The Journal of clinical psychiatryMar 7, 2001

Brain processes that may explain why some antidepressants work faster

Psychedelic Science Weekly Brief ↗PubMed ↗

Updated Mar 25, 2026

Abstract

Some antidepressant agents may reduce depressive symptoms more rapidly than others.

Selective serotonin reuptake inhibitors, venlafaxine, and mirtazapine influence serotonin and norepinephrine levels.
The review focuses on how quickly these drugs affect neurotransmission compared to traditional antidepressants.
There is potential for some antidepressants to act faster or have a stronger effect than others.
Strategies to enhance or speed up the antidepressant response are discussed, with some already tested in patients.

Simplified

All antidepressant drugs have a delayed onset of action. There is, however, evidence that some agents may attenuate depressive symptoms more rapidly than others. The present review examines the mechanisms by which selective serotonin reuptake inhibitors, the dual 5-HT norepinephrine reuptake inhibitor venlafaxine, and the alpha2-adrenoceptor antagonist mirtazapine alter 5-HT and/or norepinephrine neurotransmission. Particular attention is given to the time course with which these effects manifest themselves in relation to the possibility that these 3 types of drugs may act more rapidly, or exert a greater antidepressant action, than other agents. Based on the effects of antidepressant drugs presently available, strategies to accelerate or augment the antidepressant response are described, some of which have already been examined in patients.

Brain processes that may explain why some antidepressants work faster

Abstract

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