Antidepressant medicines

The 5 Most Used Antidepressants

Antidepressant medicines

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Every day, one six Americans takes a psychiatric medication, according to a 2017 study published in the Journal of the American Medical Association (JAMA).

 Twelve percent of these prescription drugs are antidepressants, medications that can be life-saving for people dealing with the symptoms of major depressive disorder—symptoms that range from sadness and loss of interest in things they once loved to do to extreme feelings of helplessness and even thoughts of suicide.

The most commonly used antidepressants in the study were:

  • Zoloft (sertraline hydrochloride)
  • Celexa (citalopram hydrobromide)
  • Prozac (fluoxetine hydrochloride)
  • Desyrel (trazodone hydrochloride)
  • Lexapro (escitalopram oxalate)
  • Cymbalta (duloxetine hydrochloride)

Perhaps the most recognizable among them is Prozac (fluoxetine).

It's still the best option for many people, but since it was approved by the Food and Drug Administration (FDA) in 1987, Prozac has been joined by a variety of other antidepressant medications.

If you're considering taking an antidepressant, understanding how the most popular ones work can help you and your doctor decide which might work best for you.

There are many different types of medications available to treat depression. These include:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Atypical antidepressants
  • Tricyclic antidepressants (TCAs)
  • Monoamine oxidase inhibitors (MAOIs)
  • Other medications or combinations of antidepressants

In a report issued by the National Center for Health Statistics, 12.7% of people in the United States over the age of 12 reported taking antidepressant medication in the previous month. This research also found that antidepressant use had grown by 64% between 1999 and 2014, increasing from 7.7% in 1999-2002 to 12.4% in 2011-2014. 

Prozac belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Serotonin is a neurotransmitter that's present in the gut and in the brain. Neurotransmitters are chemicals that help send messages from the end of nerve fibers to other nerves, or to muscles or other structures.

One study looking at individuals treated with antidepressants in the United States between 1996 and 2005 found that nearly 67% of respondents were treated with SSRIs. 

In the brain, low levels of serotonin have been associated with depression and anxiety as well as panic disorders and obsessive-compulsive behavior.

 Low levels of serotonin in the gut have been associated with irritable bowel syndrome (IBS), osteoporosis, and even cardiovascular disease.

 SSRIs do exactly what the name describes: They prevent ​the reuptake (movement back into the nerve endings) of serotonin, making more of the chemical available. In other words, SSRIs relieve depression by boosting low levels of serotonin in the brain.

Before SSRIs, there were two main classes of antidepressants: monoamine oxidase inhibitors (MAOIs) and tricyclics (TCAs). Both of these types of medications had more potential side effects than SSRIs and were more dangerous if someone accidentally took too much, so it's easy to see why there's been an increase in the types of SSRIs to choose from.

Some of the most commonly prescribed SSRIs include:

  • Prozac (fluoxetine): Prozac is still one of the most popular SSRIs in the United States. It's one of the only ones that the FDA has approved for children and teenagers to use. The 2017 antidepressant use study found that a little over 11% of respondents reported taking Prozac for depression.
  • Celexa (citalopram): Studies show that Celexa works as well as other SSRIs and has similar side effects. One important thing to know about this antidepressant is that taking high doses of it has been associated with a rare heart rhythm problem. An estimated 14% of respondents reported that they were taking this medication.
  • Zoloft (sertraline): Zoloft is highly effective, although some people find it's more ly than other SSRIs to cause diarrhea. Zoloft is the most commonly prescribed antidepressant; nearly 17% of those survey in the 2017 antidepressant use study reported that they had taken this medication.
  • Paxil (paroxetine): You might be more ly to have sexual side effects if you choose Paxil over other antidepressants. It's also linked to a higher risk of sweating. While paroxetine did not make the list of the 10 most commonly prescribed psychiatric drugs, it remains a popular choice for some people.
  • Lexapro (escitalopram): Along with Prozac, Lexapro is one of the only SSRIs that's been approved by the FDA for teenagers to use. Around 8% of those surveyed reported that they had taken Lexapro.

Most SSRIs are very similar in regards to how well they work, although there may be subtle differences that can make one a better choice for you than another. It takes a while for all SSRIs to build up in the body enough to have an effect on symptoms, however, so it can several weeks or even months of trial-and-error to find the particular drug and dosage that will do you the most good.

The side effects of various SSRIs can vary a bit as well, but in general, you may experience any of a few common and relatively minor temporary ones, such as nausea, diarrhea, headaches, dizziness, dry mouth, sweating, and trembling.

As for more annoying and potentially dangerous side effects, some people gain weight after they start taking an antidepressant, although sometimes it's not the drug itself but rather improved appetite and a renewed appreciation for eating that leads to the gain.

Other people find taking an antidepressant puts a damper on their sex lives: Men might have trouble getting an erection, for example, and women may have a hard time reaching orgasm, so that can be an important consideration if you're in an intimate relationship.

People taking an SSRI may find the drug causes them to feel panicky and nervous; some may have thoughts of hurting themselves or committing suicide. Adolescents are especially at risk and should be monitored closely.

Other common antidepressants belong to a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs). These inhibit the reuptake of two neurotransmitters: serotonin and norepinephrine.

The SNRIs that are available are:

  • Strattera (atomoxetine)
  • Pristiq (desvenlafaxine)
  • Cymbalta (duloxetine)
  • Fetzima (levomilnacipran)
  • Savella (milnacipran)
  • Ultram (tramadol)
  • Effexor (venlafaxine)

While Strattera is an SNRI, it is used as a non-stimulant to treat ADHD, not depression or anxiety.

One of the most commonly prescribed SNRIs is Effexor (venlafaxine), which is as effective as other antidepressants in treating depression, but does have a higher rate of causing nausea and vomiting, and may increase blood pressure and heart rate.

The SNRI Cymbalta (duloxetine) also can increase blood pressure, but the bigger concern with this drug is that in some people it can lead to liver failure, so if you have any sort of liver disease it could be a dangerous choice for you. The same is true if you drink a lot of alcohol.

In the 2017 study on psychiatric drugs, Cymbalta was the most commonly prescribed SNRI drug, with 7% of respondents reporting that they had taken this type of medication.

Tricyclics were among the first antidepressants. While they have been largely replaced by SSRIs, SNRIs, and other antidepressants, TCAs can still be a good option in cases where people have not responded to other types of antidepressants.

Types of tricyclics that are available include:

  • Elavil (amitriptyline)
  • Asendin (amoxapine)
  • Norpramin (desipramine)
  • Silenor (doxepin)
  • Tofranil (imipramine)
  • Pamelor (nortriptyline)
  • Vivactil (protriptyline)
  • Surmontil (trimipramine)

Tricyclics work by blocking the absorption of serotonin and norepinephrine. By preventing the reuptake of those neurotransmitters, it increases serotonin and norepinephrine levels in the brain, which can help to improve mood and relieve depression. 

No type of TCA medication made the top 10 list of the most commonly prescribed psychiatric drugs.

Atypical antidepressants do not fit into the other antidepressant categories and include:

Of the atypical antidepressants, Wellbutrin is one of the most commonly prescribed. It works by acting on the neurotransmitter dopamine. An estimated 24 million prescriptions for bupropion were given in the year 2017. It has a lower risk of sexual side effects. In fact, some doctors prescribe Wellbutrin along with another SSRI to help counter low libido.

Monoamine oxidase inhibitors (MAOIs) were the first type of medication developed to treat depression. They have been largely replaced by newer antidepressants that are safer and have fewer side effects. MAOIs are rarely prescribed given the significant risk associated with eating certain foods containing tyramine, which can cause a hypertensive crisis.

Some of the most commonly prescribed MAOIs include:

  • Marplan (isocarboxazid)
  • Nardil (phenelzine)
  • Parnate (tranylcypromine)
  • Emsam (selegiline)

MAOIs work by inhibiting monoamine oxidase, an enzyme that breaks down serotonin, dopamine, and norepinephrine, which are all neurotransmitters that control mood. This results in higher levels of these chemicals in the brain which helps improve mood and reduce anxiety.

A study of antidepressant usage found that almost 38% of respondents had been prescribed new medications other than SSRIs and tricyclic antidepressants (TCAs). Just over 11% had been prescribed tricyclics.

Source: https://www.verywellmind.com/most-common-antidepressants-1066939

Antidepressant Medication – HelpGuide.org

Antidepressant medicines

Antidepressants are a range of medications used in the treatment of depression and other mental health conditions, and are some of the most commonly prescribed medications around.

They include selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).

Antidepressant medications are designed to change chemicals (neurotransmitters) in the brain that affect mood and emotions. When you’re suffering from the pain and anguish of depression, that can sound a simple and convenient method of relief.

Of course, it’s important to remember that—despite what you may have heard—depression isn’t simply caused by the balance of chemicals in the brain.

Rather, it’s caused by a complex combination of biological, psychological, and social factors, including lifestyle, relationships, and coping skills that medication can’t address.

That doesn’t mean that antidepressants don’t work for some people. After all, aspirin can ease a headache even though headaches aren’t caused by an aspirin imbalance. When your depression is severe, antidepressant medication can be helpful, even lifesaving.

But, while it can help relieve symptoms in some people, it isn’t a cure for depression and is not usually a long-term solution. As time goes on, some people who respond initially to medication can slip back into depression, as can those who stop taking the medication.

Antidepressants also often come with unpleasant side effects so it’s important to weigh the benefits against the risks when considering depression medication.

Many people with mild to moderate depression find that therapy, exercise, and self-help strategies work just as well or even better than medication—minus the side effects. Even if you decide to take medication, it’s a good idea to also pursue therapy and lifestyle changes that can help you to address the underlying issues and beat depression for good.

Types of antidepressants and their side effects

Side effects are common in all antidepressants. For some people, the side effects can even be serious enough to make them stop taking the medication.

SSRIs

The most widely prescribed antidepressants come from a class of medications known as selective serotonin reuptake inhibitors (SSRIs), which include drugs such as Prozac, Zoloft, and Paxil. SSRIs act on the neurotransmitter serotonin, a brain chemical which helps to regulate mood.

SNRIs

As the name suggests, serotonin and norepinephrine reuptake inhibitors (SNRIs) act on the brain chemical norepinephrine as well as serotonin. They include the drugs Pristiq, Cymbalta, Fetzima, and Effexor and may also be used to treat anxiety and depression accompanied by pain.

Side effects of SSRIs and SNRIs

Since the neurotransmitter serotonin also plays a role in digestion, pain, sleep, and mental clarity, SSRIs and SNRIs can cause a wide range of side effects, including:

  • Nausea
  • Insomnia
  • Anxiety
  • Restlessness
  • Decreased sex drive
  • Dizziness
  • Weight gain
  • Tremors
  • Excessive sweating
  • Sleepiness or fatigue
  • Dry mouth
  • Diarrhea
  • Constipation
  • Headaches

Some SNRIs may also raise blood pressure or exacerbate liver problems. SSRIs and SNRIs can also cause serious withdrawal symptoms, especially if you stop taking them abruptly.

Atypical antidepressants

Atypical antidepressants don’t fit into other classes of antidepressants, but target different neurotransmitters to change the brain chemistry and regulate mood. They include Wellbutrin, Remeron, Desyrel, Serzone, Viibryd, and Trintellix.

The side effects vary according to the specific drug. However, many of the atypical antidepressants can cause nausea, fatigue, weight gain, sleepiness, nervousness, dry mouth, and blurred vision.

Older depression drugs

Tricyclic antidepressants (TCAs) and MAOIs (monoamine oxidase inhibitors) are older classes of antidepressants. Their side effects are more severe than those of the newer antidepressants, so they are only prescribed as a last resort after other treatments and medications have failed.

Esketamine (Spravato)

The U.S. Food and Drug Administration (FDA) recently approved esketamine (brand name Spravato) for patients with severe, treatment-resistant depression.

Taken as a nasal spray in conjunction with an oral antidepressant, esketamine may deliver rapid improvement of symptoms for some patients with major depression.

However, as a form of ketamine, it also carries some mind-altering side effects, including dissociation, changes in speech and behavior, anxiety, and suicidal thoughts. There is also the potential for abuse and misuse of this drug and, as yet, no definitive studies on its long-term effects.

Antidepressants and suicide risk

There is a danger that, in some people, antidepressant treatment will cause an increase, rather than a decrease, in depression. In fact, the FDA requires that all depression medications in the U.S. include a warning label about the increased risk of suicide in children and young adults. The suicide risk is particularly great during the first month or two of treatment.

Anyone taking antidepressants should be closely watched for suicidal thoughts and behaviors. Monitoring is especially important if this is the person’s first time on depression medication or if the dose has recently been changed. If you spot the warning signs in yourself or a loved one, contact your doctor or therapist immediately.

  • Suicidal thoughts or attempts
  • New or worse depression
  • New or worse anxiety
  • New or worse irritability
  • Feeling agitated or restless
  • Difficulty sleeping
  • Aggression and anger
  • Acting on dangerous impulses
  • Extreme hyperactivity
  • Other unusual changes in behavior

If you are concerned that a friend or family member is contemplating suicide, see Suicide Prevention.

Risk factors

Anyone who takes antidepressants can experience side effects, but certain individuals are at a higher risk:

People over 65. Studies show that some antidepressant medications may increase the risk for falls, fractures, and bone loss in older adults.

Pregnant women. The use of some antidepressants late in pregnancy may lead to short-term withdrawal symptoms in newborns after delivery. Typical symptoms include tremor, restlessness, mild respiratory problems, and weak cry.

Teens and young adults. All depression medications carry an increased risk of suicide in children and young adults.

People who may have bipolar disorder. Antidepressants can actually make bipolar disorder worse or trigger a manic episode; there are other treatments available for those with bipolar disorder.

Is depression medication right for you?

If you’re considering antidepressants as a treatment option, the following questions may help you make your decision.

Questions to ask yourself and your doctor

  • Is my depression adversely affecting my life enough to require drug treatment?
  • Is medication the best option for treating my depression?
  • Am I willing to tolerate unwanted side effects?
  • What non-drug treatments might help my depression?
  • Do I have the time and motivation to pursue other treatments such as therapy and self-help?
  • What self-help strategies might reduce my depression?
  • If I decide to take medication, should I pursue therapy and alternative treatments as well?

Questions to ask your doctor

  • Are there any medical conditions that could be causing my depression?
  • What are the side effects and risks of the antidepressant you are recommending?
  • Are there any foods or other substances I will need to avoid?
  • How will this drug interact with other prescriptions I’m taking?
  • How long will I have to take this medication?
  • Will withdrawing from the drug be difficult?
  • Will my depression return when I stop taking medication?

Guidelines for taking antidepressants

The more you know about your antidepressant, the better equipped you’ll be to deal with side effects, avoid dangerous drug interactions, and minimize other safety concerns.

Some suggestions:

Follow instructions. Be sure to take your antidepressant according to the doctor’s instructions. Don’t skip or alter your dose, and don’t stop taking your pills as soon as you begin to feel better. Stopping treatment prematurely is associated with high relapse rates and can cause serious withdrawal symptoms.

Beware of drug interactions. Drinking alcohol can lessen the effects of some antidepressant medications.

Dangerous drug interactions can also occur when SSRIs or SNRIs are taken with blood thinners, prescription painkillers, or antihistamines found in many over-the-counter cold and allergy medicines and sleep aids. Always talk to your doctor or pharmacist before combining medications.

Monitor side effects. Keep track of any physical and emotional changes you’re experiencing and talk to your doctor about them. Contact your doctor or therapist immediately if your depression worsens or you experience an increase in suicidal thoughts. See your doctor on a regular basis.

Be patient. Finding the right drug and dosage is a trial and error process. It takes approximately four to six weeks for antidepressant medications to reach their full therapeutic effect. Many people try several medications before finding one that helps.

Try therapy and self-help as well. Combining antidepressant medication with therapy and self-help measures can often be more effective than taking medication alone—or even enable you to take a lower dose. Therapy and lifestyle changes can also address the underlying causes of your depression to prevent it returning when you’re able to come off antidepressants.   

Regularly review your symptoms and medication needs. Your needs and the effectiveness of antidepressants can change over time. Some people build up a tolerance after a period of regular use, which means the medication may stop working.

Others find that as they age, they experience changing side effects. And many more find that the longer they take certain antidepressants, the harder it can be to quit.

Unless otherwise directed by your doctor, a good rule of thumb is to take the lowest effective dose for the shortest period.

Antidepressant withdrawal

Once you’ve started taking antidepressants, stopping can be tough. Many people have severe withdrawal symptoms that make it difficult to get off of the medication—another reason to not stay on any medication longer than necessary.  But if you decide to stop taking antidepressants, it’s essential to consult your doctor and taper off slowly.

Antidepressant withdrawal symptoms

When you stop taking antidepressants, you may experience a number of unpleasant—even disabling—withdrawal symptoms, including:

  • Anxiety, agitation
  • Depression, mood swings
  • Flu- symptoms
  • Irritability and aggression
  • Insomnia, nightmares
  • Extreme restlessness
  • Fatigue
  • Nausea and vomiting
  • Dizziness, loss of coordination
  • Stomach cramping and pain
  • Electric shock sensations
  • Tremor, muscle spasms

Tips for stopping your antidepressant safely

Reduce your dose gradually. In order to minimize antidepressant withdrawal symptoms, never stop your medication “cold turkey.” Instead, gradually step down your dose (many experts recommend reducing in 10% increments), allowing for at least two to six weeks or longer between each dosage reduction.

Don’t rush the process. The antidepressant tapering process may take from several months to years, and should only be attempted under a doctor’s supervision. Be patient. If at any time you experience difficulties, consider spending more time at your current dose before attempting any further reductions.

Choose a time to stop that isn’t too stressful. Withdrawing from antidepressants can be difficult, so it’s best to start when you’re not under a lot of stress. If you’re currently going through any major life changes or significantly stressful circumstances, you may want to wait until you’re in a more stable place.

Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D. Last updated: October 2019.

Source: https://www.helpguide.org/articles/depression/antidepressant-medication.htm

Antidepressants: Types, side effects, uses, and effectiveness

Antidepressant medicines

  • Types
  • Side effects
  • Uses
  • Effectiveness
  • In pregnancy
  • Alternative options

Antidepressants are medications that can help relieve symptoms of depression, social anxiety disorder, anxiety disorders, seasonal affective disorder, and dysthymia, or mild chronic depression, as well as other conditions.

They aim to correct chemical imbalances of neurotransmitters in the brain that are believed to be responsible for changes in mood and behavior.

Antidepressants were first developed in the 1950s. Their use has become progressively more common in the last 20 years.

According to the Centers for Disease Control and Prevention (CDC), the percentage of people aged 12 years and over using antidepressant in the United States rose from 7.7 percent in 1999-2002 to 12.7 percent in 2011-2014. Around twice as many females use antidepressants as males.

Antidepressants can be divided into five main types:

SNRIs and SSRIs

These are the most commonly prescribed type of antidepressant.

Serotonin and noradrenaline reuptake inhibitors (SNRIs) are used to treat major depression, mood disorders, and possibly but less commonly attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety disorders, menopausal symptoms, fibromyalgia, and chronic neuropathic pain.

SNRIs raise levels of serotonin and norepinephrine, two neurotransmitters in the brain that play a key role in stabilizing mood.

Examples include duloxetine (Cymbalta), venlafaxine (Effexor) and desvenlafaxine (Pristiq).

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They are effective in treating depression, and they have fewer side effects than the other antidepressants.

SSRIs block the reuptake, or absorption, of serotonin in the brain. This makes it easier for the brain cells to receive and send messages, resulting in better and more stable moods.

They are called “selective” because they mainly seem to affect serotonin, and not the other neurotransmitters.

SSRIs and SNRIs may have the following side effects:

Examples include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft).

There have been reports that people who use SSRIs and SNRIs, and especially those under the age of 18 years, may experience thoughts of suicide, especially when they first start using the drugs.

All antidepressants carry a black-box warning to this effect, as required by the Food and Drug Administration (FDA).

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are so named because there are three rings in the chemical structure of these medications. They are used to treat depression, fibromyalgia, some types of anxiety, and they can help control chronic pain.

Tricyclics may have the following side effects:

  • seizures
  • insomnia
  • anxiety
  • arrhythmia, or irregular heartbeat
  • hypertension
  • rash
  • nausea and vomiting
  • abdominal cramps
  • weight loss
  • constipation
  • urinary retention
  • increased pressure on the eye
  • sexual dysfunction

Examples include amitriptyline (Elavil), amoxapine- clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil) and trimipramine (Surmontil).

Monoamine oxidase inhibitors (MAOIs)

This type of antidepressant was commonly prescribed before the introduction of SSRIs and SNRIs.

It inhibits the action of monoamine oxidase, a brain enzyme. Monoamine oxidase helps break down neurotransmitters, such as serotonin.

If less serotonin is broken down, there will be more circulating serotonin. In theory, this leads to more stabilized moods and less anxiety.

Doctors now use MAOIs if SSRIs have not worked. MAOIs are generally saved for cases where other antidepressants have not worked because MAOIs interact with several other medications and some foods.

Side effects include:

  • blurred vision
  • rash
  • seizures
  • edema
  • weight loss or weight gain
  • sexual dysfunction
  • diarrhea, nausea, and constipation
  • anxiety
  • insomnia and drowsiness
  • headache
  • dizziness
  • arrhythmia, or irregular heart rhythm
  • fainting or feeling faint when standing up
  • hypertension, or high blood pressure

Examples of MAOIs include phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan) and selegiline (EMSAM, Eldepryl).

Noradrenaline and specific serotoninergic antidepressants (NASSAs)

These are used to treat anxiety disorders, some personality disorders, and depression.

Possible side effects include:

  • constipation
  • dry mouth
  • weight gain
  • drowsiness and sedation
  • blurred vision
  • dizziness

More serious adverse reactions include seizures, white blood cell reduction, fainting, and allergic reactions.

Examples include Mianserin (Tolvon) and Mirtazapine (Remeron, Avanza, Zispin).

How do antidepressants work?

This video by Paul Bogdan explains how antidepressants work.

Any side effects will ly occur during the first 2 weeks, and then gradually wear off.

Common effects are nausea and anxiety, but this will depend on the type of drug used, as mentioned above.

If the side effects are very unpleasant, or if they include thinking about suicide, the doctor should be informed at once.

In addition, research has linked the following adverse effects with antidepressant use, especially among children and adolescents.

Excessive mood elevation and behavior activation

This may include mania or hypomania. It should be noted that antidepressants do not cause bipolar disorder, but they may unmask a condition that has not yet revealed itself.

Suicidal thoughts

There have been a few reports of a higher risk of having suicidal thoughts when first using antidepressants.

This could be due to the drugs or other factors, such as the time taken for the medication to work, or possibly an undiagnosed bipolar disorder which may require a different approach to treatment.

The FDA requires that antidepressants carry a black box warning of this possible effect.

Withdrawal symptoms

Un some drugs, it is not necessary to keep raising the dose to get the same effect with antidepressants. In that sense, they are not addictive.

When you stop using an antidepressant, you will not experience the same type of withdrawal symptoms that occur, for example, when giving up smoking.

However, nearly 1 in 3 people who used SSRIs and SNRIs report some withdrawal symptoms after stopping treatment.

Symptoms lasted from 2 weeks to 2 months and included:

  • anxiety
  • dizziness
  • nightmares or vivid dreams
  • electric shock- sensations in the body
  • flu- symptoms
  • abdominal pain

In most cases, symptoms were mild. Severe cases are uncommon and are more ly after stopping Seroxat and Effexor.

Doctors should reduce the dose gradually to minimize the risk of unpleasant withdrawal symptoms.

These medications are used not only to treat depression but for other conditions too.

The primary, or approved, uses of antidepressants are to treat:

Sometimes a medication is used “off-label.” This means the use is not approved by the FDA, but a doctor may decide that it should be used as it may be an effective treatment.

Off-label uses of antidepressants include:

Studies suggest that 29 percent of antidepressant use is for an off-label purpose.

It can take several weeks for a person to notice the effects of an antidepressant. Many people stop using them because they believe the medications are not working.

Reasons why people may not see an improvement include:

  • the drug not being suited to the individual
  • a lack of monitoring by the health provider
  • a need for additional therapies, such as cognitive behavioral therapy (CBT)
  • forgetting to take the medication at the right time

Keeping in contact with the doctor and attending follow-up appointments helps improve the chances of the drug working. It may be that the dosage needs changing or another medication would be more suitable.

It is important to take the antidepressant according to instructions, or it will not be effective.

Most people will feel no benefits during the first or second week. The full effect will not be present until after 1 or 2 months. Perseverance is vital.

How long does treatment last?

According the United Kingdom’s Royal College of Psychiatry, 5 to 6 people every 10 will experience a significant improvement after 3 months.

People who use medication should continue for at least 6 months after starting to feel better. Those who stop before 8 months of use may see a return of symptoms.

Those who have had one or more recurrences should continue the treatment for at least 24 months.

Those who regularly experience recurrences depression may need to use the medication for several years.

However, a literature review published in 2011 found that long-term use of antidepressants may worsen symptoms in some people, as it can lead to biochemical changes in the body.

Share on PinterestA doctor will help weigh up the pros and cons of taking antidepressants during pregnancy

In the United States, 8 percent of women are reported to use antidepressant drugs during pregnancy.

The use of SSRIs during pregnancy has been linked with a higher risk of pregnancy loss, preterm birth, low birth weight, and congenital birth defects.

Possible problems during delivery include excessive bleeding in the mother.

After birth, the newborn may experience lung problems known as persistent pulmonary hypertension.

A study of 69,448 pregnancies found that using SNRIs or TCAs during pregnancy may increase the risk of pregnancy-induced hypertension or high blood pressure, known as pre-eclampsia. However, it remains unclear whether this is due to the drugs or the depression.

Findings published in JAMA in 2006 suggested that almost 1 in 3 infants whose mothers used antidepressants during pregnancy experienced neonatal abstinence syndrome. Withdrawal symptoms included disturbed sleep, tremors, and high-pitched crying. In some cases, the symptoms were severe.

A lab study found that rodents that were exposed to citalopram—an SSRI antidepressant—just before and after birth showed considerable brain abnormalities and behaviors.

However, for some women, the risk of continuing the medication is smaller than the risk of stopping, for example, if her depression could trigger an action that might harm herself or her unborn child.

The doctor and patient need to discuss fully the benefits and potential harms of stopping antidepressants at this time.

If possible, other therapies should be considered, such as cognitive CBT, meditation, or yoga.

Breastfeeding

Tiny amounts of some antidepressants enter the breast milk, for example, sertraline and nortriptyline.

Within a few weeks after birth, infants can break down the medication’s active ingredients in the liver and kidneys as effectively as adults do.

The decision to use antidepressants at this time will involve several factors:

  • Is the infant healthy?
  • Were they born preterm?
  • Will the mother’s condition deteriorate?

How much of the active ingredients will enter the breast milk, which depends on the type of drug

One study, published in The Journal of Clinical Endocrinology and Metabolism, found that for women who use antidepressants during pregnancy, it may take longer to be able to breastfeed.

The researchers explain that the breast glands are regulated by serotonin, so their ability to produce milk at the right time is linked to the production and regulation of this hormone.

CBT and other types of counselling and therapy can also help with depression.

St John’s wort

Hypericumwhich is made from the herb St. John’s wort, has been shown to help some people with depression. It is available over-the-counter as a supplement.

However, it should only be taken after speaking to a doctor, as there are some possible risks.

  • Combined with certain antidepressants, St. John’s wort can lead to a potentially life-threatening increase in serotonin.
  • It can worsen symptoms of bipolar disorder and schizophrenia. A person who has or may have bipolar-related depression should not use St. John’s wort.
  • It might reduce the efficacy of some prescription medications, including birth control pills, some heart medications, warfarin, and some therapies for HIV and cancer.

It is important to tell your doctor or pharmacist if you plan on taking St. John’s wort.

Some evidence supports the use of St. Johns’ wort to treat depression, but some studies have found it no more effective than a placebo.

Light box

People who experience seasonal affective disorder (SAD), or “winter blues,” may benefit from light therapy. This involves sitting in front of a light box first thing in the morning for 20 to 60 minutes. Light boxes are available to purchase online.

Vitamin D supplements may or may not help treat SAD. Evidence is not conclusive.

Diet and exercise

Some studies have shown that a healthy, well-balanced diet, plenty of exercise, and staying in touch with family and friends can reduce the risk of depression and recurrences.

Depression is a serious condition that may need medical treatment. Anyone who experiences the symptoms of depression should seek medical advice.

  • Depression
  • Mental Health
  • Psychology / Psychiatry

Source: https://www.medicalnewstoday.com/articles/248320

List of Depression Medications (114 Compared) – Drugs.com

Antidepressant medicines

Depression is a mood condition characterized by persistent and overwhelming feelings of sadness that can affect your day-to-day activities and how you think, feel, and behave. Sometimes it can affect your outlook on life and make you feel that life isn’t worth living. Depression may also be called major depressive disorder or clinical depression.

What Causes Depression?

Experts aren’t exactly sure what causes depression but believe it is due to a combination of different factors, such as genetic vulnerability, faulty mood regulation by the brain, stress, chemicals in the brain, medications, or medical problems, that all interact together to bring on depression.

The risk of developing depression is higher in women and people:

  • Aged 45 to 64 years of age or the elderly
  • With chronic or acute health conditions
  • Who are undergoing a major life event, such as a job loss, divorce, workplace stress, or physical or mental abuse
  • With severe grief due to the death of a loved one
  • Taking prescription drugs that may cause a low mood
  • Abusing alcohol or drugs.

What are the Symptoms of Depression?

Depression is not just feeling blue occasionally. It affects daily feelings, thoughts, and actions over a longer period. (MDD), can result in difficulties with family life, work, and social activities.

Symptoms may vary depending on how severe a person’s depression is but may include:

  • A prolonged and persistent low mood, tearfulness, or a sense of hopelessness that has lasted for at least 2 weeks
  • Irritability
  • Anxiety
  • Agitation or restlessness
  • Avoidance or refusal to participate in activities that were previously enjoyed
  • Withdrawal socially, from family, friends, and relationships
  • Changes in sleeping or eating habits
  • Unexplained physical problems, such as back pain or headaches
  • Alcohol, drug, or substance abuse
  • Engaging in risky or destructive behaviors
  • Self-harm or attempts at suicide.

In children and teens, symptoms may include clinginess, worry, aches and pain, and refusal to go to school.

In older adults, symptoms may be less obvious and include memory difficulties or personality changes, physical aches and pains, and fatigue.

How is Depression Diagnosed?

If your mood has been low for a while and you are having difficulty coping with day to day activities, talk to your doctor or a trusted professional. Your doctor will ask you questions about your symptoms and your medical history and may ask you to complete a questionnaire that may help to diagnose depression or refer you to a psychiatrist.

You can also call the National Suicide Prevention Hotline at 1-800-273-8255, 24 hours a day, 7 days a week, or have an online chat (http://suicidepreventionlifeline.org/). All information is confidential and free.

How is Depression Treated?

Depression is treatable with high rates of success. Treatments may include:

  • Psychotherapy
  • Antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs).

Responses to antidepressants vary, and most antidepressants take 4 to 6 weeks for full effect. About 50% of patients respond to the first treatment, whereas others may have to try a few different types of antidepressants before they find the best one for them.

There are several things you can do to help with your symptoms as well, such as:

  • Setting realistic and daily goals
  • Developing strategies to work through crises situations
  • Developing coping and problem-solving skills
  • Learning how to develop positive relationships
  • Replacing negative thoughts with positive ones.

Source: https://www.drugs.com/condition/depression.html

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