atypical antidepressant
{{Short description|Class of antidepressant medication}}
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An atypical antidepressant is any antidepressant medication that acts in a manner that is different from that of most other antidepressants. Atypical antidepressants include agomelatine, bupropion, iprindole, mianserin, mirtazapine, nefazodone, opipramol, tianeptine, and trazodone.{{cite journal | vauthors = Feighner JP | title = Mechanism of action of antidepressant medications | journal = J Clin Psychiatry | volume = 60 | pages = 4–11; discussion 12–3 | year = 1999 | issue = Suppl 4 | pmid = 10086478 }}{{cite journal | vauthors = Stahl SM | title = Basic psychopharmacology of antidepressants, part 1: Antidepressants have seven distinct mechanisms of action | journal = J Clin Psychiatry | volume = 59 | pages = 5–14 | year = 1998 | issue = Suppl 4 | pmid = 9554316 }}{{cite journal | vauthors = Frazer A | title = Pharmacology of antidepressants | journal = J Clin Psychopharmacol | volume = 17 | pages = 2S–18S | year = 1997 | issue = Suppl 1 | pmid = 9090573 | doi = 10.1097/00004714-199704001-00002}} The agents vilazodone and vortioxetine are partly atypical. Typical antidepressants include the SSRIs, SNRIs, TCAs, and MAOIs, which act mainly by increasing the levels of the monoamine neurotransmitters serotonin and/or norepinephrine. Among TCAs, trimipramine is an atypical agent in that it appears not to do this. In August 2020, esketamine (JNJ-54135419) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of treatment-resistant depression with the added indication for the short-term treatment of suicidal thoughts.{{cite news | title=FDA Approves A Nasal Spray To Treat Patients Who Are Suicidal | newspaper=NPR.org | date=4 August 2020 | url=https://www.npr.org/2020/08/04/899060885/fda-approves-a-nasal-spray-to-treat-patients-who-are-suicidal | access-date=27 September 2020}}
Buprenorphine/samidorphan (ALKS-5461) is an antidepressant with a novel mechanism of action which was formerly under development and considered an atypical antidepressant.{{cite journal | vauthors = Garay RP, Zarate CA, Charpeaud T, Citrome L, Correll CU, Hameg A, Llorca PM | title = Investigational drugs in recent clinical trials for treatment-resistant depression | journal = Expert Rev Neurother | volume = 17 | issue = 6 | pages = 593–609 | year = 2017 | pmid = 28092469 | doi = 10.1080/14737175.2017.1283217 | pmc=5418088}} They act faster than available antidepressants.