Antidepressants appeared in the late 1950s, and have been used in the treatment of individuals suffering from major depression or the depression phase of bipolar disorder. Antidepressants include the tricyclics and monoamine oxidase (MAO) inhibitors. These drugs have the effect of increasing the concentration in the nervous system of catecholamines such as epinephrine. The toxic effects of the MAO inhibitors have been largely overcome in recent years, and the drugs are still used in many instances. They have been supplanted in many uses, however, by tricyclic compounds, such as amitriptyline (Elavil), and the newer serotonin increasers, such as fluoxetine (Prozac) and sertraline HCL (Zoloft). Tricyclics are chemically similar to phenothiazines, but that activate rather than tranquilize (see stimulant). The choice of an antidepressant often has more to do with its side effects than efficacy.
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