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Antidepressants

What are antidepressants?

• An antidepressant is a medication used primarily in the treatment of clinical depression.
• Antidepressants improve or relieve symptoms of depression by affecting brain chemistry by increasing the levels of certain neurotransmitters in the brain. (Neurotransmitters help carry messages between brain cells.)
• Antidepressants are not addictive; they do not make you "high," have a tranquilizing effect, or produce cravings for more.
• Some examples of antidepressants on the market today are Prozac, Zoloft, Effexor, and Celexa.

How antidepressants work?

• Antidepressants work by affecting brain chemicals (called neurotransmitters) and play a role in mood regulation.
• Different antidepressants work on the brain chemistry in a different way, by affecting the neurotransmitters or brain chemical differently.
• Three neurotransmitters associated with depression are Serotonin, Norepinephrine, Dopamine.
• Antidepressants prevent us from getting back to the state of depression when something bad happens. After taking antidepressant medicines, we still can feel hurt, pain, worry but we feel these like normal people do, without depression.

Types of Antidepressants

Broadly speaking, antidepressants fall into the following classes:

• Monoamine Oxidase Inhibitors (MAOIs)
• Tricyclics (TCAs)
• Selective Serotonin Reuptake Inhibitors (SSRIs)

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs increase the concentration of chemicals responsible for transmitting information between nerves in particular regions of the brain, which may lead to increased mental functioning. Basically, they help brain neurotransmitters remain active longer, which may lead to a reduction in the symptoms of depression. Due to potentially serious dietary and drug interactions they are used less frequently than other classes of antidepressant drugs. However, in some cases where patients are unresponsive to other treatments they are tried, sometimes with a marked success.

More information on Monoamine Oxidase Inhibitors (MAOIs)

Tricyclics (TCAs)

They stop some neurotransmitters going back into the brain cells they came from. So, the neurotransmitters are left in the gap between brain cells, and so they keep delivering the messages for longer. Tricyclic antidepressants affect several different neurotransmitters. Side-effects usually associated with tricyclis are dry mouth, blurry vision, weight gain and sedation.

More information on Tricyclic Antidepressants

Selective Serotonin Reuptake Inhibitors (SSRIs)

They work by blocking the presynaptic serotonin transporter receptor. They work in the same way as tricyclic antidepressants, but they affect only a specific neurotransmitter called serotonin. Drugs belonging to this class include fluoxetine (Prozac), citalopram (Celexa) escitalopram (Lexapro), fluvoxamine (Luvox), sertraline (Zoloft) and paroxetine (Paxil).

More information on Serotonin Reuptake Inhibitors (SSRIs)

Which antidepressant will work best for me?

The answer to this most frequently asked question is: THE ONE THAT WORKS FOR YOU! As there are a wide variety of brains, so there are wide variety of antidepressants too. Some antidepressants may work very well for someone, but the same antidepressants may not affect somebody else.

So, it is best to consult your doctor on all antidepressant medications and let them know of any developments in treatment, including side effects.

Starting Treatment with Antidepressants

When a patient has been identified as benefitting from drug treatment, the following criteria should be observed:

• establish the presence of a depressive disorder;
• exclude another underlying severe mental disorder (e.g. schizophrenia);
• determine the severity of depression:
  psychosis (refer to psychiatric services);
  severe (refer to psychiatric services);
  moderate (start on antidepressants); or
  mild (review the patient later).
• establish whether physical illness is present;
• choose an effective, well-tolerated, safe antidepressant;
• warn the patient about possible side-effects;

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