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Antidepressants: Summary of Recommendations

Antidepressants can improve the symptoms of depression, but they can also have serious side effects. So you don’t want to take one if you don’t have to. The information in this report can help you decide—with your doctor or mental-health professional—whether an antidepressant might be right for you, and if so, which one.

Retail prices for commonly prescribed antidepressants range from about $20 a month to more than $400 a month. This report shows how you can save $100 a month ($1,200 a year) or more if you have to take an antidepressant regularly.

Here’s a thumbnail guide to help you decide if you should consider medication:

  • If you are feeling “down” or “blue”—for example, in the wake of a stressful life event, such as the death of someone close, a divorce, or a job loss—you may have mild depression. That’s especially likely if you are still able to function and have no history of depression. Your symptoms will usually ease on their own within a few months, aided, if necessary, by family support and professional counseling, without the use of an antidepressant.

  • If you are not functioning well and your symptoms have lasted for a few weeks, you are more likely to be a candidate for an antidepressant. That is especially true if there is no apparent reason for you to be depressed or if you have had repeated episodes of depression.

Your doctor may not be aware of price differences between medicines, so be cautious if he or she offers you a free sample of an antidepressant that they happen to have in their office. While the free price may be tempting, the drug may not be the right one for you. Individual needs vary and people respond to antidepressants quite differently. Some have to try two or three antidepressants before finding one that works.

Taking effectiveness, safety, side effects, and cost into account, we have chosen five Consumer Reports Best Buy Drugs as initial options to consider for depression:
  • Generic bupropion
  • Generic citalopram
  • Generic fluoxetine
  • Generic paroxetine
  • Generic sertraline
These medicines are substantially less expensive than brand-name antidepressants and are as equally effective. If you have drug coverage, talk with your doctor about finding the antidepressant that has the lowest out-of-pocket cost under your insurance plan.

This report was updated in July 2009.
Antidepressants: Drug Comparison
CR Best Buy Generic Name and Strength Brand Name1 Frequency of Use2 Average Monthly Cost3 Compare Prices
  Bupropion 75 mg tablet Wellbutrin Three a day $302
Bupropion 75 mg tablet Generic Three a day $58
  Bupropion 100 mg tablet Wellbutrin Two to four a day $294 - $588
Bupropion 100 mg tablet Generic Two to four a day $43 - $86
  Bupropion 100 mg sustained-release tablet Wellbutrin SR Two a day $246
  Bupropion 100 mg sustained-release tablet Budeprion SR Two a day $100
  Bupropion 100 mg sustained-release tablet Generic Two a day $100
  Bupropion 150 mg extended-release tablet Wellbutrin XL One a day $222
  Bupropion 150 mg extended-release tablet Budeprion XL One a day $173
  Bupropion 150 mg extended-release tablet Generic One a day $83
  Bupropion 150 mg sustained-release tablet Wellbutrin SR Two a day $280
  Bupropion 150 mg sustained-release tablet Budeprion SR Two a day $108
  Bupropion 150 mg sustained-release tablet Generic Two a day $72
  Bupropion 200 mg sustained-release tablet Wellbutrin SR Two a day $528
  Bupropion 200 mg sustained-release tablet Generic Two a day $182
  Bupropion 300 mg extended-release tablet Wellbutrin XL One a day $287
  Bupropion 300 mg extended-release tablet Budeprion XL One a day $152
  Bupropion 300 mg extended-release tablet Generic One a day $110
  Bupropion 348 mg extended-release tablet Aplenzin One a day $242
  Bupropion 522 mg extended-release tablet Aplenzin One a day $635
  Citalopram 10 mg tablet Celexa One a day $149
Citalopram 10 mg tablet Generic One a day $35
  Citalopram 20 mg tablet Celexa One a day $138
Citalopram 20 mg tablet Generic One a day $24
  Citalopram 40 mg tablet Celexa One a day $141
Citalopram 40 mg tablet Generic One a day $37
  Desvenlafaxine 50 mg sustained-release tablet Pristiq Once a day $155
  Desvenlafaxine 100 mg sustained-release tablet4 Pristiq Once a day $155
  Duloxetine 20 mg capsule Cymbalta Two a day $325
  Duloxetine 30 mg capsule Cymbalta Two a day $373
  Duloxetine 60 mg capsule Cymbalta One a day $179
  Escitalopram 5 mg tablet Lexapro One a day $121
  Escitalopram 10 mg tablet Lexapro One a day $119
  Escitalopram 20 mg tablet Lexapro One a day $123
  Fluoxetine 10 mg capsule Prozac One to two a day $213 - $426
Fluoxetine 10 mg capsule Generic One to two a day $22 - $44
  Fluoxetine 10 mg tablet Prozac One to two a day $201 - $402
Fluoxetine 10 mg tablet Generic One to two a day $44 - $88
  Fluoxetine 20 mg capsule Prozac One to two a day $214 - $428
Fluoxetine 20 mg capsule Generic One to two a day $22 - $44
Fluoxetine 20 mg tablet Generic One to two a day $32 - $64
  Fluoxetine 40 mg capsule Prozac One to two a day $435 - $870
Fluoxetine 40 mg capsule Generic One to two a day $44 - $88
  Fluoxetine 90 mg delayed-release capsule Prozac Weekly One per week $1815
  Fluvoxamine 25 mg tablet Generic One to two a day $68 - $136
  Fluvoxamine 50 mg tablet Generic One to two a day $67 - $134
  Fluvoxamine 100 mg tablet Luvox One to two a day $91 - $1826
  Fluvoxamine 100 mg tablet Generic One to two a day $58 - $116
  Fluvoxamine 100 mg continuous-delivery capsule Luvox CR One a day $178
  Fluvoxamine 150 mg continuous-delivery capsule Luvox CR One a day $189
  Mirtazapine 7.5 mg tablet Generic One at bedtime $81
  Mirtazapine 15 mg tablet Remeron One at bedtime $158
  Mirtazapine 15 mg tablet Generic One at bedtime $50
  Mirtazapine 15 mg dissolvable tablet Remeron One at bedtime $120
  Mirtazapine 15 mg dissolvable tablet Generic One at bedtime $74
  Mirtazapine 30 mg tablet Remeron One at bedtime $156
  Mirtazapine 30 mg tablet Generic One at bedtime $50
  Mirtazapine 30 mg dissolvable tablet Remeron One at bedtime $115
  Mirtazapine 30 mg dissolvable tablet Generic One at bedtime $76
  Mirtazapine 45 mg tablet Remeron One at bedtime $196
  Mirtazapine 45 mg tablet Generic One at bedtime $58
  Mirtazapine 45 mg dissolvable tablet Remeron One at bedtime $125
  Mirtazapine 45 mg dissolvable tablet Generic One at bedtime $76
  Nefazodone 50 mg tablet7 Generic Two a day $72
  Nefazodone 100 mg tablet7 Generic Two a day $70
  Nefazodone 150 mg tablet7 Generic Two a day $68
  Nefazodone 200 mg tablet7 Generic Two a day $69
  Nefazodone 250 mg tablet7 Generic Two a day $73
  Paroxetine 10 mg tablet Paxil One a day $135
  Paroxetine 10 mg tablet Pexeva One a day $178
Paroxetine 10 mg tablet Generic One a day $23
  Paroxetine 20 mg tablet Paxil One a day $145
  Paroxetine 20 mg tablet Pexeva One a day $203
Paroxetine 20 mg tablet Generic One a day $21
  Paroxetine 30 mg tablet Paxil Once a day $147
  Paroxetine 30 mg tablet Pexeva One a day $208
Paroxetine 30 mg tablet Generic One a day $45
  Paroxetine 40 mg tablet Paxil One a day $155
  Paroxetine 40 mg tablet Pexeva One a day $213
Paroxetine 40 mg tablet Generic One a day $49
  Paroxetine 12.5 mg sustained-release tablet Paxil CR One a day $127
  Paroxetine 12.5 mg sustained-release tablet Generic One a day $104
  Paroxetine 25 mg sustained-release tablet Paxil CR One a day $142
  Paroxetine 25 mg sustained-release tablet Generic One a day $111
  Paroxetine 37.5 mg sustained-release tablet Paxil CR One a day $141
  Sertraline 25 mg tablet Zoloft One a day $144
Sertaline 25 mg tablet Generic One a day $37
  Sertraline 50 mg tablet Zoloft One a day $133
Sertaline 50 mg tablet Generic One a day $33
  Sertraline 100 mg tablet Zoloft One a day $140
Sertaline 100 mg tablet Generic One a day $35
  Venlafaxine 25 mg tablet Effexor Two to three a day $171 - $256
  Venlafaxine 25 mg tablet Generic Two to three a day $107 - $161
  Venlafaxine 37.5 mg tablet Effexor Two to three a day $195 - $293
  Venlafaxine 37.5 mg tablet Generic Two to three a day $108 - $162
  Venlafaxine 50 mg tablet Effexor Two to three a day $172 - $2586
  Venlafaxine 50 mg tablet Generic Two to three a day $117 - $176
  Venlafaxine 75 mg tablet Effexor Two to three a day $229 - $344
  Venlafaxine 75 mg tablet Generic Two to three a day $110 - $165
  Venlafaxine 100 mg tablet Effexor Two a day $167
  Venlafaxine 100 mg tablet Generic Two a day $119
  Venlafaxine 37.5 mg sustained release capsule Effexor XR One a day $160
  Venlafaxine 37.5 mg sustained release tablet Generic One a day $112
  Venlafaxine 75 mg sustained release capsule Effexor XR One a day $174
  Venlafaxine 75 mg sustained release tablet Generic One a day $118
  Venlafaxine 150 mg sustained release capsule Effexor XR One a day $187
  Venlafaxine 150 mg sustained release tablet Generic One a day $127
1. "Generic" indicates drug sold by generic name

2. As typically prescribed.

3. Prices reflect nationwide retail average for May 2009, rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite®. Wolters Kluwer Health is not involved in our analysis or recommendations.

4. According to Pristiq's drug label, "in clinical studies, doses of 50-400 mg/day were shown to be effective, although no additional benefit was demonstrated at doses greater than 50 mg/day and adverse events and discontinuations were more frequent at higher doses.

5. Based on the cost of four capsules.

6. Price based on fewer than 20 prescriptions in one month.

7. The brand-name version of generic nefazodone (Serzone) was removed from the market but the generic version is still available. This drug has been associated with reports of severe liver damage and should be used with caution.