FRIDAY, May 26, 2023 (HealthDay News) — You’ve been diagnosed with depression. What’s next?
The cornerstone of treatment remains antidepressants, so it’s likely your doctor will prescribe one for you, but which one is best?
You join millions around the world who are struggling with the treatment of the mental disorder. According to the World Health Organization, an estimated 3.8% of the world’s population experiences depression. The numbers are staggering, but when depression is left untreated it can impair daily functioning, increase the risk of suicide and reduce quality of life.
Fortunately, there are many different types of antidepressants available, each with unique mechanisms of action, benefits, and possible side effects. Here, experts will examine the most commonly prescribed depression medications, how they work, and their common side effects.
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Dr. Abid Nazeer, founder, chief medical officer and medical director of Advanced Psych Solutions in Naperville, Illinois, stated, “If you don’t treat depression, you risk getting through the day, but it will feel like a struggle. If it’s treated appropriately, you can have a much better day.
Meanwhile, Pardis Khosravi, psychologist and clinical director of the Children’s Health Council in California, said, “Depression is not something you can get through or come out of with positive thoughts. It is a medical disease that, left untreated, can have a major impact on your health, quality of life and daily functioning. Untreated depression increases the likelihood of risky behaviors such as substance use, self-harm, and suicidal thoughts and/or behavior.”
While alternative therapies can be successful in treating depression, medication may become necessary in certain situations when other treatments have failed, depression symptoms significantly interfere with daily life, there is a history of mental health problems, or when a person feels too exhausted to to go. medication treatments.
Here are some of the most common depression medications:
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are a class of medications used to treat depression by increasing levels of serotonin in the brain, a crucial neurotransmitter that facilitates communication between nerve cells. The Mayo Clinic indicates that SSRIs prevent the reabsorption of serotonin in neurons, leaving more of the chemical messenger available to enhance signaling between brain cells. In addition, SSRIs are known as selective agents because they primarily affect serotonin rather than other neurotransmitters.
These SSRIs are approved by the U.S. Food and Drug Administration for the treatment of depression:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil, Pexeva)
- Sertraline (Zoloft)
While SSRIs are effective in treating depression, they can also cause a variety of side effects. According to an article published in the Primary Care Companion to the Journal of Clinic Psychologyare the most common side effects of SSRIs gastrointestinal problems, sexual dysfunction, weight gain and sleep disturbances.
Gastrointestinal side effects include nausea, diarrhea, and abdominal pain, while sexual dysfunction includes decreased libido, erectile dysfunction, and difficulty reaching orgasm.
In rare cases, SSRIs may increase the risk of suicidal thoughts, especially in young people, research shows.
SSRIs aren’t the only drugs for depression: tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) work by affecting other neurotransmitters.
SSRIs generally have fewer side effects than these older antidepressants and are typically the first-line treatment for depression. However, the choice of medication depends on individual needs, and health care providers may recommend different types of antidepressants based on the patient’s specific symptoms and medical history.
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs are another type of antidepressant that blocks the enzyme monoamine oxidase, which breaks down neurotransmitters such as serotonin, norepinephrine, and dopamine. By increasing the levels of these neurotransmitters, MAOIs can relieve symptoms of depression.
Some of the most common MAOIs are:
- Phenelzine (Nardil)
- Tranylcypromine (Parnate)
- Isocarboxazid (Marplan)
- Selegiline (Emsam) – available as a transdermal patch
These medications can be effective in treating depression. However, the Mayo Clinic states that they are generally not considered first-line therapy due to their potential for serious side effects and interactions with certain foods and medications.
According to Mental Health America, atypical antidepressants are a diverse class of medications used to treat depression that don’t fit neatly into other categories of antidepressants. They work by targeting multiple neurotransmitters in the brain, including serotonin, norepinephrine, and dopamine, to improve mood and relieve symptoms of depression. Some of the most commonly used atypical antidepressants are:
- Bupropion (Wellbutrin)
- Mirtazapine (Remeron)
- Trazodone (Desyrel)
- Vilazodon (Viibryd)
- Vortioxetine (Trintellix)
Bupropion is known for its unique mechanism of action, increasing the levels of norepinephrine and dopamine in the brain. Mirtazapine works by increasing the release of both serotonin and norepinephrine, while trazodone primarily affects serotonin levels. Vilazodone and vortioxetine are newer medications that target multiple neurotransmitters and effectively treat depression.
These medications may be helpful for individuals who have not responded to other types of antidepressants or who are experiencing side effects from other medications.
SOURCES: Abid Nazeer, MD, founder, chief medical officer and medical director, Advanced Psych Solutions, Naperville, Illinois; Pardis Khosravi, psychologist and clinical director, Children’s Health Council, Palo Alto, California.