On July 28, 1999, then-U.S. surgeon general David Satcher, M.D., Ph.D., revealed that suicide causes more deaths in teenagers and young adults than heart disease, AIDS, birth defects, stroke, pneumonia, influenza and chronic lung disease combined. Along with talk therapy, antidepressants (ADs) helps many people alleviate depression, which precipitates suicide in 40 to 85 percent of cases.
Tricyclic Antidepressants
ADs refer to the large, important groups of medications used to treat depression. Supplanted in the early 1990s by the selective serotonin reuptake inihibitors (SSRIs) as the medications of choice in depression treatment, tricyclics (TCAs) were the first medications used in severe depression. Considered "dirty drugs" because they react with numerous receptors besides the one responsible for therapeutic effect, TCAs, in even small overdoses, can cause lethal results.
Selective Serotonin Reuptake Inhibitors
As effective but safer and with significantly fewer side effects than TCAs, SSRIs, as of 2010, are the most widely used class of ADs. Relatively "clean" when compared to the TCAs, SSRIs interact little with other receptors besides the serotonin (5HT) ones believed responsible for therapeutic effect. Although SSRIs have less-intense side effects than TCAs, many individuals using SSRIs complain of sexual side effects, such as loss of libido.
Serotonin and Norepinephrine Reuptake Inihibitors
Dual-action ADs, which affect both 5HT and noradrenergic (NE) neurotransmitter systems, serotonin and norepinephrine reuptake inhibitors (SNRIs) help some people with severe depression alleviate symptoms. In his 2010 book "Handbook of Clinical Psychopharmacology for Therapists," John D. Preston, Psy.D., ABPP asserts certain SNRIs (duloxetine, venlafaxine and mirtazapine) as more effective than the SSRIs in treating severe depression.
Atypical Antidepressants
Wellbutrin, Nefazodone and BuSpar comprise the atypical ADs--medicines with properties and mechanisms of action distinct from other classes of ADs. Noteworthy because it often causes no sexual side effects, and stimulation rather than sedation, Wellbutrin affects NE and dopamine (DA) systems instead of 5HT and is one of the most commonly used drugs to augment other ADs.
MAO Inhibitors
A group of ADs now mainly used when other ADs have failed in treating depression, partly because of the risk of hypertensive reactions, monoamine oxidase inhibitors (MAOIs) can cause abrupt and severe rises in blood pressure. Often caused by eating foods high in tyramine content, such hypertensive reactions may lead to cerebral hemorrhaging and even death. Because many common food products--such as bananas, bologna, yogurt and beer--have high tyramine content, people who use MAOIs must follow strict dietary guidelines.
Stimulants
More commonly known for their use in treating attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD), since the beginning of the new millennium doctors have effectively used stimulants, such as dexedrine and ritalin, as ADs, particularly as augmenting agents. Side effects include anxiety, insomnia, agitation and appetite suppression.
References
- Surgeon General: Call To Action To Prevent Suicide
- "Handbook of Clinical Psychopharmacology for Therapists"; John D. Preston, Psy.D., ABPP; 2010
