Antidepressants
Antidepressants: Medicine for Depression
What are antidepressants?
Antidepressants are medicines used to help people who have depression. Most people with depression get better with treatment that includes these medicines.
How do antidepressants work?
Chemicals in the brain called neurotransmitters are needed for normal brain function. Antidepressants help people with depression by making these natural chemicals more available to the brain.
How long will I have to take an antidepressant?
Antidepressants are usually taken every day. It can take up to a month to see the full results of taking an antidepressant. Sometimes different kinds or amounts (dosages) need to be tried to find one that works best for you. Antidepressants are typically taken for at least 6 to 12 months. In some cases, patients and their doctors may decide that antidepressants are needed for a longer time.
What are the different kinds of antidepressants? What kinds of side effects do they have?
Antidepressants are put into groups based on which chemicals in the brain they affect. There are many different kinds of antidepressants, including:
- Selective serotonin reuptake inhibitors (SSRIs)
- citalopram
- escitalopram
- fluoxetine
- paroxetine
- sertraline
If a person has never tried an antidepressant before, SSRIs are usually the first kind of antidepressant medicine your doctor will recommend for you. These medicines tend to have fewer side effects than other antidepressants. Some of the side effects that can be caused by SSRIs include dry mouth, nausea, nervousness, insomnia, sexual problems and headache.
- Heterocyclics
- amitriptyline
- desipramine
- imipramine
- nortriptyline
This type of antidepressant is effective, but used less often because the side effects are often more extreme. Common side effects caused by these medicines include dry mouth, blurred vision, constipation, difficulty urinating, worsening of glaucoma, impaired thinking and tiredness. These antidepressants can also affect a person's blood pressure and heart rate. They are not usually recommended for older patients, people with glaucoma or men with enlarged prostates.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- venlafaxine
- duloxetine
These medicines are sometimes chosen because they don’t interfere with certain other medicines. Some common side effects caused by these medicines include nausea, especially in the first two weeks, loss of appetite, anxiety and nervousness, headache, insomnia and tiredness. Dry mouth, constipation, weight loss, sexual problems, increased heart rate and increased cholesterol levels can also occur.
- Norepinephrine and dopamine reuptake inhibitors (NDRIs)
- bupropion
This kind of medicine is sometimes recommended for people who also have attention-deficit hyperactivity disorder, cocaine dependence or want to quit smoking. You should not take this kind of medicine if you have a seizure disorder or bulimia. Some of the common side effects in people taking NDRIs include agitation, nausea, headache, loss of appetite and insomnia. However, this is also the main type of antidepressant medication that has no sexual side effects.
- Monamine oxidase inhibitors (MAOIs)
MAOIs are used less commonly than the other antidepressants. They can have serious side effects, including weakness, dizziness, headaches and trembling. Taking an MAOI antidepressant while you're taking another antidepressant or certain over-the-counter medicines for colds and flu can cause a dangerous reaction. You should not take an MAOI unless you clearly understand what medications and foods to avoid.
Will antidepressants affect my other medicines?
Antidepressants can have an effect on many other medicines. If you're going to take an antidepressant, tell your doctor about all the other medicines you take, including over-the-counter medicines and herbal health products (such as St. John's wort). Ask your doctor and pharmacist if any of your regular medicines can cause problems when combined with an antidepressant.
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Source
Written by familydoctor.org editorial staff.
American Academy of Family Physicians
Reviewed/Updated: 12/09
Created: 01/97