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Treating Depression with
Antidepressant Medications
What are the Benefits of Antidepressant Treatment?
2003 All rights reserved. Last reviewed March 2004. Most people respond well to antidepressant medication and will experience relief of symptoms and return to their epressive illness is a common disorder that afflicts more previous level of functioning. Benefits of antidepressant than 19 million people in the U.S. Symptoms of depression can include sadness, irritability, decreased interestin hobbies, change in sleep or eating pattern, decreased ener- gy, feelings of guilt or hopelessness and thoughts of suicide.
Decreased feelings of sadness, hopelessness, anxiety The two most effective kinds of treatment for depression are antidepressant medication and psychotherapy. Depending on the severity of your symptoms, antidepressant medica- Increased interest and energy in activities tion may be suggested by your Primary Care Physician Decreased feelings of guilt and self-destructive feelings (PCP) or psychiatrist. The best results are often obtained byusing a combination of both, antidepressant medication and What is the Duration of Treatment?
psychotherapy. Early treatment may help keep your symp-toms from becoming more severe, and remaining in treat- When antidepressant medication is started, you should see ment may help prevent a relapse of symptoms.
your doctor frequently. It is important to tell your doctor ifyou are thinking about hurting yourself or others, feeling It may take some time for you and your doctor to decide agitated, or noticing you feel more depressed. Your doctor which antidepressant medication and dosage is best for you will also want to check on how you are tolerating the med- in order for you to feel relief from symptoms. If you experi- ication, talk about other side effects, and adjust your dosage.
ence side effects, report them to your physician. Often, side During this time it is very important to tell your doctor if effects can be managed by dosage adjustment, adding or you are improving, feeling any side effects, having trouble combining other medications, or using a different type of taking your doses regularly, or if you have any questions or How Do Antidepressants Work?
Benefit from treatment with antidepressants may be seen asearly as two weeks; however, maximal benefit is generally not There are chemicals in our brain (neurotransmitters) that seen until six to eight weeks. Your doctor may wish to con- help our brain cells communicate with other cells. When tinue or switch medications depending on your response to there is an imbalance in these chemicals, our moods can be antidepressant medications at that time.
affected. Examples of neurotransmitters include norepi-nephrine, serotonin and dopamine.
Once you have relief from your symptoms, you will mostlikely need to stay on medication for another four to nine Antidepressants are not stimulants, they are not addictive or months. People who have had previous episodes of depres- habit forming, and they do not produce a euphoria or sion may need to continue taking antidepressant medica- “high.” Antidepressants work with your brain cells to restore tions for longer periods of time to prevent recurrence of the balance of the neurotransmitters and therefore improve It is important to remain on the medication, even when youstart to feel better. Stopping too early can cause a relapse,rebound of your depression symptoms or even medicationwithdrawal symptoms. It is important to discuss these con-cerns with your doctor.
Treating Depression with Antidepressant Medications, cont. What Are the Types of Antidepressants?
Tricyclic (TCAs):
There are four classes of antidepressant medicationsavailable: Brand Name
Medicine
Serotonin Selective Reuptake Inhibitors (SSRIs) Examples of medications in each class include:
Serotonin Selective Reuptake Inhibitors (SSRIs):
Brand Name
Medicine
Monoamine Oxidase Inhibitors (MAOIs):
Brand Name
Medicine
Other Antidepressants:
Brand Name
Medicine
*Important Note: MAOIs require strict avoidance of certain foods andmedications. How Will Your Doctor Choose the Medication?
All antidepressant medications currently available are similar in their effectiveness. Your doctor will choose whichmedication to start with based on: History of prior response to a medication Potential interactions with other medications youare taking Presence of other medical or psychiatric conditions Treating Depression with Antidepressant Medications, cont. What Are the Side Effects of Antidepressants?
What If Side Effects are a Problem?
Generally side effects are similar within each class of antide- If side effects are a problem for you, there are a number of pressants. Listed are some possible side effects common to things your doctor can do. Changes can be made in: SSRIs: nausea, vomiting, diarrhea, restlessness, agita- tion, sleep disturbances, problems with sexual function- The time of day you take your medication ing, headaches and temporary weight loss.
Do not make changes in your medication plan or stop tak- TCAs: blurred vision, dry mouth, constipation, difficul- ing your medication unless you talk to your doctor.
ty urinating, changes in sexual desire or ability, weightgain, muscle twitches, increased heart rate, low bloodpressure and dizziness and sedation.
Helpful Strategies:
MAOIs: low blood pressure, weight gain, headaches and Become educated about your medications. Ask ques- Antidepressants can sometimes cause unexpected changes in Schedule frequent visits with your doctor when you start behavior such as suicidal thoughts, hostility and agitation, or medication, change medication or change dosage.
becoming more depressed. If you or others notice changes Don't miss your scheduled appointments.
in your behavior upon start of your medications, contact Take your medication exactly as it is prescribed.
Be honest with your doctor about your concerns, aboutmissed doses, and about side effects.
How Long Will the Side Effects Last?
Tell your doctor about all of the medications you take,including over-the-counter-medications, vitamins and Each medication acts differently and not all the medications in these classes produce all these effects. Not all individuals If you miss a dose, do not “double up.” Take your next Do not stop taking the medication without consulting When they happen, side effects usually occur early in treat- ment. In fact, you may experience side effects before you Do not drink alcohol or use illicit drugs while taking start to experience relief of your symptoms. However, the antidepressants. Combining medication with alcohol or side effects of most antidepressants are mild and disappear drugs may cause serious harm or death.
over time — usually a week or two after starting the medica- Use caution with caffeine intake (teas, colas, coffee).
tion. Usually, side effects such as sedation with TCAs and Caffeine can interfere with your mood, sleep or your the nausea and vomiting with SSRIs disappear about one or two weeks after the patient begins taking the medication.
Some side effects might remain throughout treatment and The information about educational or therapeutic approaches is provided for you should discuss all side effects with their doctor.
educational purposes only. Certain treatments may or may not be coveredthrough your benefit plan. Coverage typically depends on your plan specifica-tions and relevant guidelines maintained in relation to your benefit plan 8 0 0 K i n g F a r m B o u l e v a r d , S u i t e 6 0 0 • R o c k v i l l e , M D 2 0 8 5 0 •
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