**MEDS POST**
I'm gonna save this novel of a post here for future use if necessary. Click only if you're interested in learning about antidepressants --> General information about antidepressants
Antidepressants work by affecting neurotransmitters and neurotransmission. Abnormally low levels of various neurotransmittors in the brain are thought to cause depression as well as other disorders such as anxiety and schizophrenia. The categories of antidepressants are named by the neurotransmitter and action that are affected-- for example, SSRI = selective serotonin reuptake inhibitor, meaning that an SSRI decreases the reuptake (absorption, basically) of the neurotransmitter serotonin, thereby raising its level. These varying mechanisms are only relevant to (1) understand the risks/side effects/etc. of the medication your doctor has prescribed, as these vary by category, and (2) consider talking to your doctor about switching to a different category instead of another drug in the same category if you've tried several drugs in that category without success.
It is important to note that up to half the people who are prescribed a given antidepressant do not see improvement, although one should not conclude that a medication is ineffective until it has been taken consistently for at least 2 months. Trying a number of different options is frequently necessary; what works wonders for one person may do nothing for another, and vice versa (the same goes for side effects). Furthermore, approximately one-third of users find that a formerly effective medication stops working over time and may need to increase their dosage or switch medications to regain effect. It is possible to relapse while on medication. Medication works only slightly longer than it is taken, so stopping medication is not unlikely to lead to a return of depression. Antidepressants may also reduce disorders commonly experienced in depression patients, such as anxiety; however, it is also possible that the other disorder(s) can worsen depending on the individual. There is an elevated risk of suicide during the first few weeks of taking antidepressants, particularly in teenage or child sufferers.
Major categories of antidepressants
- SSRIs: The most common type of antidepressant these days. Prozac, Lexapro, Zoloft, and Paxil are a few examples. They are safer overall than some other types of antidepressants (see descriptions below to understand what I mean by "safer"), but common side effects include the following: anxiety, insomnia, decreased appetite or weight gain over long-term use (note: these types of apparent contradictions are common in both depression and treatment-- different people get different side effects), dry mouth, decreased sex drive. It is worth noting that any weight gain is not the direct result of the medication-- instead, the medication may cause increased cravings or increased daytime sleepiness, leading to increased consumption and decreased exercise, respectively. Some people may see some effect in the first 7-10 days of treatment, but it typically takes 2-4 weeks to see full improvement (outliers may take up to 8 weeks) and results are best when medication is taken consistently for at least 6 months. Suddenly stopping taking these medications can cause physical and mental withdrawal symptoms, so tapering off the medication for up to a month is strongly recommended.
- SNRIs: These are also fairly common these days. Cymbalta and Effexor are examples. Side effects and results/withdrawal information are similar to SSRIs, but these medications involve a different mechanism.
- MAOIs: Relatively uncommon now, these used to be very widely used. Nardil and Emsam (the latter is in patch form) are examples. MAOIs have fallen from favor because they can cause a life-threatening sudden rise in blood pressure if certain foods are eaten-- these foods include cheese, soy, and fruit/meat/yogurt/etc. that is overripe/not fresh. Other medications can also cause the reaction, so users must be completely free of residual SSRIs and avoid certain other drugs such as cold medicine. The patch and certain other new formulations can either drastically reduce or completely do away with the food interaction risk, however, and these medications may be effective for people who have failed to respond to more widely prescribed SSRIs/NSRIs, people with significant anxiety/irritability aspects to their depression, and people whose depression is markedly worst at night rather than in the morning. Non-food-related side effects are minimal.
Smaller categories of antidepressants include the following: TCAs (such as Elavil and Tofranil) are the oldest category and are now seldom used except in particularly severe cases due to the high incidence of disruptive and potentially fatal side effects; NDRIs (such as Wellbutrin); NDDIs; SSREs; and NRIs (such as Strattera) which may particularly improve motivation and concentration. There are also augmenter drugs that can be used in combination for best results: for example, lithium, Lamictal, Risperdal, Zyprexa, and Seroquel can be used as mood stabilizers for people who are bipolar or experiencing significant anxiety along with their depression (as long as the primary medication is not an MAOI).
Help your doctor select the best antidepressant for you
Your doctor will try to prescribe a medication that he thinks will be effective given the specific symptoms that you exhibit. If you have concerns that are not readily apparent or are not directly related to depression-- for example, a desire to avoid weight gain or a family history of bipolar disorder-- you should express the concerns to your doctor, as he/she may be able to suggest a medication that addresses your concern or eases your fear.
Antidepressants work by affecting neurotransmitters and neurotransmission. Abnormally low levels of various neurotransmittors in the brain are thought to cause depression as well as other disorders such as anxiety and schizophrenia. The categories of antidepressants are named by the neurotransmitter and action that are affected-- for example, SSRI = selective serotonin reuptake inhibitor, meaning that an SSRI decreases the reuptake (absorption, basically) of the neurotransmitter serotonin, thereby raising its level. These varying mechanisms are only relevant to (1) understand the risks/side effects/etc. of the medication your doctor has prescribed, as these vary by category, and (2) consider talking to your doctor about switching to a different category instead of another drug in the same category if you've tried several drugs in that category without success.
It is important to note that up to half the people who are prescribed a given antidepressant do not see improvement, although one should not conclude that a medication is ineffective until it has been taken consistently for at least 2 months. Trying a number of different options is frequently necessary; what works wonders for one person may do nothing for another, and vice versa (the same goes for side effects). Furthermore, approximately one-third of users find that a formerly effective medication stops working over time and may need to increase their dosage or switch medications to regain effect. It is possible to relapse while on medication. Medication works only slightly longer than it is taken, so stopping medication is not unlikely to lead to a return of depression. Antidepressants may also reduce disorders commonly experienced in depression patients, such as anxiety; however, it is also possible that the other disorder(s) can worsen depending on the individual. There is an elevated risk of suicide during the first few weeks of taking antidepressants, particularly in teenage or child sufferers.
Major categories of antidepressants
- SSRIs: The most common type of antidepressant these days. Prozac, Lexapro, Zoloft, and Paxil are a few examples. They are safer overall than some other types of antidepressants (see descriptions below to understand what I mean by "safer"), but common side effects include the following: anxiety, insomnia, decreased appetite or weight gain over long-term use (note: these types of apparent contradictions are common in both depression and treatment-- different people get different side effects), dry mouth, decreased sex drive. It is worth noting that any weight gain is not the direct result of the medication-- instead, the medication may cause increased cravings or increased daytime sleepiness, leading to increased consumption and decreased exercise, respectively. Some people may see some effect in the first 7-10 days of treatment, but it typically takes 2-4 weeks to see full improvement (outliers may take up to 8 weeks) and results are best when medication is taken consistently for at least 6 months. Suddenly stopping taking these medications can cause physical and mental withdrawal symptoms, so tapering off the medication for up to a month is strongly recommended.
- SNRIs: These are also fairly common these days. Cymbalta and Effexor are examples. Side effects and results/withdrawal information are similar to SSRIs, but these medications involve a different mechanism.
- MAOIs: Relatively uncommon now, these used to be very widely used. Nardil and Emsam (the latter is in patch form) are examples. MAOIs have fallen from favor because they can cause a life-threatening sudden rise in blood pressure if certain foods are eaten-- these foods include cheese, soy, and fruit/meat/yogurt/etc. that is overripe/not fresh. Other medications can also cause the reaction, so users must be completely free of residual SSRIs and avoid certain other drugs such as cold medicine. The patch and certain other new formulations can either drastically reduce or completely do away with the food interaction risk, however, and these medications may be effective for people who have failed to respond to more widely prescribed SSRIs/NSRIs, people with significant anxiety/irritability aspects to their depression, and people whose depression is markedly worst at night rather than in the morning. Non-food-related side effects are minimal.
Smaller categories of antidepressants include the following: TCAs (such as Elavil and Tofranil) are the oldest category and are now seldom used except in particularly severe cases due to the high incidence of disruptive and potentially fatal side effects; NDRIs (such as Wellbutrin); NDDIs; SSREs; and NRIs (such as Strattera) which may particularly improve motivation and concentration. There are also augmenter drugs that can be used in combination for best results: for example, lithium, Lamictal, Risperdal, Zyprexa, and Seroquel can be used as mood stabilizers for people who are bipolar or experiencing significant anxiety along with their depression (as long as the primary medication is not an MAOI).
Help your doctor select the best antidepressant for you
Your doctor will try to prescribe a medication that he thinks will be effective given the specific symptoms that you exhibit. If you have concerns that are not readily apparent or are not directly related to depression-- for example, a desire to avoid weight gain or a family history of bipolar disorder-- you should express the concerns to your doctor, as he/she may be able to suggest a medication that addresses your concern or eases your fear.