Antidepressant Medications

Antidepressants are non habit-forming prescription medications used to stabilize mood and treat clinical depression. Antidepressant medication is a powerful tool that can be used either alone or in tandem with other types of treatment to combat the effects of clinical depression. They help to elevate mood, relieve symptoms of depression and give the sufferer a much-needed emotional “boost” to better cope with the challenges of everyday life.

Clinical depression, particularly in individuals who suffer from its more severe forms, is more than simply “feeling down." It’s a serious medical condition that affects both the mind and the body. Often the result of a chemical imbalance in the brain, the symptoms of clinical depression can impact nearly every aspect of life. Affecting almost 10% of the population or 19 million Americans every year, it often requires treatment by a medical professional in order for an individual to return to a normal quality of life.

The root causes of depression are continually being studied, but it is generally agreed that clinical depression is caused by a malfunction of monoamine neurotransmitters in the brain, better known as the chemicals serotonin and norepinephrine. Since these neurotransmitters are necessary for normal brain function, and control everything from eating and sleeping to pain and especially mood, having an imbalance of these important chemicals causes symptoms such as sadness, anxiety, loss of sleep, loss of enjoyment in pleasurable activities, restlessness, difficulty concentrating, fatigue and irritability. When neurotransmitter levels in the brain are low, the messages which regulate functions of the body are decreased, and the messages fail to pass between brain cells optimally. The result can be clinical depression.

Antidepressant medication has been shown to be beneficial in helping balance these neurotransmitting chemicals by making them more available to the brain. Antidepressants are thought to increase the sensitivity of receptors in the brain that regulate glutamate, a nonessential amino acid. This increased sensitivity prevents glutamate from over-stimulating the areas of the brain that relate to depression and anxiety. As the brain’s chemical balance is restored, an individual’s mood is elevated, and the symptoms of depression are relieved.

The type of antidepressant prescribed for an individual is usually based on a number of factors. Understanding the individual’s symptoms is key. The individual’s ability to tolerate an antidepressant’s side effects can also determine the right type and will vary depending on the individual and his or her unique body chemistry and genetic make-up. Likewise, potential interactions ith other medications an individual is taking are also considered, as are lifestyle factors such as pregnancy and breast-feeding, which can preclude the use of many antidepressants. Factors such as the antidepressant’s effectiveness for a first-degree relative such as a brother, sister or parent, are also taken into consideration since there is scientific evidence to suggest that clinical depression is hereditary.

There are four kinds of antidepressant medications, which work in slightly different ways toward the same goal of restoring balance to the neurotransmitters in the brain. The first type of antidepressant medications, developed in the 1950s, is Monoamine Oxidase Inhibitors (MAOIs, which are often prescribed under brand names such as Nardil and Parnate). MAOIs are used to treat social anxiety as well as depression and halt the breakdown of monoamine neurotransmitters, which helps to increase the amount of these chemicals in the brain.

Tricyclic Antidepressants (TCAs, which are often prescribed under brand names such as Norpramin and Tofranil) are used to treat chronic pain in addition to treating depression symptoms like anger and irritability. TCAs lessen the likelihood of reabsorption of serotonin and norepinephrine by the brain cells as well as, in some cases, also dopamine.

The most widely prescribed antidepressants are what are known as Serotonin Reuptake Inhibitors (SSRIs, which are often prescribed under brand names such as Prozac, Zoloft and Paxil). These popularly used medications help individuals overcome depression by keeping a larger amount of serotonin in the receptor areas of the brain so that it can be better utilized by the brain.

The fourth type of antidepressant medications are the Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs, which are often prescribed under brand names such as Cymbalta and Effexor). These medications work similarly to SSRIs and are used to relieve symptoms such as sadness and irritability. Instead of simply improving the availability of serotonin to the receptor areas of the brain, SNRIs also improve the availability of norepinephrine as well.

The amount of time for which antidepressants are prescribed varies for each individual. Some only require a few months, while others will need to continue for a few years, depending on the severity of the depression. Most antidepressant medications have a delayed onset of action, which means that it often takes anywhere from two to eight weeks before the drug will be fully effective in the body. Many individuals are tempted to stop taking their medication once they start feeling relief from their symptoms and their mood improves. Conversely, others may feel discouraged that it is taking so long to feel the effects of the medication. In both cases, it’s best to continue on the medication for at least a few months – anywhere from four to nine months – to prevent a relapse of clinical depression. For some individuals with chronic major depression, the use of antidepressant medications may be indefinite. Discontinuing the use of an antidepressant under any circumstances should only be done under the care and guidance of a medical professional.

While the benefits of antidepressant medication can be considerable, there are side effects for each type of antidepressant that are important to be aware of, as they will likely be factors in choosing the best antidepressant for the individual. Because of the often serious food and drug interactions associated with MAOIs, they are usually only prescribed for individuals for whom other medications and therapies have not been successful. In response to the side effects of MAOIs, TCAs became the preferred method of treatment for several years. Their use has since been replaced by newer antidepressant medications which carry less of a danger of overdose.

Both SSRIs and SNRIs tend to have far milder side effects and usually include insomnia and nervousness, such as trouble falling asleep or waking up during the night. Nausea and headaches are common as well. SNRIs tend to have side effects such as constipation and dry mouth, both of which can be alleviated by drinking plenty of fluids and consuming more fiber. Blurred vision and drowsiness can also occur, but both usually pass fairly quickly into the course of antidepressant treatment.

Sexual side effects tend to be common to all the antidepressant medications and typically include reduced sex drive and erectile dysfunction. Usually these conditions can be treated effectively with other prescription medications (brand names such as Viagra and Cialis) to help the individual return to his or her normal lifestyle.

The good news about antidepressant side effects is that they generally only last as long as it takes the body to adjust to the new medication. Side effects tend to be mild, are usually short in duration, and rarely remain long-term. Any unusual reactions, however, including any impairment in an individual’s normal functioning, especially suicidal thoughts, should be reported to a medical professional immediately.

Likewise, a medical professional should always be consulted with regard to the use of over-the-counter medications like decongestants or social drugs such as alcohol while using an antidepressant. While many medications are considered quite safe, when combined with antidepressants they can cause serious health problems.

With the many varieties of antidepressant medications available, it may seem confusing as to which one will provide the best treatment for an individual’s depression. For many individuals it may be necessary to try a few different antidepressants before finding the one that is the best fit. This is because it is difficult to gauge the effectiveness of a particular antidepressant for that individual until he or she has spent a considerable amount of time taking the medication. Taking into consideration the side effects of any given antidepressant, choosing the right one may also be a matter of honing in on the medication that is easiest to tolerate. Medical professionals regularly check with patients to ensure the effectiveness of the antidepressant, but having honest and open communication between the doctor and the patient is key to ensuring the best antidepressant medication is being used.

While antidepressants are not necessarily considered a cure for clinical depression, they can often help dramatically reduce symptoms and be an extremely helpful part of a depression treatment plan. The best way to deal with clinical depression is to work closely with a medical professional who can help develop ways of dealing with the condition that are the most effective. Antidepressants have helped millions feel relief from the symptoms of clinical depression and return to normal, satisfying lives. Regardless of the approach, working together with a trusted medical professional is crucial when dealing with this challenging and complex condition.