| Duloxetine (Cymbalta) | SNRI | 30 mg – 120 mg /day |
| Venlafaxine (Effexor) | SNRI | 37.5 mg – 225 mg /day |
| Imipramine (Tofranil) | TCA | 75 mg – 200 mg /day |
| Amitriptyline (Elavil) | TCA | 50 mg – 150 mg /day |
| Phenelzine (Nardil) | MAOI | 15 mg – 90 mg /day |
| Isocarboxazid (Marplan) | MAOI | 20 – 60 mg /day |
Apart from the above-mentioned antidepressants, there are some other antidepressants which can also be used. Atypical antidepressants are also considered quite effective.
They are so-called because of their distinct mechanism of action. Unlike other antidepressants, they do inhibit the reuptake of any excitatory neurotransmitter.
Instead, atypical antidepressants have a dual mode of action. They can activate 5-HT1 receptors, which are one of the serotonin receptors.
They also enhance the stimulatory action of the noradrenergic system which increases the secretion of serotonin, while preventing the inhibitory action of the noradrenergic system which hinders the release of serotonin.
This means that instead of inhibiting the reuptake of serotonin from the synaptic cleft, atypical antidepressants work to increase the secretion of the said excitatory neurotransmitter.
They are also serotonin-specific and may or may not affect other neurotransmitters. The exact mechanism of action is still a topic for research. Some common atypical antidepressants include Mirtazapine (Remeron), Vortioxetine (Trintellix), Trazodone (Desyrel), and Nefazodone (Serzone).
Dopamine-norepinephrine reuptake inhibitors are also used, which include drugs like Bupropion (Wellbutrin). It can actively inhibit the reuptake of dopamine and norepinephrine to counteract the symptoms associated with both anxiety and depression.
All of these meds are associated with some side effects. These side effects can vary. Some people end up tolerating SSRIs quite well. For some who don’t, your doctor will prescribe another antidepressant that may help you recover from the symptoms associated with your mental health condition.
You just have to make sure that you’re doing your part well. Take your meds on time, eat good food, keep moving, and always have a positive mindset. Taking care of yourself may seem like hard work, but it’s something you owe yourself.
Conclusion
In this blog post, we have discussed the type of antidepressants that can be used for the treatment and management of both anxiety and depression.
We have learned that the most frequently prescribed antidepressants for such cases are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, tricyclic antidepressants and Monoaminoxidase inhibitors can also be used, but they are not considered the first line of therapy.
Most commonly, your doctor will prescribe you Sertraline because of its amazing results to manage both anxiety and depression at the same time. Make sure you consult your healthcare provider for such matters.
FAQs: Best antidepressant for anxiety and depression
What is the best antidepressant for both anxiety and depression?
SSRIs are one of the most commonly prescribed antidepressants for the management and treatment of both anxiety and depression. These drugs are very well tolerated and can significantly help restore your mental health. For severe anxiety and depression, some doctors prescribe two SSRIs in combination, mostly Sertraline and Escitalopram, to help relieve the disturbing symptoms associated with persistent depression.
What is the most effective antidepressant for anxiety?
Selective serotonin reuptake inhibitors (SSRIs) are considered the most effective drugs for the treatment and management of anxiety. Among SSRIs, Sertraline has some particular importance. It is approved by the Food and Drug Administration (FDA) for the treatment of generalised anxiety disorder and social anxiety disorder. However, there are other options available as well for people who do not respond well to SSRIs.
What are the top 3 antidepressants?
The top antidepressants include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Atypical antidepressants
- Tricyclic antidepressants (TCAs)
- Dopamine and norepinephrine reuptake inhibitors (DNRI)
- Monoaminoxidase inhibitors (MAOIs)
What is the most common drug prescribed for anxiety and depression?
Zoloft is the most commonly prescribed antidepressant for the treatment and management of both anxiety and depression, almost in the entire world. It is a selective serotonin reuptake inhibitor (SSRI). It works by inhibiting the reuptake of serotonin by blocking serotonin transporters (SERT). Zoloft is generally well tolerated and it has changed many lives, but it may cause serious side effects in some individuals. Make sure you ask your healthcare provider before using Zoloft.
What type of antidepressant gives you energy?
The type of antidepressant that treats your depression-induced lethargy can help boost your energy levels. The most common examples include Wellbutrin and Prozac. The kind of antidepressant you should take depends on the type of symptoms you have. If you suffer from depression-induced insomnia. There’s no point in taking a medication like Wellbutrin as it’ll make you even more restless. For such a person, taking an antidepressant that can help them fall asleep is a better choice.
References
- Medications that treat anxiety and depression https://www.singlecare.com/blog/medication-for-anxiety-and-depression/
- F Kapczinski et al. Cochrane Database Syst Rev. (2003) – Antidepressants for generalised anxiety disorder https://pubmed.ncbi.nlm.nih.gov/12804478/
- Cyril Höschl et al. Expert Rev Neurother. (2008) – Escitalopram for the treatment of major depression and anxiety disorders https://pubmed.ncbi.nlm.nih.gov/18416657/
- Selective Serotonin Reuptake Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK554406/
- SNRIs: their pharmacology, clinical efficacy, and tolerability in comparison with other classes of antidepressants https://pubmed.ncbi.nlm.nih.gov/16142213/
- Tricyclic antidepressants https://www.ncbi.nlm.nih.gov/books/NBK557791/
- Monoaminoxidase inhibitors https://www.ncbi.nlm.nih.gov/books/NBK539848/
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