A Basic Overview Of Depression Medication Used Today

Antidepressants are often prescribed to those suffering through depression and depression symptoms as part of a treatment plan. They work off of the belief that low levels of chemicals in the brain called neurotransmitters play a part in depression. An increase of these chemicals may cause improvement in mood, appetite, brain function and sleep habits for patients battling the illness. They usually just address the symptoms of depression and not the root causes for the disorder, so in a lot of cases antidepressants are just part of the treatment process that may also include psychotherapy. For those suffering with major depression, antidepressants may offer relief. For more mild to moderate cases of depression, the results may be mixed.

Antidepressants are not a cure for depression, but they can help severe patients stabilize and improve the way they feel as they work to recover from their depressive episode. They can only be prescribed by physician’s and psychiatrists and often times may produce unwanted side effects.

Studies have called into question the efficacy of antidepressants and if they truly offer any benefit to patients. They can take several weeks for any substantial effect to be seen and once they are stopped a relapse of depression symptoms may occur.

There are several types of depression medications that work in slightly different ways to relieve the signs of depression. It is important to know how they work, and what side effects and risks may be involved before this course of treatment is carried out.

Different Types of Antidepressants?

Serotonin, norepinephrine and dopamine are the three key neurotransmitters thought to be associated with depression. The different types of depression medication all deal with at least one of these three brain chemicals to some degree or another.

MAOIs (Monoamine Oxidase Inhibitors)

These were the first kind of antidepressants to be established. This medication targets the enzyme monoamine oxidase which breaks down serotonin, norepinephrine and dopamine. When the enzyme is blocked or “inhibited” it cannot break down those three chemicals thus keeping their levels high in the brain.

MAOIs are used with caution as concerns over possible interactions with certain foods and other drugs exist.

Brand names of some popular MAOIs include Nardil (Phenelzine), Parnate (Tranylcypromine), Marlpan (Isocarboxizid) and Emsam and Zelapar (Selegiline)

TCAs (Tricyclic Antidepressants)

TCAs have been around since the 1950s and primarily target norepinephrine levels with a minor effect on serotonin levels in the brain. Brand names of tricyclic antidepressants include Pamelor (Nortriptyline), Norpramin (Desipramine), Tofranil (Imipramine), Vivactil (Protriptyline) and Surmontil (Trimipramine)

SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)

These block the reuptake (reabsorbtion) of both serotonin and norepinephrine inside of the brain. Sometimes referred to a a dual uptake inhibitor, SNRIs may also affect other neurotransmitters as well. Brand names of SNRIs include Effexor and Effexor XR (Venlafaxine), Pristiq (Desvenlafaxine) and Cymbalta (Duloxetine). SNRIs are occasionally used to treat anxiety.

SSRIs (Selective Serotonin Reuptake Inhibitors)

These are also a relatively new form of antidepressants, coming after TCAs, and are probably the most widely prescribed kind of depression medication. These work solely to increase the levels of serotonin in the brain by blocking the reuptake (reabsortion) of the chemical.

Some of the brand names of popular SSRIs include Zoloft (Setraline), Prozac (Fluoxetine), Paxil (Paroxetine), Celexa (Citalopram) and Lexapro (Escitalopram).

Side Effects and Risks Associated with Antidepressants

Treatment of depression symptoms with any of the different types of antidepressants does not come without any risks.. Patients are urged to discuss with their psychiatrist or prescribing physician any of the potential side effects or health risks that might occur when taking depression medications.

MAOIs – There are some side affects associated with MAOIs, but their interactions with other drugs as well as with certain foods has been their greatest detractor and has limited their use. MAOIs may cause fainting spells as a result of lowering blood pressure. Some other side effects may include, dry mouth, sexual dysfunction, aches, insomnia and weight gain.

Besides serotonin, dopamine and norepinephrine, monoamine oxidase also break down tyramine, a chemical found in aged foods such as cheeses. MAOIs prevent the normal breakdown of tyramine causing levels of it to build in the body. Too much tyramine can lead to high blood pressure or hypertensive crisis. Anyone prescribed an MAOI should alter their diets to avoid foods with tyramine.
The greatest risks of MAOIs come as a result of interactions with other drugs or supplements. They should not be used along side substances that raise levels of serotonin, norepinephrine or dopamine.

TCAs – Each of the different TCAs may carry their own set of side effects but the most common may be:

  • Dry mouth
  • Dizziness
  • Blurred vision
  • Constipation
  • Weight gain
  • Fatigue
  • Aches
  • Decreased libido
  • Nausea
  • Light sensitivity
  • Increase in appetite
  • Seizures
  • Drowsiness

SNRIs – Some of the more common side effects one may experience with SNRIs may include:

  • Appetite changes
  • Tremor
  • Dizziness
  • Reduced libido, climactic difficulty
  • Blurred vision
  • Heart palpitations
  • Aches
  • Insomnia or sleeping too much
  • Nausea
  • Dry mouth
  • Weakness
  • Increase in sweat production

SSRIs – Side effects of SSRIs are similar to other types of antidepressants and may include the following:

  • Sexual side effects, reduced libido, erectile dysfunction
  • Headaches
  • Dry mouth
  • Diarrhea or constipation
  • Insomnia or drowsiness
  • Increase in sweat production
  • Weight gain
  • Nausea
  • Restlessness

Nearly half of all patients taking a SSRI report some kind of sexual side effect.

Patients taking warafin should also use caution as SSRIs increase the effectiveness of warafin and it may lead to immoderate bleeding.
Those using SSRIs while taking NSAIDs are at great risk of intestinal bleeding.

Note: There is always a slight chance and risk with any antidepressant that instead of lowering depression symptoms, they might make them worse in certain individuals increasing the risk of suicide. Extreme caution and careful monitoring of children and teenagers who are prescribed depression medications should be exercised. Although it is more prevalent in younger patients, all patients should take notice of the state of their depression symptoms when taking antidepressants.

Any changes for the worse should be reported to the primary physician or psychiatrist immediately.

Patients should not stop their antidepressants abruptly. They should slowly ween themselves off of the medication by slowly decreasing their dosage over a period of time and only under the guidance of the prescribing doctor. They should never do it on their own.

Weighing the Risks

Each antidepressant approved to treat depression comes with some form of risk or potential for side effects. It is not uncommon for patients to try different types or brands of depression medication due to side effects. It may take a few tries before finding an antidepressant who’s side effects are not present or at least tolerable for the patient.

Before starting on an antidepressant it is important for depression sufferers to be well informed of what to expect and to weigh the potential side effects and health risks to the potential benefits the medication might give them. A thorough discussion between a psychiatrist and the patient is always recommended prior to the start of antidepressant treatment.

While antidepressants are not a magic cure for depression and some might argue against their effectiveness, they are still a big part of modern psychiatry.