In most cases, when adults suffer from serious, persistent depression, they are given antidepressants as a first form of treatment. Antidepressants are a type of medication designed to treat clinical depression and prevent it recurring. They’re also used to assist with various other conditions, including obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and long-term chronic pain. There are several types of depression medications, all of which improve symptoms of depression by increasing the levels of certain brain chemicals called neurotransmitters. Certain neurotransmitters, such as serotonin and noradrenaline, can improve mood and emotion. Although the notion that these pills can improve your condition is highly appealing, are antidepressants always the best option?
Clinical depression is a more severe form of depression that can affect many areas of life. It’s not the same as depression caused by a loss or a medical condition. This type of condition infects mood and behavior, as well as physical functions like sleep and appetite. Some people have trouble sleeping, lose weight, and feel agitated. Others, on the other hand, may sleep and eat too much, feel worthless and constantly guilty. In addition, other symptoms include:
- Fatigue, decreased energy
- Feelings of guilt and worthlessness
- Insomnia, or excessive sleeping
- Difficulty concentrating
- Loss in interest in activities once found satisfying, including sex
- Persistent anxious and sad feelings
- Overeating or loss of appetite
- Persistent pain, headaches, cramps
- Thoughts of suicide and suicide attempts
Clinical depression affects twice as more women than men. The condition is most common in people who are 25-44 years of age, and less common in those over 65. Research shows that 5%-9% of women and 2%-3% of men are likely to experience clinical depression at any point in life. It’s also estimated that 10%-25% of all people who develop clinical depression have previously had dysthymia, and each year about 10% of those with dysthymic disorder will develop a major depressive episode.
Moreover, if left untreated, symptoms of clinical depression may worsen and cause great suffering, and possibly lead to suicide. Unfortunately, almost 50% of the people who experience symptoms of clinical depression never get diagnosed or treated for their condition.
Although the real core of clinical depression is not known, there are several factors that can contribute to its development, including a combination of genes and stress, changes in the balance of hormones, as well as alcohol abuse, drug abuse, particular types of medications like steroids, and certain medical conditions like cancer.
Major Types of Antidepressants
Antidepressants are grouped according to how they work. There are various types, including:
- SSRIs: selective serotonin reuptake inhibitors
SSRIs are the most common prescribed antidepressants that can ease the symptoms of clinical depression, are relatively safe, and cause fewer side effects than other medications. They include Celexa, Lexapro, Luvox, as well as Paxil, Prozac, and Zoloft.
- SNRIs: serotonin and noradrenaline reuptake inhibitors
SNRIs can help relieve depression symptoms like irritability and sadness, and can also help with anxiety disorders and nerve pain. They may be helpful if the individual suffers from chronic pain in addition to depression.
- TCAs: tricyclic antidepressants
TCAs are among the earliest developed antidepressants, are effective, but generally replaced by other medications with fewer side effects. They relieve depression when other treatments fail.
- RIMAs: reversible inhibitors of monoamine oxidase A
RIMAs increase the amount of noradrenaline and serotonin in the brain and can work as antidepressants.
Tetracyclic antidepressants are similar to tricyclic antidepressants. Some of them are more often used to treat schizophrenia rather than depression.
- NaSSAs: noradrenergic and specific serotonergic antidepressant
NaSSAs enhance adrenergic and serotonergic neurotransmission in the brain involved in mood regulation.
- MAOIs: monoamine oxidase inhibitors
MAOIs are a group of medicines that can treat depression. They can take up to three weeks to build up their effect to work fully.
How Antidepressants Work in the Brain
- SSRIs block serotonin from being reabsorbed back into the nerve cells they came from. This leads to an increased concentration of serotonin in the synaptic cleft, and all this extra serotonin can then strengthen communication between the nerve cells. Moreover, with this higher connectivity, individuals battling with depression can overcome hopelessness, sadness, and lack of interest in life.
- SNRIs block the re-uptake of serotonin and norepinephrine. They include Cymbalta, Effxor, Khedezla, Fetzima, and Pristiq.
- Tetracyclic and tricyclic antidepressants work by inhibiting a number of neurotransmitters, including serotonin, epinephrine, and norepinephrine, from re-uptake as well as binding to nerve cell receptors.
- RIMAs reduce the activity of monoamine oxidase that is present throughout the body. They increase the amount of noradrenaline and serotonin. RIMA drugs bind with the enzymes in a reversible manner and can detach, thereby reactivating the enzyme.
- NaSSAs inhabit negative feedback effects on norepinephrine and serotonin secretion by the presynaptic cell. This action increases the concentrations of these neurotransmitters in the synaptic cleft. Moreover, they also block some serotonin receptors on the postsynaptic cell, which enhances serotonin neurotransmission.
- MAOIs elevate the levels of serotonin, dopamine, and norepinephrine by inhabiting and enzyme called monoamine oxidase. When not inhibited, this enzyme breaks down serotonin, dopamine, and norepinephrine.
- Melatonergic antidepressants act on brain receptors for melatonin, as well as serotonin receptors.
Common Side Effects of Antidepressants
All antidepressants can cause unpleasant side effects, including:
- increased appetite and weight gain
- loss of sexual desire, erectile dysfunction, and decreased orgasm
- blurred vision
- muscle twitching
In addition, the side effects of antidepressants can cause problems at the beginning, but they improve with time. It’s relevant to continue treatment as it usually takes several weeks before patients start to benefit from treatment. With time, most patients find that benefits of treatment outweigh any issues from side effects.
People taking antidepressants can become physically dependent on the drugs, but this doesn’t mean they have an addiction. Even though antidepressants are thought to be non-addictive, an individual can still create a dependency through continued abuse. However, antidepressants aren’t addictive in the same way substances are. Antidepressant dependence can form in people who never needed these drugs in the first place.
Furthermore, doctors often misdiagnose almost two-thirds of patients with depression and prescribe unnecessary medications. Millions of Americans suffer from depression and related mental health illnesses each year, so getting access to these drugs is relatively easy. Some patients, can also self-medicate if they feel as if the antidepressant is not alleviating all of the depression issues. Others, may self-medicate when faced with a triggering event such as death. There are people who will try to get a hold of these pills just to elevate their mood. However, addiction is more common in people with mood disorders like depression. If antidepressants aren’t helping, a depressed person might turn to other substances to help them feel better.
Moreover, doctors still debate whether antidepressants cause addiction, but many consider these pills to be non-addictive. Others, on the other hand, take the withdrawal symptoms of antidepressants into consideration as an evidence that addiction can form.
Quitting an antidepressant suddenly can cause withdrawal symptoms, including:
- Violent thoughts and actions
- Vivid dreaming
- Mood swings
- Cardiac arrhythmia
- Increased risk of suicide
- Memory problems
- Panic attacks
- Erectile Dysfunction
The best way to quit antidepressants is by slowly reducing doses over several weeks with the help of a doctor. Those quitting antidepressants should find an alternate treatment for their depression. Certain therapies may even be more effective than taking antidepressants for depression.
Furthermore, a 30-90 day inpatient program can also help patients safely quit antidepressants. There are various private antidepressant rehab centers that provide complete confidentiality. Patients here will receive help by medical professionals who will offer them the greatest care possible.
If someone you know is depressed and has a substance use problem, there are many affordable ways to get them help. Call an addiction specialist to discuss options.
For more information please call our Addiction Treatment Helpline at (844) 439-4765. This is a Free and completely confidential call. We are available 24/7. In many cases, your health insurance company will cover 100% of the treatment cost. So please call now.