TCM Clinical Dashboard
Depression - TCM Single Herb Dashboard
Gold-standard depression medications
Conventional Medicine View
How it explains depression: Conventional medicine has historically viewed depression as a problem of low serotonin and related brain-chemical signaling, which is why antidepressant medications were designed to raise those signals. Today, mainstream medicine usually says depression is more complex than just serotonin, but medications are still used because they can shift brain signaling and help many people feel better over time.
What is serotonin? Serotonin is a signaling chemical used by the brain, gut, and blood platelets.
What does serotonin control? It helps regulate mood, sleep, appetite, pain perception, stress response, memory and learning, intestinal movement, and platelet-related blood clotting functions.
Do these drugs cure depression? Usually no. They are mainly used to reduce symptoms and lower relapse risk, not as a guaranteed permanent cure.
Will some people stay on them long term? Yes. Some people taper off later, but others stay on them for years depending on how often depression returns and how severe it is.
Possible long-term side effects: sexual dysfunction, weight gain, emotional blunting, and sleep-related problems in some patients.
PubMed verification: Monoamine hypothesis review
| Medication class | What it is commonly used for | What it actually does in the body |
|---|---|---|
| SSRIs sertraline, escitalopram, fluoxetine, similar first-line antidepressants | Often the default first medication class for major depression because it is effective and usually easier to tolerate than older antidepressants. | They block serotonin reuptake, which leaves more serotonin available for nerve cells to use; over time this helps calm stress circuits and supports healthier mood signaling. |
| SNRIs venlafaxine, duloxetine, desvenlafaxine | Used when depression comes with low energy, poor concentration, or sometimes more physical pain symptoms. | They block reuptake of both serotonin and norepinephrine, which can strengthen mood, alertness, and stress-response signaling over time. |
| Bupropion | Often chosen when low motivation, fatigue, or concern about sexual side effects is important. | It mainly raises norepinephrine and dopamine activity rather than serotonin, so it can support drive, focus, and mental energy. |
| Mirtazapine | Often chosen when depression comes with insomnia, poor appetite, or weight loss. | It changes specific norepinephrine and serotonin receptors in a way that increases release of these mood-related signals and often makes people feel sleepier and hungrier. |
Neurotransmitters
Serotonin
Serotonin is a signaling chemical used by the brain, gut, and blood platelets. It helps regulate mood, sleep, appetite, pain perception, stress response, memory and learning, intestinal movement, and platelet-related blood clotting functions.
Dopamine
Dopamine is involved in reward, motivation, attention, movement control, and goal-directed behavior. It also affects endocrine signaling and helps drive mental energy, interest, and action.
Norepinephrine
Norepinephrine helps control arousal, attention, alertness, stress readiness, blood pressure, and heart-related sympathetic signaling. It is a major part of the body’s fight-or-focus response.
Epinephrine
Epinephrine, also called adrenaline, is a stress hormone and signaling chemical that raises heart rate, blood pressure, blood sugar availability, airflow, and blood flow to muscles during acute stress.
柴胡 (Chai Hu - Bupleurum)
Mechanisms
Serotonin and dopamine modulation, HPA axis regulation, increased BDNF, and anti-inflammatory effects.
Clinical evidence
Improves HAM-D scores; comparable to SSRIs in mild-moderate depression in formula-based trials.
Best use
Stress-driven depression and cortisol dysregulation patterns.
郁金 (Yu Jin - Curcuma)
Mechanisms
MAO inhibition, increased serotonin and dopamine, anti-inflammatory actions, and neuroprotection.
Clinical evidence
Comparable to fluoxetine in RCTs; significant symptom reduction versus placebo.
Best use
Biochemical depression and monoamine-deficiency style patterns.
远志 (Yuan Zhi - Polygala)
Mechanisms
Increased BDNF, neurotransmitter enhancement, better synaptic plasticity, and GABA modulation.
Clinical evidence
Improves mood and cognition; used in depression with memory impairment.
Best use
Depression with brain fog or cognitive decline.
Sources
合欢皮 (He Huan Pi - Albizia)
Mechanisms
Serotonin and GABA modulation, anti-anxiety actions, and anti-inflammatory effects.
Clinical evidence
Improves mood and sleep; reduces depressive behavior, with limited human data.
Best use
Depression with anxiety and insomnia.
Sources
石菖蒲 (Shi Chang Pu - Acorus)
Mechanisms
Dopamine and serotonin modulation, neuroprotection, and cognitive enhancement.
Clinical evidence
Improves post-stroke depression and cognition.
Best use
Neurological depression related to brain injury or aging.
Sources