I'm a firm believer in getting all the information you can before you make a decision. In today's post, I've complied some basic information when it comes to antidepressants. It's a good stating point, and can give you some good ideas of things to talk about with your doctor. Don't completely rule out something that could really help you. You take medication for allergies, the flu, diabetes, etc. Why not mental illness too?
Finding the right antidepressant
Your particular symptoms. There are tons of antidepressants on the market, but you have to find the one that works based on your symptoms. You have to be aware have how you feel and any changes once you start taking medication. If your depression symptoms include low energy, an antidepressant that's slightly stimulating may be the best choice. On the other hand, if you have trouble sleeping, an antidepressant that's slightly sedating may be a good option.
Possible side effects. Side effects of antidepressants vary from one medication to another and from person to person. Many people stop taking antidepressants because they have side effects to a medication without trying to find the correct one. Be sure you're taking notes of any side effects, and if they get too bad, call your doctor.
Whether it worked for a close relative. How a medication worked for a first-degree relative, such as a parent, sibling, or even a child can indicate how well it might work for you. If you have a family member taking antidepressants, write the name down and talk it over with your doctor.
Whether you're pregnant or breast-feeding. Many antidepressants may not be safe for your baby when taken during pregnancy or later when you're breast-feeding because they can be passed to the baby. They're happy enough. No sharing. Many women believe that there isn't help for them when pregnant or breastfeeding. This isn't true. There are some antidepressants that ARE safe to take when pregnant or breastfeeding. Always talk with your doctor about your options.
Types of antidepressants
Certain brain chemicals called neurotransmitters are associated with depression, specifically the neurotransmitters serotonin, norepinephrine, and dopamine. Most antidepressants relieve depression by affecting these neurotransmitters. Each type of antidepressant affects one or more of these neurotransmitters in slightly different ways.
Selective serotonin reuptake inhibitors (SSRIs)
Many doctors start depression treatment by prescribing an SSRI. These are the "go-to" medications when first starting to treat a mental illness because of they're high success rate and their ability to help with a wide array of symptoms. Their side effects also tend to be milder. SSRIs include:
- Fluoxetine (Prozac, Prozac Weekly, Sarafem)
Fluvoxamine (Luvox, Luvox CR)
Paroxetine (Paxil, Paxil CR, Pexeva)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Venlafaxine (Effexor XR).
These medications are called "atypical" because they don't fit neatly into other categories. Generally, atypical antidepressants cause fewer sexual side effects than other antidepressants do. Atypical antidepressants include:
Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL) People with seizure disorders or who have
bulimia or anorexia shouldn't take bupropion.
Trazodone (Oleptro). This mild antidepressant is often prescribed as a sleep aid because it can be very sedating.
Mirtazapine (Remeron, Remeron SolTab). Like trazodone, mirtazapine can be sedating. It may increase lipid levels and cholesterol.
Nefazodone. This antidepressant is effective, but isn't commonly prescribed because it has been linked to dangerous liver problems.
Tricyclic and tetracyclic antidepressants
These are older antidepressants and while thy can be effective, they are not usually a first-choice treatment for depression because of numerous side effects such as dry mouth, constipation, difficulty urinating, sedation, weight gain, and sexual side effects. In some cases, a low dose of a cyclic antidepressant may be added to another antidepressant, such as an SSRI, to increase the antidepressant effect. These medications are not usually given to older adults or people who have low blood pressure or certain heart problems. Tricyclic and tetracyclic antidepressants include:
Doxepin (Silenor, Zonalon)
Imipramine (Tofranil, Tofranil-PM)
Nortriptyline (Pamelor, Aventyl)
Monoamine oxidase inhibitors (MAOIs)
Monoamine oxidase inhibitors are used as a last resort because of numerous, potentially dangerous serious side effects. Side effects can include dizziness, dry mouth, upset stomach, difficult urination, twitching muscles, sexual side effects, drowsiness, and sleep problems. MAOIs can cause potentially fatal high blood pressure when combined with certain foods and beverages and certain other medications. MAOIs include:
- Tranylcypromine (Parnate)
Selegiline (Emsam, Eldepryl, Zelapar) - Emsam is a type of MAOI that you stick on your skin (transdermal patch).
Making antidepressants work for you.
Be patient. This is one of the hardest parts of taking medication for a mental illness. You want to feel better quickly, but unfortuneately, it doesn't work like that. Once you and your doctor have selected an antidepressant, it may take six or more weeks for it to be fully effective. And with some medications, you can take the full dosage immediately. With others, you may need to gradually increase your dose. Talk to your doctor or therapist about coping with depression symptoms as you wait for medications to take effect.
See if the side effects improve. Many antidepressants cause side effects that improve with time. For example, initial side effects when starting an SSRI can include nausea, loose bowel movements, headache, and insomnia, but these symptoms usually go away as your body adjusts to the antidepressant. While you do want to try and give the medication time to adjust in your system, if you are worried about a side effect or how you are reacting overall to the medication, don't hesitate to call your doctor.
If it doesn't work — try something else. This is where many people struggle. Once one doesn't work, you have to be willing to try again. And again. And again if need be. It can take several tries and combinations to find the right one (or more) that works for you. Don't give up after just one try, because there is one that will help you feel better. You just have to Be Patient.
Take your antidepressant consistently and at the correct dose. Make sure you are taking it at the right time of day too. Most antidepressants need to be taken in the morning with food. There are a few, however, that are taken before bed. You need to go over with your doctor about when and how you are supposed to be taking your medication. If you have questions, ask!
Don't stop taking an antidepressant without talking to your doctor first. Some antidepressants can cause significant withdrawal-like symptoms unless you slowly taper off your dose. It can be more dangerous to go cold-turkey than to taper off. Always stop taking antidepressants with the help of your doctor.
Try psychotherapy. In many cases, combining an antidepressant with mental health counseling is more effective than taking an antidepressant alone. It can also help prevent your depression from returning once you're feeling better.
It's a hard and long process, but if you keep pushing through, you'll find something that works for you and starts really helping you feel more like you.