There are several types of antidepressant medications used to treat depressive disorders. These include selective serotonin reuptake inhibitors (SSRIs), tricyclics, and monoamine oxidase inhibitors (MAOIs). The SSRIs, as well as other medications that affect neurotransmitters such as dopamine or norepinephrine, generally have fewer side effects than tricyclics. Sometimes your doctor will try a variety of antidepressants before finding the medication or combination of medications most effective for you.
What Conditions Are Antidepressants Used For?
"Major depression" is the type of depression that will most likely benefit from treatment with medications. It is a condition that lasts 2 weeks or more, and interferes with a person's ability to carry on daily tasks and enjoy activities that previously brought pleasure.
Depression can be caused by a number of factors, but the brain functions differently in people who are depressed. Depression runs in families, and genes appear to be involved. Your environment and learning may also play a role. Episodes of depression may be triggered by stress, difficult life events, side effects of medications, medication/substance withdrawal, or even infections that can affect the brain.
Symptoms of depression may include:
- Feeling sad or "down"
- Being unable to enjoy normal activities
- Feeling "numb" or emotionless rather than sad
- Having no appetite and losing weight (although some people eat more and gain weight when depressed)
- Sleeping too much or too little, having difficulty going to sleep, sleeping restlessly, or awakening very early in the morning
- Feeling guilty, worthless, or hopeless
Some depressed people lack energy while others feel jumpy and agitated. In severe depression, people can have delusions that they are unworthy, sinful, or terminally ill. Feelings of depression are sometimes worse at a particular time of day.
You don't need to have all of these symptoms to be depressed. Depression can be mild or severe, and it can can occur along with other medical disorders such as cancer, heart disease, stroke, Parkinson's disease, Alzheimer's disease, and diabetes. Depression may be overlooked while the more obvious physical aspects of these diseases are treated.
The antidepressant medications that are used for serious depression also may help some people who have milder depression. Antidepressants work by gradually reducing the symptoms of depression and helping depressed people feel the way they did before they became depressed.
How Are Antidepressants Prescribed?
Your doctor or health care provider will choose an antidepressant based on your particular symptoms. You may notice improvement in the first couple of weeks, but usually the medication should be taken regularly for at least 6-8 weeks before the full therapeutic effect occurs.
If there is little or no change in symptoms after 6 or 8 weeks, you may be switched to a different medication, or a second medication may be added. There is no way of knowing beforehand which medication will be effective, so you may have to try a few different drugs.
Antidepressants are usually given for at least 6 to 12 months. When a patient and the healthcare provider feel that medication can be discontinued, they should discuss how to best taper off the medication gradually. Never discontinue medication without talking to your doctor about it. For people who have had several bouts of depression, long-term treatment with medication is the most effective means of preventing more episodes.
The dose of your antidepressant depends on the type of drug and your body chemistry, age, and weight. Antidepressant dosages are often started low and raised gradually over time until the desired effect is reached without the appearance of troublesome side effects. Some of the newer antidepressants may be started at or near the target dose.