Antidepressants are prescription medications. They are designed to help patients experiencing a variety of mental health conditions. There are several different types of antidepressants, and each functions differently. Primary doctors and psychiatrists can prescribe this type of medication. Patients should have a psychiatrist regularly evaluate their mental health when they are on antidepressants.
In addition to depression pills, patients coping with mental health issues are typically advised to engage in other depression remedies. Examples include counseling with a licensed therapist. Some conditions may require a combination of antidepressants for the most effective treatment. However, patients must fully understand antidepressants before ensuring that they receive the best medicine for depression.
Types Of Antidepressants
Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and citalopram, are the most frequently prescribed type of antidepressants. These medicines work by blocking the absorption of serotonin in the brain. This can help in stabilizing mood. Selective noradrenaline reuptake inhibitors (SNRIs), such as venlafaxine, are similar to SSRIs. They slow the breakdown of both noradrenaline and serotonin in the brain. Tricyclic antidepressants, such as doxepin, have a three-ring structure as part of their chemical composition. 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. This leads 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. Monoamine oxidase inhibitors and tricyclic antidepressants are considered if the newer antidepressants are ineffective for the patient's needs. Less commonly, doctors may choose to prescribe a noradrenaline and specific serotonergic antidepressant. One example of this type is mianserin. This type of antidepressant can help treat personality disorders.
Antidepressants are typically used to treat moderate and severe cases of depression. They may also be prescribed as part of a combination treatment for patients with severe anxiety and panic attacks. Doctors may also use this type of medication to treat 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 and longer.
Patients who take antidepressants for 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. The dosage of the original antidepressant may need to be increased.
Antidepressants are most commonly used to treat depression and anxiety. However, 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 for physical health conditions as well. Tricyclic antidepressants help reduce chronic pain for some patients, and they may also be prescribed for fibromyalgia patients. 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 doctor if other treatments could be tried first. Patients who use antidepressants for chronic pain might wish to consult with a counselor. They should always let their doctor know if their pain intensifies, moves, or changes in any way.
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 their medicine. 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 this medication could cause various physical effects. For example, SSRIs and SNRIs could lead to low blood sugar and sodium. They may 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. Seizures have occurred in some patients who take this drug as well. Other potential side effects of this type of medication include an irregular heartbeat, abdominal cramps, anxiety, constipation, and increased eye pressure. Patients taking these medications may need to have their blood pressure, heart rhythm, and eye pressure monitored closely. Monoamine oxidase inhibitors could also produce seizures, high blood pressure, heartbeat irregularities, and anxiety. Patients taking them 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. They have also been associated with potentially serious side effects, such as seizures and reduced white blood cell counts.
SSRIs should not be taken with tricyclic antidepressants, monoamine oxidase inhibitors, or other medicines that increase serotonin levels in the brain. Taking them together could lead to a dangerous condition known as serotonin syndrome. In addition, patients should avoid using 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 many medications as well. Examples include clonidine, cimetidine, and amitriptyline.
Patients should inform their doctor of all prescription and 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.
Many patients do not experience perfect results from the first antidepressant they try. In many cases, their doctor will adjust their dose first. This can help many patients, since some individuals will need a higher dose of the same medication than others. However, some patients may need to try more than one antidepressant before finding the one that works for them. Switching antidepressants is not a cause for concern, though it must be taken seriously.
First, patients should never stop taking their current medication before talking to their doctor. If it is an emergency, a phone call will be enough. In other cases, they should book an appointment and discuss it then. Doctors will be able to not only wean patients off their current antidepressant, but also switch them to one that they believe will be an appropriate alternative. Their instructions will help prevent side effects, withdrawal, and other issues. Overall, patients need to listen to their doctor and switch antidepressants under their direction.
Tapering Off Antidepressants
Patients may want to stop taking their antidepressants for several reasons. It is worth noting that one of the reasons that patients may want to taper off their antidepressants is because they are feeling better. However, patients are often feeling better because their medication is working. In all cases, though, patients must talk to the doctor who prescribed the antidepressant first! They will determine when it is safe and necessary for patients to taper off antidepressants. Most doctors will recommend that patients on antidepressants for a minimum of six months after they start feeling better.
When it is time to taper off this medication, the key is to do so gradually and based on a doctor’s recommendation and instructions. Different antidepressants will require different schedules for tapering off of them. This also applies to different doses of the same medication. Thus, patients should discuss the process in detail with their doctor and regularly check in with them throughout the tapering process.
Reasons For No Improvement
There are quite a few reasons why some patients may not see any improvement when they are taking an antidepressant. One of them is that they are not taking a high enough dose. Another one is that the specific antidepressant they are taking is not working for them and they need a different one. These reasons for no improvement are ones that doctors can fix easily by adjusting the patient’s prescription.
Antidepressants are effective for many patients, though it is worth understanding that some patients may need multiple treatments to see improvement in their symptoms. The most common combination is antidepressants and therapy. In rarer cases, some patients may find that antidepressants are not for them and need a different approach to their treatment that does not include them. Patients should talk to their doctor about these possibilities as well.
Getting The Best Results
There are a few key elements that help patients with getting the best results from their antidepressants. The most important element is that patients must always listen to the doctor who wrote their prescription and the instructions they gave them for the dose, how often to take the medication, when to take it, as well as whether or not to take the antidepressant with food. The doctor knows how the medication should work and, thus, how to give patients their best chance of success.
However, there is more to getting the best results. Patients should also know that it takes some time for antidepressants to start being effective at the level intended. This timeline can vary depending on the specific medication, as well as the dose and dosage frequency. It is common for antidepressants to take at least three weeks to begin being effective. Of course, patients should also regularly communicate with their doctor, particularly about concerning side effects or a lack of results. Some patients will need to try more than one antidepressant before they see the results that they need.
Some depression patients may need what some doctors refer to as combination treatments. In certain cases, patients may need more than one medication for depression. This is often to combat side effects from the first antidepressant. One such combination is adding trazodone to selective serotonin reuptake inhibitors. The reason is that trazodone helps reduce insomnia, which is a side effect of SSRIs.
Of course, combination treatments for depression may also include additional strategies, such as mindfulness, meditation, and cognitive behavioral therapy. Adding these strategies alongside antidepressants is quite common. In addition to being common, studies show that combining medication with these therapies increases the overall effectiveness of a patient’s depression treatment.