Antidepressant Medication

It is never easy to deal with depression. Along with making several lifestyle changes, you will have to take antidepressant medication to keep things under control. Antidepressants do not cure depression, but they certain help in making your symptoms more manageable. There are different types of antidepressants available today, and you have to choose a different one if you do not get desired results from the one you are taking. Work with your doctor and try different antidepressants until you find the one that really helps.

Available Antidepressant Medications

Most antidepressants work by slowing down the release of certain chemicals called neurotransmitters from the brain. Your brain cannot function properly in the absence of neurotransmitters, such as norepinephrine and serotonin, which help control your mood and are involved in other functions, such as sleep, eating, thinking and feeling pain. Today, you can find many different types of antidepressants, and how one antidepressant medication works may be a bit different from the way other works. For instance:

1. MAOIs

They were the first class of antidepressant medications, but are not that popular mainly due to drug interactions as well as interactions with certain foods. These antidepressants are usually beneficial for depressed patients who are fatigued or sleep a lot.

  • Examples: The most popular examples of this antidepressant medication are phenelzine (Nardil), isocarboxazid (Marplan), tranylcypromine (Parnate), and selegiline transdermal system (EMSAM).
  • Possible Side Effects: The most common side effects associated with the use of MAOIs are insomnia, headaches and Hypertension.

2. SSRIs

This class of antidepressants has been introduced quite recently, but they work quite effectively by elevating the level of serotonin in the brain.

  • Examples: The most common examples of SSRIs are escitalopram (Lexapro), citalopram (Celexa), fluoxetine (Sarafem or Prozac), sertraline (Zoloft), paroxetine (Paxil CR, Pexeva or Paxil), and fluvoxamine (Luvox).
  • Possible Side Effects: You may have to deal with side effects such as headaches, vomiting, nausea and diarrhea. Other common side effects include restlessness, insomnia and agitation. Some people also experience sexual dysfunction, as well as unexplained weight loss or weight gain. Lowering the dose may help prevent most of these side effects.

3. Tricyclic Antidepressants

Tricyclic antidepressants or TCAs prove quite effective for the treatment of depression; however, they are not as safe as some of the new antidepressants are. They produce quite a few side effects and are usually administered only if you get no benefits from SSRIs.

  • Examples: The most common examples of this antidepressant medication are imipramine (Tofranil), amitriptyline (Elavil or Endep), desipramine (Norpramin), nortriptyine (Pamelor or Aventyl), doxepin (Adapin or Sinequan), trimipramine (Surmontil), and protrityline (Vivactil).
  • Possible Side effects: These antidepressants may cause cardiovascular problems, such as abnormal heart rates, orthostatic hypotension, and abnormal heart rhythms. Orthostatic hypotension may also cause dizziness. Tricyclic antidepressants may also have anticholinergic effects, which usually manifest as constipation, dry mouth, sexual dysfunction, urinary hesitation, visual disturbance and increased heart rate.

4. SNRIs

These are the newest antidepressants available in the market and they work by increasing the levels of norepinephrine and serotonin in the brain.

  • Examples: The most common examples of this antidepressant medication arevenlafaxine (Effexor), duloxetine (Cymbalta), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima).
  • Possible Side Effects: You usually experience the same side effects that are associated with SSRIs. Some people may also have to deal with hypertension, especially when they take higher doses of SNRIs.

5. NDRIs

Norepinephrine and dopamine reuptake inhibitors (NDRIs) are increasingly popular and work quite effectively too. Never use bupropion with 14 days of taking an MAO inhibitor because of the probability of a dangerous drug interaction.

  • Examples: The most common example of NDRIs is bupropion (Forfivo XL, Aplenzin and Wellbutrin).
  • Possible Side Effects: There are certain side effects like seizure in certain cases, but NDRIs usually have fewer or no sexual side effects. If you stop bupropion suddenly, you may experience withdrawal symptoms.

6. Atypical Antidepressants

These are quite different from other types of antidepressants, but they work well for some patients.

  • Examples: The most common examples are vortioxetine (Brintellix), trazodone (Oleptro), and mirtazapine (Remeron).
  • Possible Side Effects: These antidepressants have sedating effects on your nervous system, so it is important to take them in the evening only. Some antidepressants in this class have fewer sexual side effects.

7. Other Antidepressants

In addition to these antidepressants, your healthcare provider may consider including other medications in your treatment program to enhance the effects of any antidepressant medication that you may be taking. Usually, they combine two antidepressants or medications, such as antipsychotics or mood stabilizers. They may also prescribe anti-anxiety and stimulant medications for better effects.

Precautions When Using Antidepressant Medications

As mentioned, there are certain risks associated with almost all types of antidepressants. You need to know these risks before you start taking any antidepressant medication. Keep in mind that you are more likely to deal with side effects if:

  • You are over 65 years of age and take SSRI medications. These medications increase risk for fractures, falls and bone loss.
  • You are pregnant. There may be withdrawal symptoms in newborns if you take SSRs late in pregnancy. The most common symptoms are restlessness, tremor, weak cry, and mild respiratory problems.
  • You are a young adult. There is an increased risk of suicide associated with the use of depression medications in children and young adults.
  • You have bipolar disorder. Taking antidepressants can make your disorder worse and even trigger a manic episode. 

Watch the video below to know what antidepressant abuse and withdrawal means:

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