Antidepressants are the medications most often prescribed to treat clinical depression. Depression is caused by an imbalance in the brain’s chemicals. Dopamine, serotonin, and norepinephrine effect a person’s emotional response affecting mood. These medications are effective by balancing the brain’s natural chemicals. Antidepressants help control these chemicals and bring them back into balance.
Among the different antidepressants, Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed medications. Examples include:
- Citalopram (Celexa)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Escitalopram (Lexapro)
Other common antidepressants are Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs). These medications include duloxetine and venlafaxine. These medications work in a similar way to SSRIs. Both SNRIs and SSRIs are newer classes of antidepressants. They are more often prescribed because of their few side effects.
However, older medications are sometimes the best solution despite their many side effects and interactions. These older classification of antidepressants include:
- Monoanamine Oxidase Inhibitors (MAOIs)
Bupropion works on dopamine receptors. Unlike other medications, this drug does not fit into the specific SSRI and SNRI grouping.
What side effects can be expected?
All medications have some side effects, but it is important to remember everyone reacts differently. The good part about antidepressants is the side effects are usually short lived. As with any medication, any unusual reactions or long-term side effects should be reported to your doctor immediately.
Common side effects of SSRIs and SNRIs include:
- Sleeplessness or drowsiness, this may occur during the first few weeks of treatment. If the sleeplessness or drowsiness does not go away after a few weeks adjustments may need to be made to the dosage or time the pill is taken.
- Agitation or feeling jittery
- Sexual problems which may include reduced sex drive or problems enjoying and having sex
Patients taking tricyclic antidepressants may experience the following side effects.
- Sexual problems, which may include a reduced sex drive, problems having sex, and problems enjoying sex.
- Dry mouth
- Bladder problems, which includes difficulty emptying the bladder or weakened urine stream. Men with enlarged prostate may need to speak with their doctor prior to taking this medication.
- Blurred vision
Patients taking MAOIs have additional concerns they must pay close attention to. Certain medications such as cold medications and decongestants, and foods such as wine and cheese contain a substance known as tyramine. This substance, when mixed with a MAOI can cause an increased in blood pressure. This sudden increase can cause a stroke. Patients taking an MAOI should get a list of medications and foods that they must avoid from their physician.
How to take antidepressants.
When taking an antidepressant, patients must follow the dosing directions carefully. For this medication to work correctly specific doses should be taken at specific times of the day. The medication also needs to be taken for the specific length of time as prescribed by the psychiatrist.
Never stop an antidepressant without your doctor’s instruction. Stopping the medication too soon may lead to a relapse in the depression symptoms and can also lead to withdrawal type symptoms.
There are times when depression medication does not work the first time. It can take time for the antidepressants to build up in the system, hard to treat depression may require a change in medication. Don’t be afraid to tell your doctor when something doesn’t seem to be working.
Antidepressant FDA warnings
For adults, antidepressants are safe with few side effects. However, recent studies indicate they may not be safe for children and teens. According to research, 4% of the nearly 4400 participants involved either thought about or attempted suicide. Only 2% of the participants who were receiving sugar pills instead of the antidepressants had similar thoughts or actions.
The FDA does have a warning on antidepressants that are used to treat children and young adults stating that there may be an increased risk of suicidal thinking or attempts. The FDA urges anyone who has increased thoughts of suicide to speak with their physician immediately.
The warning also affects patients of all ages during the first few weeks of treatment. The FDA suggests that family members or caretakers should monitor patients for increased suicidal thinking or behavior or other changes in behavior such as withdrawal from normal situations, agitation, and sleeplessness. As usual, caretakers should report any significant changes to the doctor.