Antidepressants (SSRIs, SNRIs & Newer Agents)
Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and newer treatments for depression and anxiety.
How Antidepressants Work
SSRIs (sertraline, fluoxetine, escitalopram) increase serotonin levels in the brain by blocking its reabsorption. SNRIs (duloxetine, venlafaxine) also increase norepinephrine. Newer agents like Spravato (esketamine nasal spray) target the glutamate system for treatment-resistant depression. Auvelity combines dextromethorphan with bupropion.
Antidepressants (SSRIs, SNRIs & Newer Agents) — Ranked by Cost Per Claim (Cheapest First)
| # | Drug | Generic Name | Cost/Claim | Generic? |
|---|---|---|---|---|
| 1 | Cymbalta | Duloxetine | $19.00 | Yes |
| 2 | Duloxetine | Duloxetine Hydrochloride | $21.00 | Yes |
| 3 | Pristiq | Desvenlafaxine | $139.00 | Yes |
| 4 | Trintellix | Vortioxetine | $278.00 | No |
| 5 | Auvelity | Dextromethorphan/Bupropion | $375.00 | Yes |
| 6 | Spravato | Esketamine | $1,839.00 | Yes |
Potential Savings
Generic SSRIs cost $4-20/month and are equally effective as brand-name versions for most patients. Spravato ($1,839/claim) is reserved for treatment-resistant depression — it requires in-office administration and monitoring.
First-line generic: sertraline at $4.00/claim. Ask your doctor if this is appropriate for you.
Key Facts
- 1.21 million US adults (8.4%) had at least one major depressive episode in the past year
- 2.Generic SSRIs (sertraline, fluoxetine, escitalopram) cost $4-20/month — among the cheapest drugs available
- 3.Brand-name antidepressants can cost 10-400x their generic equivalents
- 4.Spravato (esketamine) costs $1,839/claim but is the only FDA-approved nasal spray for treatment-resistant depression
- 5.SNRIs like generic duloxetine ($19-21/claim) also treat chronic pain and fibromyalgia
Frequently Asked Questions
The cheapest option is Sertraline (generic Zoloft) at $4 per claim. Generic SSRIs cost $4-20/month and are equally effective as brand-name versions for most patients. Spravato ($1,839/claim) is reserved for treatment-resistant depression — it requires in-office administration and monitoring.
SSRIs (sertraline, fluoxetine, escitalopram) increase serotonin levels in the brain by blocking its reabsorption. SNRIs (duloxetine, venlafaxine) also increase norepinephrine. Newer agents like Spravato (esketamine nasal spray) target the glutamate system for treatment-resistant depression. Auvelity combines dextromethorphan with bupropion.
All spending data comes from the CMS Medicare Part D Drug Spending Dashboard. Patent and generic information comes from the FDA Orange Book. Prices shown are average cost per 30-day supply claim under Medicare Part D.