Atypical Antidepressants


Overview: Medications in the ‘Atypical Antidepressant’ class are occasionally used to treat depression. The medications that belong in this class are simply antidepressants that act in an atypical manner compared to other antidepressants. Some other conditions that are helped by atypical antidepressants include Anxiety, Obsessive-Compulsive Disorder and Post-traumatic stress disorder.





How do they work?: Atypical antidepressants raise the levels of various transmitters such as dopamine, serotonin and norepinephrine. These are believed to subsequently help improve mood and emotion. It is recommended that any antidepressant medication is used in conjunction with some form of psychotherapy.


How effective are they?: Recent research has suggested that some Atypical antidepressants are just as good as SSRIs and SNRIs in treating depression. Atypical antidepressants are useful for anyone suffering from moderate or severe depression. Bupropion (Wellbutrin) is often used as an add-on medication for SSRIs, which has been proven to be useful.


Treatment Course: Atypical Antidepressants generally come in tablet form, though some can be injected or taken as a liquid if required. Once prescribed, a low dose will initially be prescribed. A typical treatment course lasts six months, though it can often rise to around 18 months, or even indefinite use. Unfortunately, it takes at least two weeks for benefits to be felt. At first, your mood may start to increase again. The full benefits of antidepressants normally take up to six weeks to be felt. If after this point you haven’t witnessed an improvement, it is worth talking to your GP or mental health specialist. They may suggest switching antidepressants. Many people succeed on their second antidepressant. It is highly likely you will experience some mild side effects early in the treatment. It is crucial however to not stop taking the tablets, as these side effects will disappear quickly.


Types of Atypical Antidepressants: There are primarily four atypical antidepressants that are prescribed in the United Kingdom for mental health conditions. Mirtazapine and Bupropion are the most popular.



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Side Effects

We recommend consulting the individual page for each antidepressant for information on side effects – as they differ from tablet to tablet. Furthermore, the leaflet that comes with each pack of tablets contains enhanced information on side effects. Side effects generally are only present in the first few days of treatment, with the body needing time to get used to treatment. You will often see a GP during the first month of treatment to see how you are reacting.


Atypical Antidepressants often cause a dry mouth, dizziness, constipattion and lightheadedness when first taking them. Unlike most other antidepressants, atypical medicines don’t tend to cause sexual dysfunction. As always, it is important to read the information leaflet.




As with any medication, you must be careful when taking antidepressants. Your GP or mental health professional should make you aware of any types of medicine or foods that you should avoid. Some frequently used medications, even over-the-counter ones shouldn’t be used with antidepressants. It is worth looking at the individual page of each antidepressant to see cautions, but an overview is provided here.


Other Medicines: Ibuprofen and aspirin are often not recommended when using antidepressants. Each information leaflet will provide the types of medicines not to be used. It is important NOT to combine medicines from different classes of antidepressants, or take two from one class at the same time. You should also avoid the herbal remedy St John’s Wort.


Alcohol: Alcohol acts as a depressant, therefore it is recommended that anyone taking an antidepressant stays away from drinking alcohol.


Pregnancy and Breastfeeding: Antidepressants generally aren’t recommended for pregnant women. Taking antidepressants while breastfeeding also isn’t recommended.


Young People: People under the age of 18 are rarely prescribed antidepressants, instead being offered therapy. The exception to this is the SSRI Fluoxetine (Prozac). If therapy hasn’t worked, antidepressants can be prescribed. People under the age of 25 taking antidepressants have been shown to be vulnerable to suicidal thoughts – a serious side effect.


Illicit Drugs: The use of illegal or recreational drugs isn’t recommended, as they can react unpredictably with antidepressants. Cannabis, cocaine, heroin and ketamine have been known to particularly worsen symptoms.


As always, ensure you read the information leaflet.