Antidepressants(A complete guide)

Antidepressants are medications that help relieve the symptoms of major depressive disorder (MDD), social anxiety disorder and other anxiety disorders, seasonal affective disorder (SAD) and dysthymia, mind chronic depression, as well as other conditions. 

In this blog post, you will learn about what antidepressants are used for, who should take antidepressants, the classes of antidepressant medications and how they work, and common side effects. 

Who should take antidepressants?

If you suspect you have MDD, SAD, an anxiety disorder, or another related condition, talk to your doctor about taking antidepressants. In addition, a loved one or friend may reach out to discuss these symptoms with you and point you in the direction of help. These are debilitating mental health conditions and you should not feel like you have to go through them alone. 

MDD is a mood disorder that causes feelings of worthlessness and loss of interest in daily activities. Common symptoms of MDD are as follows: 

 

·      Chronic feelings of sadness, tearfulness, emptiness, or hopelessness

·      Loss of interest in activities that once used to bring enjoyment (i.e., sex, hobbies) 

·      Outbursts of anger 

·      Irritability

·      Frustration

·      Issues with sleeping too much or insomnia

·      Lack of energy and fatigue 

·      Changes in eating patterns and weight (i.e., increased appetite and weight gain or reduced appetite and weight loss)

·      Anxiety

·      Agitation

·      Restlessness

·      Slowed speaking, thinking, and movement 

·      Feelings of worthlessness 

·      Ruminating on past failures

·      Feelings of guilt 

·      Trouble concentrating, making proper decisions, and remembering things 

·      Physical problems such as back pain or headaches that cannot be explained by another medical condition 

SAD is a subtype of depression that is heavily related to changes in seasons. It usually begins at the same time every year and usually occurs during fall and winter months. If you have any of the following symptoms, you may be diagnosed with SAD: 

·      Feelings of depression most of the day almost every day

·      Low energy

·      Loss of interest in activities that used to bring enjoyment

·      Trouble sleeping, usually oversleeping 

·      Changes in appetite or weight 

·      Feelings of hopelessness, worthlessness, or guilt

·      Feeling agitated or sluggish 

·      Frequent thoughts of death or suicide

In the winter months, people with SAD may frequently oversleep, gain weight due to food cravings high in carbohydrates, or have fatigue and lack of energy. More rarely, people can suffer from SAD in the spring or summer months. These patients are likely to experience trouble sleeping (insomnia), reduced appetite and weight loss, and agitation or anxiety. 

To get more insight into depression and to see some interesting articles, click here. 

How do antidepressants work? 

One of the most frequently asked question people have related to their medicines is, what are the signs that tell an antidepressant is working.

Antidepressants are used as a medication for depression. They do not cure depression, but they may reduce the severity of symptoms. Sometimes it takes a lot of trial and error to find the right antidepressant for you based on side effects or the extent of symptom relief. 

There are different classes of antidepressants that work in slightly different ways. Usually, they work by increasing the levels of certain neurotransmitters in the brain. Neurotransmitters are chemical messengers in the brain that relay information from one neuron to the next to regulate all of our behaviors. Serotonin and dopamine are two neurotransmitters that have been associated with depression. 

Classes of antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).

SSRIs are usually the first medication prescribed to patients suffering from depression. They work by increasing the amount of available serotonin in the brain. SSRIs usually cause the least side effects and are less likely to lead to problems at higher doses. Common SSRIs include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro). 

SNRIs increase the amount of available serotonin and norepinephrine in the brain. Norepinephrine is another neurotransmitter that plays a role in energy and alertness. Examples of SNRIs include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq), and levomilnaciprain (Fetzima). 

The drug Venlafaxine is good but some doctors want to see who is more effective amongst Venlafaxine and Sertraline.

Atypical antidepressants do not fit into the classes of medications described above. These include trazodone, mirtazapine (Remeron), vortioxetine (Trintellix), vilazodone (Viibryd) and bupropion (Wellbutrin SR, Wellbutrin XL, others).

Tricyclic antidepressants include imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin and desipramine (Norpramin). This class of medication usually causes more side effects than newer antidepressants and are typically not prescribed unless other medications are ineffective at treating the symptoms of depression. 

MAOIs, such as tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan), also cause serious side effects and are not prescribed as often as newer antidepressants. Taking an MAOI requires a strict diet because there can be fatal interactions between this medication and specific foods, including pickles, wine, and also some medications including pain medications, decongestants, and certain herbal supplements. Selegiline (Emsam), which is an MAOI in a patch form, may cause fewer side effects than oral forms of MAOIs. MAOIs cannot be combined with SSRIs. 

Antidepressants should be taken in combination with the right kind of psychotherapy, such as talk therapy or cognitive behavioral therapy (CBT). These therapies teach the patient active coping mechanisms to manage depression symptoms. 

What are some common side effects of antidepressants? 

Possible side effects of antidepressants include dry mouth, weight gain, or sexual side effects. These side effects sometimes make it difficult to stick to the treatment. It is important to talk to your doctor or pharmacist if you are experiencing unwanted side effects. 

Frequently asked questions (FAQs) about antidepressants: 

Want to learn more about antidepressants? Try these books!

Medications for Anxiety & Depression – A no-nonsense, comprehensive guide to the most common (and not so common) antidepressants and anti-anxiety drugs available

If you are suffering from major depressive disorder (MDD), including treatment resistant depression and dysthymia, generalized anxiety disorder (GAD), panic disorder, phobic disorder, obsessive compulsive disorder (OCD), or any mood disorder on the depressive or anxious spectrum, this book is for you. It is important to understand which medications might be prescribed to you and how they work, as well as common side effects. Benjamin Kramer provides extensive details on common and non-common antidepressants and anti-anxiety medications (anxiolytics) includingSSRIs (selective serotonin re-uptake inhibitors, such as Zoloft, Paxil, Prozac and Lexapro), SNRIs (Serotonin and Norepinephrine re-uptake inhibitors uch as Effexor and Cymbalta), atypical antidepressants (such as Remeron, Buspar and Wellbutrin), TCAs (Tricyclic antidepressants, such as Endep and Anafranil), Benzodiazepines (such as Xanax, Ativan and Klonopin), “Off-label” and experimental options including stimulants (amphetamine, methylphenidate), Lyrica, tramadol memantine and ketamine. This book also discusses upcoming drugs for depression and anxiety that are supposed to become available soon. 

Understanding Antidepressants

Dr. Wallace B. Mendelson, Professor of Psychiatry and Clinical Pharmacology at University of Chicago, explains how antidepressants work, their interactions with other medications, how long they stay in the body, side effects, and what to consider when choosing one. About 10% of the population in the United States is taking antidepressants, and about 16 million Americans experience a major depressive episode each year, so it is important to thoroughly understand how this condition is treated. 

The Mindfulness Journal: Daily Practices, Writing Prompts, and Reflections for Living in the Present Moment

As described above, journaling is a great way to give yourself a stress release. Whether you are dealing with mental health issues, heartbreak, a problem at work, or any other life stressor, this journal is for you. This Mindfulness Journal can easily be added into your daily routine and can serve as an outlet for stress-reduction that will help you appreciate every single day and moment. It includes 365 daily writing prompts divided into 52 weekly mindfulness topics. The prompts are extremely unique, fun, and engaging, so you will never get bored while journaling. Additionally, each prompt is on its own separate page so you will have more than enough room for reflection and to write down all of your thoughts, big or small. Although it is suggested to journal once a day, you can spend as much or as little time as you want on each prompt. 

I am not in recovery. I am in discovery: Journaling my mental illness

Journaling is a great way to help process and keep track of your experiences and feelings while you are going through depression or seasonal affective disorder (SAD). This journal contains 94 daily templates to aid in your discovery process.

In this blog articles, you should have learned about the different types of antidepressants, how they work to treat depression and anxiety, and common side effects. 

References

Antidepressants: Selecting one that’s right for you.Mayo Clinic. December 31^st, 2019.