Antidepressants: FSA Eligibility

What are antidepressants?

Antidepressants are a class of drugs that are designed to modify an individual's brain chemistry, specifically affecting the balance of chemicals that contribute to a person's mood and behaviors. Today, 1 in 10 Americans is on some form of antidepressant to treat a wide range of medical conditions and disorders, such as depression, anxiety, post-traumatic stress disorder (PTSD), attention-deficit disorders, eating disorders and much more (WebMD).

Antidepressants were developed in the 1950s, largely by accident by Swiss researchers who found that a drug could tweak the brain's neurotransmitters by sending patients into bouts of euphoria. While these researchers were largely working with individuals with schizophrenia who had a negative reaction to the drug, scientists theorized it could be an effective treatment for depression. One of the first antidepressants called imipramine and marketed as Tofranil, was released in 1958 and sparked a wave of new antidepressant development.

What are the most common types of antidepressants?

Antidepressants fall into a wide range of potential categories based on their chemical composition and overall use. These include via Mayo Clinic:

SSRIs (Selective Serotonin Reuptake Inhibitors)

This is the most commonly prescribed class of antidepressants that primarily act on a chemical in the brain called serotonin. As reuptake inhibitors, this class of drugs prevents the reabsorption of neurotransmitters back into nerve cells in the brain after they are released to send messages between nerve cells. With an increased level of communication between nerve cells, this can strengthen circuits in the brain which regulate mood. These medications include common antidepressants like Zoloft, Prozac, Paxil, Lexapro and more.

Atypical Antidepressants

Another class of antidepressants is considered "atypical," and as opposed to SSRIs that just target serotonin, these medications target multiple neurotransmitters at once. In addition to serotonin, atypical antidepressants can regulate the levels of dopamine and norepinephrine that can also contribute to a person's moods and behaviors. The most common atypical antidepressants include Wellbutrin, Cymbalta, Effexor, Remeron and Desyrel.

Tricylic Antidepressants

Tricylic antidepressants are among the oldest style of antidepressants that include the forerunner of the drug class, imipramine. In most cases, these antidepressants are considered a last resort due to their high risk of side effects, and SSRIs and Atypical antidepressants are usually prescribed first. These medications have a broad mechanism of action and inhibit the brain's reuptake of serotonin and norepinephrine, as well as partially preventing the reabsorption of dopamine. The most common types of tricylic antidepressants include Elavil, Anafranil, Norpramin, Sinequan, Tofranil, Aventyl, Vivactil and Surmontil.