Background: The fate of 14 antidepressants along with their respective N-desmethyl metabolites and the anticonvulsive drug carbamazepine was examined in a primary sewage treatment plant (STP) and following advanced treatments with ozone (O₃). The concentrations of each pharmaceutical compound were determined in raw sewage, effluent and sewage sludge samples by LC-MS/MS analysis. The occurrence of antidepressant by-products formed in treated effluent after ozonation was also investigated. Results: Current primary treatments using physical and chemical processes removed little of the compounds (mean removal efficiency: 19%). Experimental sorption coefficients (K_d) of each studied compounds were also calculated. Sorption of venlafaxine, desmethylvenlafaxine, and carbamazepine on sludge was assumed to be negligible (log K_d ≤ 2), but higher sorption behavior can be expected for sertraline (log K_d ≥ 4). Ozonation treatment with O₃ (5 mg/L) led to a satisfactory mean removal efficiency of 88% of the compounds. Screening of the final ozone-treated effluent samples by high resolution-mass spectrometry (LC-QqToFMS) did confirm the presence of related N-oxide by-products. Conclusion: Effluent ozonation led to higher mean removal efficiencies than current primary treatment, and therefore represented a promising strategy for the elimination of antidepressants in urban wastewaters. However, the use of O₃ produced by-products with unknown toxicity.