After you found out you had depression, you probably saw a doctor and started taking medication. Now you probably feel that you are getting better. That heavy burden and pressure you felt is now a little less. So now you probably think, "Okay, now I feel better, so I can stop taking this medication." But your doctor probably says, "We will continue using this medication for a while longer." Why do you say that? Let's talk about this in detail today.
Why do I need to continue taking medication even after I am cured?
The first thing to understand is that antidepressants are not like medicines for a cold or a cough. When we have a cold, we take medicine for a few days to completely cure the illness. But depression is a different condition. These medicines control the symptoms of depression and provide relief to your mind.
Think of it like taking medication for diabetes or high blood pressure. Rather than completely eliminating the disease, those medications help control it and help you live a normal life. Depression can sometimes be a chronic illness that requires long-term treatment .
If you are experiencing depression for the first time, the American Psychiatric Association recommends that you continue to take medication for about four to five months , even after your symptoms have significantly improved and you feel better. If you have had depression several times before, you may need to take medication for even longer, perhaps even for the rest of your life.
This is because if you stop taking the medication too soon, the risk of relapse is much higher. Continuing to take medication to control the disease in this way is called "Maintenance Treatment."
What are the common medications for depression?
There are several types of medications used to treat depression. Each of these works in a slightly different way. Your doctor will choose the medication that is best for you based on your condition, symptoms, and other health conditions.
Newer Antidepressants
Over the past two decades, many more effective medications with fewer side effects have been introduced.
| Drug category | The way it works is simple. | Possible side effects |
|---|---|---|
| SSRIs (Selective Serotonin Reuptake Inhibitors) Ex: Fluoxetine, Sertraline, Citalopram, Escitalopram | It improves the function of serotonin , a chemical messenger in the brain that controls our mood. | Stomach upset, sexual dysfunction, insomnia, dizziness, weight change, headache. (Mostly mild) |
| SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors) Ex: Venlafaxine, Duloxetine | It increases the activity of both chemical messengers called serotonin and norepinephrine . | Stomach upset, sleep problems, sexual dysfunction, headache, anxiety, dizziness, weakness. |
| NDRIs (Norepinephrine and Dopamine Reuptake Inhibitors) Ex: Bupropion (Wellbutrin) | It affects the activity of the chemical messengers norepinephrine and dopamine . | Stomach upset, headache, sleep problems, tremors, anxiety. (Sexual side effects and weight gain are rare. ) This medicine is not suitable for people who have had seizures in the past. |
| NaSSAs (Noradrenergic and Specific Serotonergic Antidepressants) Ex: Mirtazapine (Remeron) | Both serotonin and norepinephrine are affected differently. | Stomach upset, drowsiness, weight gain, anxiety, dizziness. |
Older Antidepressants
There are also medications that have been used to treat depression in the past. These are Tricyclic Antidepressants and MAOIs (Monoamine Oxidase Inhibitors) . These work by affecting the chemical messengers (neurotransmitters) in the brain.
Although these medications are very effective for some people, they have many side effects. And because they can cause problems with other medications and certain foods, doctors no longer recommend them as a first choice. However, these older medications may be a good option for some people who don't respond to newer medications.
Other Medicines
Sometimes, the doctor may decide to prescribe other medications along with the medication for depression.
- Medications for anxiety or insomnia: These help control the anxiety and sleep problems that come with depression.
- Atypical Antipsychotics: Medications such as Aripiprazole (Abilify) and Quetiapine (Seroquel), which are usually given for schizophrenia or bipolar disorder, can help boost the effectiveness of an antidepressant when it is not enough.
- L-methylfolate (Deplin): Although not classified as a drug by the FDA, it is considered a "medical food." This is a potent form of the B vitamin called folate. It helps regulate chemical messengers in the brain that control mood. It has been effective in treating depression that has not responded to other treatments.
How do you find the right medicine for you?
Unfortunately, it's not easy to find the right medication and dose for you. Everyone responds differently to the same medication. Even your doctor can't predict exactly how well a medication will work for you.
So this is something that needs to be done with some patience . You may need to try switching between medications. Usually, you will start to feel some relief within a few weeks of starting an antidepressant, but it can take several months to feel the full effects. So don't give up too quickly. Over time, your doctor may increase or decrease your dosage based on your condition.
If you've been taking a medication for a long time and it's not helping, be sure to talk to your doctor about it. He or she may recommend trying a different medication. Over time, you may find a medication or combination of medications that works for you.
The most important thing is, even if you feel better now, never stop taking your medication without first consulting your doctor. Doing so can cause your depression to return, or with some medications, can cause side effects like flu-like symptoms, nausea, and dizziness. Therefore, if you stop taking your medication, do so gradually, following your doctor's instructions.
Your doctor should see you regularly, especially when you first start a new medication. During this time, talk openly about any discomfort or problems you may be experiencing with the medication.
Take-Home Message
- Depression is not a weakness, it is a medical condition that requires treatment, just like diabetes.
- Even if you feel better, continue taking your medication for as long as your doctor tells you to prevent a relapse. This is called "maintenance treatment."
- It may take some time to find the right medication and dosage for you, so be patient with your treatment.
- Never stop taking medication or change the dosage without your doctor's approval.
- If you have any questions about the medication or any discomfort you are experiencing, discuss it openly with your doctor.
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