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Antidepressants: Summary of Recommendations
Costs for commonly-prescribed antidepressants vary from $32 to more than $200 per month. This report shows how you can save $100 a month ($1,200 a year) or more if you have to take an antidepressant.

Antidepressants can improve the symptoms of depression, but they can also have serious side effects. You may not need one. A thumbnail guide:
  • If you are feeling "down" or "blue" — for example, in the wake of a stressful life event such as the death of a loved one, divorce or job loss — you may have mild depression. That's especially likely if you are still able to work and function and have no history of depression. Your symptoms may resolve on their own, aided by family support, professional counseling, or psychotherapy — and without the need of an antidepressant.
  • If you are not functioning well, and your symptoms (see page 6 of the full report) have lasted three weeks or longer, you are more likely to be a candidate for taking an antidepressant. That is especially true if there is no apparent reason for you to be in the doldrums, or if you have had repeated episodes of depression.

Use the information in this report to enhance your understanding of whether an antidepressant might be right for you, and if so, which one. Then talk with your doctor or a mental health professional. Bear in mind that individual needs vary and people respond to antidepressants quite differently. Some people have to try two or three before one works.

Your doctor may not be aware of price differences between medicines, and be cautious if he or she offers you a free sample of an antidepressant that's the only one on hand in the office. It may not be the right drug for you.

Taking effectiveness, safety, side effects and cost into account, we have chosen three Consumer Reports Best Buy Drugs as initial options to consider for depression:

  • Generic fluoxetine at a dose of 10 mg or 20 mg taken once a day, at a cost of $32 to $37 a month.
  • Generic citalopram at a dose of 20mg or 40mg once a day at a cost of $50 to $52 per month.
  • Generic bupropion at a dose of 75mg to 100mg taken three times a day at a cost of $60 to $71 per month.

These medicines are substantially less expensive than most other antidepressants, and are as effective as any of them. If you have drug coverage, talk with you doctor about finding the antidepressant that has the lowest out-of-pocket cost under your insurance plan.

Other important considerations:
  • Talk with your doctor about starting with a low dose to minimize side effects. If the drug doesn't help within 8 to 12 weeks, talk with your doctor about a higher dose or switching to another antidepressant.
  • Tell your doctor about other mood, emotional or mental symptoms, such an anxiety or panic attacks. These are important in deciding which antidepressant is right for you.
  • If you have taken an antidepressant before and it worked, you may want to stick with that one, or its generic equivalent.
  • Tell your doctor whether the differences in side effects among the antidepressants are important to you. (See page 10 of the full report.)
  • If you have frequent thoughts about suicide in the first few weeks of taking an antidepressant, contact your doctor or therapist to discuss this.
Antidepressants: Drug Comparison
Recommendations: Antidepressants
CR Best Buy Generic Name and Dose Brand Name1 Drug is a Generic Frequency of use per day2 Average Monthly Cost3 Compare
Prices
  Bupropion 75mg tablet Wellbutrin No Three $246
best buy Bupropion 75mg tablet Generic Yes Three $57
  Bupropion 100mg sustained release tablet Wellbutrin SR No Two $246
  Bupropion 100mg sustained release tablet Budeprion SR No Two $104
  Bupropion 100mg sustained release tablet Generic Yes Two $100
  Bupropion 100mg tablet Wellbutrin No Three $336
best buy Bupropion 100mg tablet Generic Yes Three $66
  Bupropion 150mg sustained release tablet Wellbutrin SR No Two $268
  Bupropion 150mg sustained release tablet Budeprion SR No Two $108
  Citalopram 20mg tablet Celexa No One $124
best buy Citalopram 20mg tablet Generic Yes One $30
  Citalopram 40mg tablet Celexa No One $130
best buy Citalopram 40mg tablet Generic Yes One $37
  Duloxetine 20mg enteric coated capsule Cymbalta No One-Two $151-$302
  Duloxetine 30mg enteric coated capsule Cymbalta No One-Two $171-$342
  Duloxetine 60mg enteric coated capsule Cymbalta No One $162
  Escitalopram 5mg tablet Lexapro No One $115
  Escitalopram 10mg tablet Lexapro No One $111
  Escitalopram 20mg tablet Lexapro No One $115
  Fluoxetine 10mg capsule Prozac No One $201
  Fluoxetine 10mg capsule Sarafem No One $227
best buy Fluoxetine 10mg capsule Generic Yes One $27
  Fluoxetine 10mg tablet Prozac No One $180
best buy Fluoxetine 10mg tablet Generic Yes One $81
  Fluoxetine 20mg capsule Sarafem No One $225
  Fluoxetine 20mg capsule Prozac No One $199
best buy Fluoxetine 20mg capsule Generic Yes One $27
best buy Fluoxetine 20mg tablet Generic Yes One $31
  Fluvoxamine 50mg tablet Generic Yes One at bedtime $64
  Fluvoxamine 100mg tablet Generic Yes Two a day $116
  Mirtazapine 15mg tablet Remeron No One at bedtime $134
  Mirtazapine 15mg tablet Generic Yes One at bedtime $51
  Mirtazapine 15mg sublingual tablet Remeron No One at bedtime $106
  Mirtazapine 15mg sublingual tablet Generic Yes One at bedtime $79
  Mirtazapine 30mg tablet Remeron No One at bedtime $144
  Mirtazapine 30mg tablet Generic Yes One at bedtime $49
  Paroxetine 20mg tablet Paxil No One $134
  Paroxetine 20mg tablet Pexeva No One $173
  Paroxetine 20mg tablet Generic Yes One $21
  Paroxetine 30mg tablet Paxil No Once $138
  Paroxetine 30mg tablet Pexeva No One $164
  Paroxetine 30mg tablet Generic Yes One $51
  Paroxetine 12.5mg sustained release tablet Paxil CR No One $125
  Paroxetine 25mg sustained release tablet Paxil CR No One $134
  Paroxetine 37.5mg sustained release tablet Paxil CR No One $139
  Sertraline 25mg tablet Zoloft No One $134
  Sertraline 25mg tablet Generic Yes One $42
  Sertraline 50mg tablet Zoloft No One $128
  Sertraline 50mg tablet Generic Yes One $36
  Venlafaxine 37.5mg sustained release capsule Effexor XR No One $142
  Venlafaxine 37.5mg tablet Effexor No Two $188
  Venlafaxine 37.5mg tablet Generic Yes Two $120
  Venlafaxine 75mg sustained release capsule Effexor XR No One $154
  Venlafaxine 50mg tablet Effexor No Two $176
  Venlafaxine 50mg tablet Generic Yes Two $128
  Venlafaxine 75mg tablet Effexor No Two $198
  Venlafaxine 75mg tablet Generic Yes Two $136
  Venlafaxine 150mg sustained release capsule Effexor XR No One $165

(1) "Generic" indicates that this drug is sold as a generic, as also indicated in column three.

(2) Per day except where noted.

(3) Prices reflect nationwide retail averages for September 2006, rounded to the nearest dollar; information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.

(4) Could not obtain updated prices for mirtazapine (Remeron). The monthly cost presented here is for April 2006.

(5) These are new generic drugs, as of summer or fall 2006. Their prices will decline when other generic companies are permitted to sell their versions in 2007.