Serotonin-Related Antidepressants and the Treatment of Bipolar Disorder

By Candida Fink, Joe Kraynak

The following table lists several antidepressants used in the treatment of bipolar disorder besides Selective Serotonin Reuptake Inhibitors (SSRIs) and Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) that affect serotonin but differ structurally from the SSRIs and SNRIs.

Two of the medications in the table are used commonly as sleep aids because they’re so sedating, and some affect other neurotransmitters as well.

Potential Benefits and Side Effects of Other Serotonin-Related
Antidepressants
Generic Name Brand Name Average Adult Dose Potential Benefits Some Possible Side Effects*
Mirtazapine Remeron 15 to 25 mg/day Antidepressant (approved for use in unipolar depression); very
sedating (often used as a sleep aid).
Suicidal ideation; agitation; disinhibition; mania; sedation;
weight gain; dry mouth; increased cholesterol.
Nefazodone Serzone 300 to 600 mg/day Antidepressant (approved for use in unipolar depression);
antianxiety.
Suicidal ideation; agitation; disinhibition; mania; liver
abnormalities (liver function should be monitored); sedation;
insomnia; headache; dry mouth; constipation; muscle weakness;
sexual dysfunction.
Trazodone Desyrel 150 to 600 mg/day Antidepressant (approved for use in unipolar depression);
sedative (often used as a sleep aid).
Suicidal ideation; agitation; disinhibition; mania; sedation;
dry mouth; headache; dizziness and nausea; sexual dysfunction;
priapism (an erection that doesn’t stop, which can be a medical
emergency).
Vilazodone Viibryd 20 to 40 mg/day Antidepressant (approved for use in unipolar depression). Suicidal ideation; agitation; disinhibition; mania; belly and
gastrointestinal problems; sexual dysfunction.
Vortioxetin Brintellix 5 to 20 mg/day Antidepressant (approved for use in unipolar depression). Suicidal ideation; agitation; mania; nausea; sexual
dysfunction.

mg/day = milligrams per day

* Other side effects may occur that arent listed.