PEBC: What You Need to Know: Atypical Antidepressants

Examples (ones that do not fit into SSRI or SNRI categories): vortioxetine, vilazodone, trazodone, bupropion, mirtazapine

Dosing:

-all can be dosed once daily

-bupropion sustained-release is given twice daily, whereas extended-release is once daily

Adverse Effects:

-dry mouth, constipation (mirtazapine, bupropion)

-nausea (vortioxetine)

-diarrhea (vilazodone)

-dizziness (vortioxetine, trazodone)

-insomnia (bupropion, vortioxetine)

-drowsiness (trazodone, mirtazapine)

-weight gain (less with bupropion)

-seizures (bupropion)

-QT prolongation

Drug Interactions:

-Contraindicated with MAO inhibitors - ensure 14 days between stopping MAOI and starting new agent

-serotonin syndrome with other triptans, tricyclic antidepressants (not a problem for bupropion since it only affects dopamine and norepinephrine)

-bupropion is a CYP2D6 inhibitor itself