Depression medications

Not only the diagnosis takes time, but also the selection of the most effective treatment method is a long and delicate process. About 30% of patients taking antidepressants are not cured of depression. This may be due to the peculiarities of the psychological or biological structure, or due to the impossibility of taking further medication due to strong side effects.

If a patient has liver problems, kidney problems, or heart disease, then taking antidepressants can be dangerous. The doctor, in this case, may prescribe an ineffective drug, or a low dose, which ultimately leads to treatment failure.

If you are going to take antidepressants to treat depression, remember the following:

  1. Only 30% of patients reach a state of complete remission after the first course of taking antidepressants. This data is provided by the National Institutes of Health in 2006. Those patients whose condition improved, took a larger dose of medication for a longer time than the rest.
  2. The effect of antidepressants is strictly individual. Quite naturally, if during treatment, you try a lot of antidepressants until you find the right remedy.
  3. For some patients, one remedy for depression does not help, they must take several drugs at the same time.

Together with your doctor, you will be able to choose the most effective antidepressant and its optimal dose, which will help alleviate the symptoms of depression.

What is an antidepressant?

The very first method of treatment that the doctor prescribes is the use of antidepressants in combination with psychotherapy. If the prescribed antidepressant did not produce the expected result, the doctor will prescribe another antidepressant of the same class – but with other side effects – or in addition to it an antidepressant of another class. You can also try changing the dose or taking two different antidepressants at the same time.

What types of antidepressants exist?

Below is a list of the main types of antidepressants and the names of popular companies that produce them:

  • Selective serotonin reuptake inhibitors were released in the mid-80s. To date, they are the most requested in the treatment of depression. When using antidepressants of this class do not need to adhere to a special diet. They are safe even for patients with cardiovascular diseases, including cardiac arrhythmias and drops in blood pressure. Medicines of Celex, Lexapro, Luvox, Paxil, Prozac (cheaper analogue of fluoxetine), Zoloft are drugs of this class. Side effects are minor, although their manifestation is individual. Side effects include stomach upset, sexual problems, fatigue, tremors, changes in body weight, and headaches.
  • Serotonin and noardrenaline reuptake inhibitors are a newer class of antidepressants. Such drugs as Effexor and Zimbalta are related to it. Side effects include stomach upset, insomnia, sexual problems, tremors, and fatigue.
  • Aminoketones, like Wellbutrin, treat depression in a little-known way. They differ from antidepressants by a slight effect on the chemical elements of the brain. Side effects are mild and include stomach upset, insomnia, headaches, and anxiety. Wellbutrin does not cause sexual problems.
  • By tetracyclic antidepressants include Remenron. The mechanism of action of Remeron is not known, but it has been proven that it affects norepinephrine and serotonin, like other antidepressants. Side effects are minor and include stomach upset, insomnia, weight gain and trembling.
  • Tricyclic antidepressants are one of the first drugs used in the treatment of depression. These include drugs such as Elavil (amitriptyline), Norpramine (desipramine), Tofranil (imipramine), and Pamelor (nortriptyline). In some people, antidepressants of this class cause strong side effects, which reduces their use to a minimum. However, if the patient is resistant to modern antidepressants, tricyclic antidepressants are an effective treatment. When you receive these drugs you need to conduct ongoing blood tests to monitor the level of tricyclics in the body. These drugs can not be taken for people with heart disease.
  • Monoamine oxidase inhibitors (MAO) are first-generation antidepressants. MAO inhibitors block the enzyme monoamine oxidase, which destroys the hormones responsible for the transmission of nerve impulses between the cells of the body, from which the person’s mood and physiological state depends. The most common antidepressants of this class are Nardil (phenylzine), Parnate (tranylcypromin) and Marplan (isocarboxazid). Although these drugs give a good result in the treatment of depression, they are used very rarely because of side effects. These antidepressants interact with other medications, which is life-threatening. A significant danger when using MAOIs is the consumption of foods containing tyramine, which is derived from the amino acid tyrosine and, when interacting with MAOI, can lead to a hypertensive crisis. Food products that negatively interact with MAO inhibitors include cheese, wine, chocolate, bananas, and chicken liver. However, the use of these antidepressants is used when the patient is resistant to other classes of antidepressants and depression that is not treatable.

Are antidepressants and adjuvants used together?

In addition to antidepressants, simultaneous administration of auxiliary medicines is often prescribed. This is called “augmentation” – enhancing the action of an antidepressant with another drug. The following is a list of auxiliary drugs:

  • Certain anticonvulsants, which are usually prescribed for epilepsy, can enhance the effect of antidepressants. For example, Lakmital and Tagretol (carbamazepine) were prescribed for people with difficult-to-treat depression.
  • Neuroleptic drugs, like Tsipreksa or Rispedral, are additionally prescribed for people with depression that cannot be treated, especially in the presence of hallucinations.
  • B-adrenergic agent, like Visken (pindolol), is used in the treatment of heart disease and blood pressure drops. It also enhances the effect of some antidepressants.
  • Buspar (Buspirone), a drug used in the treatment of anxiety syndrome, gives a good result in intractable depression.
  • Lithium is a drug widely used in the treatment of bipolar disorder. It helps to balance the mood. Studies have also shown that this drug is an effective remedy for non-treatable depression. However, due to the fact that Lithium is dangerous in large doses, the doctor must monitor your condition while taking it.
  • The synthetic analogue of the hormone, which is produced by the thyroid gland, Cytomel (liothyronine) also enhances the effect of some antidepressants.
  • Stimulants, like Ritalin and Dexedrine, increase the effect of antidepressants on depression, which is not amenable to treatment. Often they are prescribed for attention deficit hyperactivity disorder.

What to do to achieve the best result in the treatment of depression?

  • Watch your mood. Constant monitoring of your mood and behavior will allow the doctor to cure depression even before it gets out of control. Try to record mood swings every week and contact your doctor every time you feel that you are not in control of the situation.
  • Build yourself community support. Although you cannot control depression, there are still things that you can control. You can create yourself a strong support group. Despite your community activities, your support group may involve your spouse or spouse, family members, close friends, employees, religious or community organizations.
  • Strictly adhere to the prescribed treatment plan. To see the effect of antidepressants, they must be taken at least eight weeks. Do not miss the medication hours and do not refuse treatment early. If you do not adhere to the rules of taking antidepressants, you will not give them a chance to alleviate your condition.
  • Consult a mental health professional for help. Any doctor can prescribe antidepressants for you, but the prescription alone will not give the expected result. In addition, you should consult a psychiatrist or a psychologist. By definition, depression is a difficult condition to treat. Therefore, it is very important to talk with a specialist in this area during treatment. Although psychologists will not be able to prescribe antidepressants, they are good specialists in the field of psychotherapy. You can attend psychotherapy sessions while taking antidepressants in parallel, or use psychotherapy as the only treatment. Try to find a specialist who has experience in treating unresponsive depression.
  • Change your lifestyle. Always take the medicine at the same time, for example, when you have breakfast or go to bed. Get yourself a medicine box for each day of the week. It will be easier to see if you missed the dose. Since each of us can sometimes just forget to take medicine, ask your doctor what you should do in this case.
  • Do not ignore the manifestation of side effects. Side effects are one of the most common reasons patients refuse treatment. For example, British scientists conducted research on the basis of 1000 patients with depression. As a result, they received the following numbers – 65% of patients at some point simply refused treatment, of which 45% refused treatment because of the side effects of medications. If you notice a manifestation of side effects, tell your doctor about it. Find out whether it is possible to reduce them to a minimum. But remember that at the beginning of the treatment process, the manifestation of side effects is more pronounced, but over time they disappear.
  • Never stop taking antidepressants without a doctor’s permission. If for some reason you need to stop taking the medication, tell the doctor about it and he will work out a schedule for you to gradually reduce the dose. Never stop taking antidepressants all of a sudden, it can increase the manifestation of side effects and aggravate the depression itself.
  • Do not think that when you feel better, you can refuse to take medicine. If you have a non-treatable depression, you will have to take antidepressants for several months – or even a year – even after your condition has improved. Such a long-term treatment will help you avoid re-manifestation of depression in the future.
  • Try to get a full sleep. Talk to your doctor if you have trouble sleeping. Currently, non-addictive sleeping pills are already available. Also, cognitive-behavioral therapy used in patients with sleep problems, anxiety syndrome, and the fear that they will not fall asleep give a good result.

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