The biggest fear many people have when starting medication for depression is the side effects. It's normal to have questions like "Will it make me feel better?", "Will it affect my sex life?", "Will there be other problems?". So today we're going to talk about a relatively new type of medication that has fewer side effects than others. That is an antidepressant called NDRI. If your doctor has prescribed this type of medication for you, this article will be very important for you.
What is NDRI? How does it work?
Simply put, our feelings of happiness, sadness, and activity are controlled by chemical messengers in the brain called neurotransmitters. In conditions like depression, the balance of these messengers becomes a bit disrupted. Different types of antidepressants improve our mood by affecting these messengers in different ways.
NDRI is an abbreviation for Norepinephrine and Dopamine Reuptake Inhibitors . These medications primarily work by increasing the levels of two neurotransmitters in the brain called Norepinephrine and Dopamine. These have a major impact on our alertness and happiness.
The only NDRI currently available in Sri Lanka is Bupropion . Your doctor may have prescribed it under a brand name like Wellbutrin . Sometimes it is added to other antidepressants for people who have not fully responded to them. Bupropion is also prescribed by doctors under the brand name Zyban as an aid to quitting smoking.
One big advantage of NDRIs is that they are much less likely to cause side effects, such as weight gain or decreased sexual desire, that are seen with many other antidepressants.
Common (but not scary) side effects
Like any medication, NDRIs can have minor side effects. But most of these are temporary . That is, they will mostly go away after a few weeks of using the medication as your body gets used to it.
| Side Effect | Things to do and things to know |
|---|---|
| Dry Mouth | This is the most common side effect. Drink lots of water, suck on an ice cube, brush your teeth regularly. Cutting down on things like alcohol, coffee, and smoking also helps. |
| Nausea/Vomiting | This can be greatly reduced when the medicine is taken with a meal. |
| Insomnia | NDRIs can cause some people to have trouble falling asleep because they are a little stimulating. If you have this problem, avoid taking your last dose of the day too close to bedtime. |
| Headache | This usually goes away within a few days of starting the medication. |
| Weight Loss | Although many antidepressants complain about weight gain, NDRIs may actually help you lose a little weight. |
| Anxiety | Things like exercise, yoga, and meditation can help calm your mind. |
| Dizziness | This can happen when you get up too early. Get up slowly and drink plenty of water. |
| Constipation | Eating foods high in fiber (fruits, vegetables, legumes), exercising, and drinking plenty of fluids can help. |
In addition to these, rare side effects include rapid heartbeat, sore throat, uncontrollable shaking, skin rash, sweating, ringing in the ears, stomach pain, muscle pain, and frequent urination.
Serious side effects to watch out for
These are very rare, but we should definitely be aware of them. If you experience anything like this, you should inform your doctor immediately.
1. Seizures
For most people, this risk is very low. However, the risk may be slightly higher for someone with the following conditions:
- If you have eating disorders (Anorexia or Bulimia)
- If you have had a seizure before
- If you have had a serious head injury
- If you have liver disease
- If you are addicted to alcohol or drugs
2. High Blood Pressure
Your doctor will check your blood pressure regularly after you start taking the medication. This is especially important if you are using something like nicotine patches to quit smoking.
3. Increased pressure in the eyes (Angle-closure Glaucoma)
This is an eye emergency that can come on suddenly. It can even lead to vision loss. If you have eye pain, changes in vision, swelling or redness in or around your eyes , tell your doctor right away.
4. Suicidal Thoughts
This is very important. During the initial period of using any antidepressant, including NDRIs, there is a very small chance that some people (especially young people) will experience increased depression or suicidal thoughts.
If you or someone you know experiences extreme anger, agitation, sadness, fear, or any other unusual, severe emotion while taking this medicine, it is essential to call your doctor immediately or go to the nearest hospital Emergency Department (ETU).
Interactions with other medications
This is also very important. You should tell your doctor about all the medications you take, including vitamins, herbal supplements, and even over -the-counter medications. Some medications can increase the risk of seizures when combined with NDRIs. Other medications can also decrease the effectiveness of NDRIs.
Be sure to ask your doctor if it's safe to take NDRIs, especially if you're taking any of the following:
- MAOI antidepressants (if taken within 2 weeks)
- Any other antidepressant
- Alcohol and drugs
- Antipsychotics
- Medicine for seizures
- Stimulants
- Types of Steroids
- Insulin and other diabetes medications
- Some antibiotics
- Beta-blockers
- Medications for heart rhythm disorders
- Painkillers containing codeine
- Sleeping pills and sedatives
Most importantly: Never take more than one Bupropion-containing medication at a time (e.g., taking Wellbutrin and Zyban together). Taking too much medication (overdose) can cause severe side effects, seizures, or even death.
When to call the doctor
Even if you experience a minor side effect, tell your doctor about it. He or she may be able to adjust the dose or prescribe a different medication to control the side effect. Also, be sure to tell your doctor if you are pregnant, trying to get pregnant, or breastfeeding.
If you have any of the following symptoms, it is an emergency . Call your doctor immediately or go to the nearest hospital Emergency Treatment Unit (ETU) . If you suspect an overdose, you can also call the National Poisons Information Centre at the Colombo National Hospital .
| Emergency! Seek medical advice immediately. | |
|---|---|
| Symptom | Description |
| Seizures | If the body shakes uncontrollably. |
| Hallucinations | If you see or hear things that aren't really there. |
| Fainting | If you suddenly lose consciousness and fall. |
| Changes in heart rate | If you feel like your heart is beating too fast, too loud, too slow, or too irregularly. |
Take-Home Message
- NDRIs are a relatively safe type of antidepressant with few common side effects, such as weight gain and decreased sexual desire.
- Minor side effects such as dry mouth and insomnia may occur, but they usually go away within a few weeks.
- It is important to inform your doctor about all other medications, vitamins, and herbal products you are taking.
- Never stop taking medication or change the dosage without medical advice.
- If you experience serious symptoms such as seizures, loss of consciousness, or severe mental changes, seek medical help immediately.
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