Do you often feel heavy, sad, or lonely? Maybe your doctor has diagnosed you with depression and told you to start taking medication for it. Some people get a little scared when they hear about this medication. Questions like "Will I get addicted to this?" and "Are there many side effects?" come to mind. So today, let's talk about these medications for depression, or `(Antidepressants)`, very simply, in a way that you can understand.
What is this medicine for depression?
Simply put, these are medications that your doctor prescribes to treat depression. Once your doctor has determined that you have moderate to severe depression, these medications may be given alone or in combination with talk therapy/counseling.
Also, these medications are used not only for depression, but also for several other mental health problems.
- Obsessive-Compulsive Disorder (OCD)
- Social Phobia
- Panic Disorder
- Generalized Anxiety Disorder (GAD)
- Posttraumatic Stress Disorder (PTSD)
Sometimes, doctors use these medications for other health conditions than the ones they are approved for. For example, some older types of antidepressants (Tricyclic Antidepressants) are sometimes prescribed for pain, insomnia, and even migraines.
What are the main types of these medications?
These medications fall into several main categories. Each category works in a slightly different way. Let's take a look at the main types.
1. SSRIs (Selective Serotonin Reuptake Inhibitors)
This is the most common type of medication currently prescribed by most doctors in the world. You will likely be given one of these medications first because they have relatively few serious side effects.
| Characteristic | Description |
|---|---|
| Functionality | It increases the levels of the chemical messenger serotonin in the brain, which improves mood. |
| Common side effects | Stomach upset, nausea, headache, insomnia or drowsiness, decreased sexual desire. (These usually subside after the first few weeks). |
| Examples | Fluoxetine, Sertraline, Citalopram, Escitalopram |
2. SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)
This is another class of medication that, like SSRIs, is often given as a first-line treatment.
To reduce nausea from these medications, taking the medication with food is a good idea.
- Action: These increase levels of both the chemical messengers serotonin and norepinephrine in the brain.
- Common side effects: nausea, dry mouth, sweating, dizziness, headache.
- Examples: Venlafaxine, Duloxetine, Desvenlafaxine.
3. TCAs (Tricyclic Antidepressants)
These are a somewhat old type of medication. Doctors don't use them very often these days. The reason is that they have a few more side effects, and the risk of overdose is high if the dosage is increased.
Typically, a doctor considers this type of medication for people with severe depression who are not responding to medications like SSRIs and SNRIs.
- Common side effects: dry mouth, blurred vision, constipation, difficulty urinating, drowsiness, weight gain.
- Examples: Amitriptyline, Imipramine, Clomipramine.
4. MAOIs (Monoamine Oxidase Inhibitors)
This was the first antidepressant to be discovered. These are also used very rarely now. The main reason for this is that you have to follow some very strict rules about eating and drinking while taking these medications.
Remember, some common foods (e.g. cheese, some types of sausage, soy sauce) can react with this medication, causing a sudden and dangerous increase in blood pressure. So if you are given this medication, your doctor will give you a long list of good and bad things to eat. Also, this medication is not given with other antidepressants.
How does the medicine start working?
This is a very interesting question. Scientists still don't know 100% exactly how this drug works. But this is the best understanding we have right now.
The nerve cells in our brain communicate with each other through chemicals called neurotransmitters . Think of these as little messengers. In the brain of someone with depression, the activity of some of these mood-regulating messengers (e.g., serotonin, norepinephrine, dopamine) may be reduced.
Antidepressant medications work by making these messengers stay in the space between nerve cells (the synapse) longer. That is, they increase the effectiveness of those messengers. This is what gradually improves mood and reduces symptoms of depression.
The most important thing is that you don't get results right away with this medication. It can take 6-8 weeks for most medications to take full effect. So it's important to be patient and continue taking your medication as your doctor tells you.
The most serious risks and things to be careful about
Although most of these medications are safe, there are a few things we should definitely be aware of.
| Special points to note | |
|---|---|
| Suicidal thoughts (Suicide Risk) | This is the most important thing. Some antidepressants, especially in young people under 25, have been found to increase suicidal thoughts in the first few weeks of starting the medication or when the dose is changed . This is why they have a 'Black Box Warning'. If you or someone you know is having these thoughts, tell your doctor immediately, or go to the nearest hospital emergency department (ETU). You can also call the national mental health helpline number 1926 for help. |
| Discontinuation Syndrome | Never stop taking this medication suddenly without your doctor's advice. Doing so may cause dizziness, nausea, lightheadedness, insomnia, and electric shock sensations. The condition may also return. If you stop taking this medication, do so under the supervision of your doctor, and gradually reduce the dose. |
| Serotonin Syndrome | This happens rarely. But it is very dangerous. This happens when serotonin levels in the brain increase unnecessarily. If symptoms such as high fever, body tremors, unexplained anxiety, sweating, and rapid heartbeat occur, it is an emergency. You should go to an ETU immediately. |
| Pregnant and lactating mothers | If you are planning to become pregnant, are pregnant, or are breastfeeding, be sure to discuss this medication with your doctor before using it. The best decision is to discuss the risks and benefits to you and your baby. |
How do I choose the right medicine for me?
This is the problem that many people have. You may not find the right medicine right away. It's like choosing a pair of shoes. Some are too tight, some are too big, and you have to try on a few until you find the right one.
Your doctor will first choose a medication after considering many factors, such as the nature of your symptoms, other medical conditions you have, other medications you are taking, and your tolerance for side effects.
If you're still not feeling any better after 6-8 weeks, or if you're having bothersome side effects, don't be shy or afraid to tell your doctor. He or she may be able to adjust the dosage, add another medication, or switch you to a different medication altogether. This is normal.
Take-Home Message
- Antidepressants are a very effective treatment for moderate to severe depression. They are not addictive.
- This medication should only be used on the recommendation of a doctor. Do not blindly take a medication that a friend is taking or buy it from a pharmacy.
- It may take some time to find the right medication for you. So be patient, talk openly with your doctor, and stick with your treatment.
- Never stop taking medication suddenly without your doctor's advice. If you do stop, do it gradually.
- If you have suicidal thoughts during the initial stages of taking the medication, do not hide it and seek medical advice immediately or call 1926. You are not alone, help is available.
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