THIRD-GENERATION AND SPECIAL ANTIDEPRESSANTS

BRAND NAME (GENERIC NAME)	HOW THE DRUG WORKS	SPECIAL USES	DAILY DOSE
Desyrel (Trazodone)	Serotonin 2 antagonist	Insomnia—the drug of choice for insomnia because it is not addicting and boosts serotonin which often is the reason for insomnia. Very useful for alcoholics and drug abusers.	50-600 mg
Effexor XR (venlafaxine)	Boosts serotonin (and norepinephrine in doses greater than 150 mg)	Energizing antidepressant, generalized anxiety, panic disorder, chronic pain (at doses of 225 mg or higher). Taper dose slowly when discontinuing med.	75-300 mg
Cymbalta (duloxetine)	Boosts serotonin and norepinephrine in equal amounts	Energizing antidepressant, peripheral neuropathy, fibromyalgia, chronic pain, stress urinary incontinence	60 mg
Wellbutrin XL (bupropion)	Boosts dopamine and norepinephrine	Activating and motivating antidepressant, useful in cocaine-induced depression, improves cognitive slowing, reverses SSRI-induced sexual dysfunction, reduces craving during smoking cessation	150-450 mg
Remeron (mirtazapine)	Blocks alpha 2 adrenergic presynaptic receptors, blocks 5HT2A, 5HT2C, 5HT3 serotonin receptors	Boosts usefulness of Effexor XR, improves appetite, insomnia and anxiety. Good med for nausea because of 5HT3 effects. Ideal patient for this med is depressed, skinny, sleepless and anxious (or sad, skinny, sleepless and scared).	15-45 mg