Dual action antidepressants and some important considerations.

OBJECTIVE

To review controlled studies of long-term treatment and their side-effects with newer dual action antidepressants following an acute episode of major depression.

METHOD

A literature review (MedLine) was undertaken and references were selected for their relevance and methodology in describing their contribution to the examination of our objective.

RESULT AND CONCLUSION

Three dual action antidepressants are identified: venlafaxine, mirtazapine and milnacipran. These are more effective and better tolerated than the older tricyclic antidepressants in the treatment of an acute episode of depression and in the prevention of relapse. They also offer advantages in that they lack autonomic side-effects of the tricyclics. However, sedation, nausea and sexual side-effects may occur with venlafaxine, and weight gain with mirtazapine.