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January 5, 2012

How Do Antidepressants Work?

Antidepressants are commonly used to treat depression, quite often in combination with psychotherapy. But what exactly are antidepressants and how do they help with depression? Antidepressants are prescription drugs believed to help restore the brain's chemical balance. That's because depression is associated with abnormal levels of certain brain chemicals called neurotransmitters, such as serotonin, norepinephrine and dopamine. These neurotransmitters play an important role in normal brain function including mood and sleep regulation, along with emotional responses and pain levels. Antidepressants help improve depression symptoms by restoring neurotransmitters to normal levels. Evidence suggests the effectiveness of antidepressants for people experiencing the intense sadness, fatigue, hopelessness and lack of interest that characterize depression. Experts caution antidepressants are not a magic bullet to solve existing problems, which is why medication is often combined with psychotherapy. It's also important to know it may take up to two months before you feel the effects of your antidepressant. There are a number of types of antidepressants, typically grouped according to the brain chemicals each affects. If you've never taken antidepressants, your mental health provider may prescribe a selective serotonin reuptake inhibitor, SSRI, for short. SSRIs may have fewer and milder side effects. But it's not uncommon to experience dry mouth, nausea, headache, insomnia or sexual problems. SSRIs include Celexa, Lexapro, Luvox, Paxil, Prozac and Zoloft, which generally are also considered safe for patients with cardiovascular and blood pressure issues. Newer antidepressants include serotonin and norepinephrine reuptake inhibitors, known as SNRIs. These include Effexor, Pristiq and Cymbalta. Side effects of SNRIs may include anxiety, dizziness, fatigue, insomnia, stomach upset and sexual problems. Monoamine oxidase inhibitors (MAOIs) are another type of antidepressants. These drugs including Nardil, Parnate and Marplan are believed to block breakdown of neurotransmitters, helping prevent mood changes. However, MAOIs are associated with serious side effects including interactions with food interactions and various other medications. Other types of antidepressants include norepinephrine and dopamine reuptake inhibitors, called NDRIs, such as Wellbutrin or Zyban, also used for smoking cessation. For many, the plus side of these drugs is that they often have fewer sexual side effects than other antidepressants. It's important to work with your mental health professional in finding the right dosage of the right medication that works best for you. Equally important is communicating with your mental health provider and being open to trying another type or class of drug, if necessary. Depending upon the severity of depression, your mental health provider may prescribe medications in addition to your antidepressants, such as anticonvulsants, anti-psychotics or stimulants such as Ritalin or Dexadrine. Remember, antidepressants can't make your problems go away. But they may make it easier to cope. Antidepressants are typically taken for a minimum of about six months. But you should never assume it's okay to stop taking depression medication without your doctor's consent. Even then, it's important to gradually reduce dosages to prevent side effects or worsening of depression symptoms. A Food and Drug Administration warning issued in 2004 addressed a connection between antidepressants and increased risk of suicide among children, adolescents and young adults. But it's important to know studies show antidepressants have also saved innumerable lives. Still, this information underscores the importance of alerting your mental health provider to suicidal thoughts or tendencies, and any other problems or side effects that may be associated with antidepressant medication. You should also ensure your mental health provider knows about any other medications you're taking including over-the-counter medications, nutritional supplements, or even homeopathic or natural remedies. Talk with your mental health provider about antidepressants and any depression symptoms you may have.


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Last Updated:
December 20, 2012