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Group Main Use	Medication Brand/Generic	Form	Dose Schedule	Dose Range	Most Common Side Effects for Group	Pros for Group	Cautions for Group
Remeron (depression booster, sleep, and appetite increase)	Remeron mirtazapine	Tablet, Scored 15 mg 30 mg 45 mg Solutab 15, 30, 45mg	Once a day, evening	Child:7.5-30 mg Adoles:7.5-45 mg Adult 15-45 mg	Sedation, often increases appetite. May be less sedation at higher doses.	Less GI or sexual side effects than SRI group. Helps sleep, agitation and anxiety. Combination of Norepinephrine and serotonin boost. May boost other meds. Few interactions. No Routine labs or EKG. May help GI. Generic	As with all antidepressants, avoid combinations or overlap with MAOI. Same time onset as SRI or TCA.
Wellbutrin (depression, booster)	Wellbutrin bupropion HCI Aplenzin bupropion HBr Zyban	Tablet (not scored) 75 mg 100mg 174, 348 = 300, 522mg SR 100, 150, 200mg 150mg XL 300mg XL	Given 2-3 times a day. Start in the a.m. SR 1-2 times a day. XL once a day Aplenzin once a day	Child: 37.5-150mg Adoles: 75-300mg Adult:  150-450mg	Increased energy. Decreased appetite.	No significant sexual side effects. No labs or EKG needed. Very few interactions. May help Attention Deficit Hyperactivity Disorder. Good for boosting other meds. Approved to help stop smoking. Generic	Avoid if personal seizure history. Caution if family seizure history. Avoid if bulimia. Probably less effective than SRI for severe anxiety. Same time onset as SRI and TCA and all other antidepressants.
(depression sleep)	Desyrel trazodone	Tablets 50mg, 100mg, 150mg, 300mg	Usually bedtime only	Child: 25-200mg Adoles: 25-300mg Adult: 50-600mg	Sedation significant especially with Trazodone. Dizziness.	Excellent sleep aid. Often used to help sleep along with SRI or Wellbutrin. Not habit forming. Inexpensive generic.	One in 10,000 risk of priapism. Trazodone relatively weaker antidepressant and anti-anxiety medication.
SNRI Serotonin and Norepinephrine Inhibitors (depression, anxiety, panic, OCD, pain) Savella (fibromyalgia, depression) Fetzima (depression)	Effexor (venlafaxine) Effexor XR (venlafaxine) Pristig XR (desvenlafaxine)	tablet, scored 25, 37.5, 75, 100 mg XR (extended release) 37.5, 75, 150 mg XR tablets 50, 100 mg	2 or 3 times a day XR once a day	Child: 25-200 mg Adoles: 75-300 mg Adult: 150-450 mg 50 -  < 400 mg	Similar to SRI plus a bit more night sweat and constipation sometimes.	Effexor and other SNRI's  increase both serotonin and norepinephrine thus affecting two important neurotransmitter systems, unlike SRI's. May be broader spectrum effect because of two transmitters increased. Fewer interactions. Same as Effexor. Research shows some benefit against pain. FDA approval of Cymbalta for pain is a plus.	Slight risk increased blood pressure at doses over 200 mg total a day. (less than 5% chance.) Discontinuation syndrome (nausea, dizziness, "flu-ish," "out of sorts" may occur if stopped suddenly without taper or skip on or several days. Not dangerous, but unpleasant. More likely with Paxil or Effexor, not with Prozac because it lasts longer. Can occur with SRI, SNRI, or TCA. Cymbalta rare liver injury especially if alcohol abuse.
	Cymbalta (duloxetine)	capsule 20 mg 30 mg 60 mg	once or twice a day	30-120 mg usually 60 mg for adults	Similar to SRI and Effexor above. Tends to increase energy and weight neutral.
						Although Savella is an SNRI like others and approved in Europe for depression, it is FDA approved so far only for Fibromyalgia. Fetzima is approved for depression, not fibromyalgia. These 2 emphasize norepinephrine more than serotonin. Both are brand only.	Because it is an SNRI avoid use with an SRI or other SNRI. These 2 SNRI meds are very similar to other 3. Newer in US.
	Savella milnacipran Fetzima levomilnacipran	Tablets 12.5, 25, 50, 100mg XR capsules 20, 40, 80, 120mg	Usually twice a day Once a day	12.5 to 200mg 100mg is adult usual dose after building up slowly. 40-120mg adults	Like other SNRIs. Can affect liver or urine flow. Nausea and constipation are most common. Little weight effect if any.