Overview Of Antidepressants

Antidepressants are prescription medications that could help patients experiencing a variety of mental health conditions such as mild chronic depression, major depression, social anxiety disorder, and seasonal affective disorder. There are several different types of antidepressants, and each type functions in a different way. Patients may need to take antidepressants for several years, and some conditions might require a combination of antidepressants for the most effective treatment. Antidepressants can be prescribed by primary care physicians and psychiatrists. In addition to the use of medication, patients coping with mental health issues are typically advised to have regular counseling sessions with a licensed therapist. Patients should have their mental health evaluated by a physician at regular office visits while taking this medicine.

The major antidepressant types, uses, side effects, and potential interactions are described below.

Types Of Antidepressants

Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, sertraline, and citalopram, are the most frequently prescribed type of antidepressants. These medicines work by blocking the absorption of serotonin in the brain, and this can help in stabilizing mood. Selective noradrenaline reuptake inhibitors (SNRIs), such as venlafaxine and nefazodone, are similar to SSRIs, and they slow the breakdown of both noradrenaline and serotonin in the brain. Tricyclic antidepressants such as doxepin and nortriptyline have a three-ring structure as part of their chemical composition, and they were first introduced in the 1950s. Also introduced in the 1950s, monoamine oxidase inhibitors block the action of an enzyme known as monoamine oxidase, leading to higher levels of serotonin in the brain. Today, doctors often start by prescribing a selective serotonin reuptake inhibitor or a selective noradrenaline reuptake inhibitor, and monoamine oxidase inhibitors and tricyclic antidepressants are considered if the newer antidepressants are ineffective for the patient's needs. Less commonly, doctors might choose to prescribe a type of antidepressant known as a noradrenaline and specific serotonergic antidepressant such as mianserin. This type of antidepressant can help with the treatment of personality disorders.

Learn about the common uses for antidepressants next.

Common Uses

Antidepressants are typically used to treat moderate and severe cases of depression, and they may also be prescribed as part of a combination treatment for patients with severe anxiety and panic attacks. Doctors may also use antidepressants in the treatment of obsessive-compulsive disorder and social anxiety disorder. Before being prescribed an antidepressant, patients will undergo a screening test to ensure they meet the criteria for clinical depression. The test asks the patient a series of questions about how often feelings of sadness, hopelessness, or emptiness have occurred in the past two weeks (as well as longer). Patients who take antidepressants for the treatment of depression should let their doctor know if their symptoms are getting worse. In these cases, doctors may need to add another antidepressant to the patient's medications, and the dosage of the original antidepressant might be increased.

Get familiar with uncommon uses for antidepressants next.

Uncommon Uses

While antidepressants are most commonly used to treat depression and anxiety, doctors may use them 'off-label' to treat other mental health conditions on a case-by-case basis. For example, SSRIs and SNRIs may be used to treat some cases of attention deficit hyperactivity disorder. Antidepressants could be considered in the treatment of physical health conditions as well. Tricyclic antidepressants help reduce chronic pain for some patients, and they might be prescribed for fibromyalgia patients as well. Doctors could consider prescribing either SSRIs or SNRIs for patients coping with menopausal symptoms and chronic pain caused by neuropathy too. Since these uses are 'off-label,' patients may want to ask their physician if other treatments could be tried before an antidepressant is prescribed. Patients who use antidepressants for chronic pain might wish to consult with a counselor, and they should always let their healthcare provider know if their pain intensifies, moves, or changes in any way.

Keep reading to learn about side effects to watch for now.

Side Effects to Watch For

All antidepressants can increase the risk of suicidal thoughts, particularly in young adults. For this reason, the medication must have a black box warning on the label. The risk of suicidal thoughts is highest when patients have just started taking the medicine, and patients should report any suicidal thoughts or changes in mood to their doctor right away. In addition to this potential side effect, different types of antidepressants could cause various physical effects. For example, SSRIs and SNRIs could lead to low blood sugar and sodium, and they might also cause sedation, insomnia, weight loss, dry mouth, nausea, and skin rashes. Some patients have reported dizziness, abnormal thinking, and agitation while taking these antidepressants.

Tricyclic antidepressants may cause high blood pressure, and seizures have occurred in some patients who take this drug. Other potential side effects include an irregular heartbeat, abdominal cramps, anxiety, urinary retention, constipation, and increased eye pressure. Patients taking tricyclic antidepressants may need to have their blood pressure, heart rhythm, and eye pressure monitored closely. Like tricyclic antidepressants, monoamine oxidase inhibitors could also produce seizures, high blood pressure, heartbeat irregularities, and anxiety. Patients taking these antidepressants have reported blurred vision, edema, fainting upon standing, and headaches as well. Noradrenaline and specific serotonergic antidepressants could cause weight gain, blurred vision, dry mouth, drowsiness, and constipation, and they have been associated with potentially serious side effects such as seizures and reduced white blood cell counts.

Discover medication interactions with antidepressants next.

Medication Interactions

SSRIs should not be taken with tricyclic antidepressants, monoamine oxidase inhibitors, sumatriptan, or other medicines that increase the levels of serotonin in the brain. Taking these medicines together could lead to a dangerous condition known as serotonin syndrome. In addition, patients should avoid using nonsteroidal anti-inflammatories during treatment with SSRIs if at all possible. The use of these medications together is associated with an increased risk of gastrointestinal bleeding. Tricyclic antidepressants are known to interact with carbamazepine, clonidine, cimetidine, and amitriptyline. Patients should inform their healthcare team of all prescription drugs, over-the-counter medicines, herbal supplements, and natural remedies that they are using before any antidepressant is prescribed. Pharmacists will also check for potential drug interactions before dispensing the prescription.