title: Dual action antidepressants and some important considerations.
abstract: OBJECTIVE
  To review controlled studies of long-term treatment and their side-effects with newer dual action antidepressants following an acute episode of major depression.
  
  
  METHODS
  A literature review (MedLine) was undertaken and references were selected for their relevance and methodology in describing their contribution to the examination of our objective.
  
  
  CONCLUSIONS
  Three dual action antidepressants are identified: venlafaxine, mirtazapine and milnacipran. These are more effective and better tolerated than the older tricyclic antidepressants in the treatment of an acute episode of depression and in the prevention of relapse. They also offer advantages in that they lack autonomic side-effects of the tricyclics. However, sedation, nausea and sexual side-effects may occur with venlafaxine, and weight gain with mirtazapine.
authors.affiliation: Phillip Health Centre, Woden, Canberra, Australia.
authors.forename: Ramesh K
authors.initials: RK
authors.lastname: Gupta
authors.forename: John W
authors.initials: JW
authors.lastname: Tiller
authors.forename: Graham D
authors.initials: GD
authors.lastname: Burrows
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D003511:Cyclohexanols / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D003521:Cyclopropanes / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000494:pharmacology* / Q000627:therapeutic use*; D000078764:Milnacipran; D000078785:Mirtazapine; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced; D000069470:Venlafaxine Hydrochloride; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D000317:Adrenergic alpha-Antagonists; D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D003521:Cyclopropanes; D006634:Histamine H1 Antagonists; D008803:Mianserin; D000078764:Milnacipran; D000078785:Mirtazapine; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride