Atypical Antidepressants

The residual class — everything outside the SSRI, SNRI and tricyclic groupings, which means the family is defined by what it is not and nothing generalises across it. Bupropion inhibits noradrenaline and dopamine reuptake and lowers the seizure threshold. Mirtazapine antagonises α₂ and H1 and sedates heavily. Trazodone blocks 5-HT2A. Agomelatine is a melatonin agonist. Vortioxetine acts at several serotonin receptors as well as the transporter.

Two members carry facts the heading actively hides. Tianeptine is a μ-opioid agonist: it produces opioid effects, opioid dependence and an opioid withdrawal, and it is met in the recreational supply on those terms rather than as an antidepressant. Nefazodone is a strong CYP3A4 inhibitor and has been withdrawn in places over liver injury. Read this family member by member, because the class name tells you nothing.