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Which antidepressants come in liquid forms?

Many, but not all, antidepressant medications are available as liquid formulations, which include “oral solutions” (to be taken as provided) and “oral concentrates” (must be diluted before taking). These are useful in many situations—for children, those with trouble swallowing, when very slow increases or decreases in dose are required, and so on.

The following are the liquid preparations of antidepressant medications that are available in the US.


Selective Serotonin Reuptake Inhibitors (SSRIs)

Citalopram (generic only) 10 mg/5 mL (Prescribing Information). Available in 75 mL, 150 mL, 240 mL, 300 mL, and 450 mL packaging (source: goodrx.com).

Escitalopram oral solution (generic only) 5 mg/5 mL (Prescribing Information). Available in 150 mL, 240 mL, 300 mL, 450 mL, and 600 mL packaging (source: goodrx.com). The brand name Lexapro® oral solution is no longer available (source: Lexapro® Prescribing Information).

Fluoxetine oral solution (generic only) 20 mg/5 mL (Prescribing Information). Available only in 120 mL packaging (source: goodrx.com).

Paroxetine oral suspension (Paxil® oral suspension and generic) 10 mg/5 mL (Paxil® Prescribing Information; generic Prescribing Information). Both brand-name and generic paroxetine oral solutions are available only in 250 mL packaging (source: goodrx.com).

Sertraline oral solution (Zoloft® oral solution and generic) 20 mg/mL (Zoloft® oral solution Prescribing Information; generic Prescribing Information). Both brand-name and generic sertraline oral solutions are available only in 60 mL packaging (source: goodrx.com). Note: Sertraline oral solution is a “concentrate” that must be diluted before it is taken.

Fluvoxamine (not available in a liquid formulation)


Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

None of the SNRIs is available in the United States in a liquid formulation. This includes (alphabetically): desvenlafaxine extended-release, duloxetine, levomilnacipran, milnacipran, and venlafaxine/venlafaxine extended-release.

In Europe, venlafaxine is available as an oral solution (75 mg/5 mL; Summary of Product Characteristics)


Tricyclic antidepressants (TCAs)

Nortriptyline 10 mg/5 mL. Available in 75 mL, 115 mL, 150 mL, 300 mL, and 473 mL packaging (source: goodrx.com).


MAO inhibitors (MAOIs)

None of them is available as a liquid (phenelzine, tranylcypromine, isocarboxazid).


Other antidepressants

Bupropion/ bupropion sustained-release (SR)/ bupropion extended-release (XL)—not available as a liquid

Mirtazapine—not available as a liquid


Summary

SSRIs: Liquid formulations are available in the US for all but one of the six SSRIs—for citalopram, escitalopram, fluoxetine, paroxetine, and sertraline, but not for fluvoxamine.

TCAs: A liquid formulation is available for nortriptyline.

Other antidepressants: A liquid formulation is NOT available for ANY of the serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants other than nortriptyline, or any of the MAO inhibitors.


Related Pages

How to manage patients who are “sensitive to medications”

Antidepressants: What are the alternatives to the oral route?

Sometimes, a medication may be given rectally

Can patients who are NPO not take medications orally?


Medication formulations and their contents

Do sustained-release preparations have fewer adverse effects?

Extended-release preparations of psychotropic medications

Which extended-release capsule can be opened and how?

Two patients where opening medication capsules was helpful

Why, when, and how to split medication tablets

Recommended pill cutters and pill crushers

Which tablets are actually extended-release formulations and so should not be cut?

Orally disintegrating tablets (ODTs) can be useful 

Psychotropic medications are sometimes given sublingually

Gluten in medications

Can lactose in medication pills cause intolerance?


Medication cost, generics, pharmacies

How to find out the price of medications, compare prices, and get the lowest possible price

Tips on reducing the cost of medications by using higher strength pills

Medications from Canadian pharmacies?

Using a Canadian pharmacy can reduce the cost of some medications

Should we encourage patients to use independent pharmacies?

Medication prices on Costco.com versus on Goodrx.com

A simple way to significantly reduce the cost of l-methylfolate (Deplin®)

How can I know in advance whether the insurance will cover this medication?

Prior authorization for medications

Pharmacy benefit managers

Are generic medications really equivalent to brand-name medications?

Which manufacturers of generic versions of psychotropic medications are better or worse?


Main Menu: Medications


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Disclaimer: The material on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified healthcare professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.

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Comments

  1. Theodore Miller MD says

    August 21, 2022 at 12:15 pm

    I believe this was widely done in the U.S. Fluoxetine is stable in acidic solutions. Alan Schatzberg’s Biological Therapies in Psych once had an article about “the end of Cranzac”.
    I would have pts dissolve a 10-20mg FLX cap in 20 ounces of orange or cranberry juice and slowly titrate down their SRI dose as tolerated. Usually folks seem to benefit from encouragement to proceed slowly. Altering proportions, it becomes possible to ingest very small increments of SRI. Giving pts substantial control over the rate of titration seemed to facilitate the process and mitigate some of the distress at hving a withdrawal reaction.

    Your newsletter is the ideal mix of expert opinion and evidenced based care. It is the most useful resource I’ve encountered in years. Thank you so much for your efforts!

    Reply
  2. Theodore Miller says

    August 15, 2022 at 10:59 am

    Do you ever have patients make their own liquid formulation of fluoxetine in acidic fruit juice, typically orange or cranberry?

    Reply
    • Rajnish Mago, MD says

      August 16, 2022 at 9:09 pm

      Hi Dr Miller. I have not done this. Please do share your experience with this, if any. At 20 mg/day, a month’s supply of fluoxetine oral solution costs $34 out of pocket per goodrx.com. Thanks!

      Reply

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