Depression is one of the most common mental health problems affecting people of all ages and backgrounds. According to the American Psychiatric Association, up to 25 percent of the population will suffer from a depressive disorder at some point over the course of their life. The Journal of the American Medical Association published an article in 2002 highlighting the increased use and effectiveness of pharmaceutical treatments for depression due to improvements in medications and the increased availability of reliable and diagnostic tools for primary caregivers.
SSRI Medications
The most common class of antidepressant medication is selective serotonin reuptake inhibitor (SSRI). This type of medication causes an increase in the level of serotonin by blocking the mechanism that typically causes serotonin to be reabsorbed. The commercial names of some commonly prescribed medications that fall into this category include Celexa, Lexapro, Prozac, Paxil and Zoloft. According to the Clinical Handbook of Psychotropic Drugs, these medications are effective for treating major depression, depression secondary to another mental illness, the depressed phase of bipolar disorder and other disorders such as obsessive-compulsive disorder, social anxiety disorder, PTSD and panic disorder.
NDRI Medications
Norepinephrine dopamine reuptake inhibitors (NDRI) work similarly to SSRIs except they block the reabsorption of norepinephrine and dopamine instead of serotonin. The most common medication of this kind is Wellbutrin, which comes in regular release, sustained release and extended release versions. Compared to SSRI medications, Wellbutrin tends to have a lower incidence of sexual dysfunction side effects and a decreased risk for seizures.
SNRI Medications
Selective serotonin norepinephrine reuptake inhibitors (SNRI) work similarly to SSRI and NDRI medications, blocking both serotonin and norepinephrine. Commonly prescribed medications in this category include Effexor and Cymbalta. At lower doses serotonin reuptake is blocked, and at higher doses norepinephrine and dopamine reuptake is blocked. According to the Clinical Handbook of Psychotropic Drugs, these drugs may have a faster onset of action and may increase energy moreso than SSRI drugs.
Suicide Risks
It is important to note that antidepressant medications typically increase energy within a week, but individuals do not report feeling "better" until two or three weeks of use. The increase of energy that occurs prior to feeling happier can create a window in which the risk of suicide increases, especially for impulsive individuals and teenagers. This increased risk is due to the fact that the individual has the energy to plan and execute a suicide plan whereas when he was more depressed he did not have the available energy or motivation to put such a plan into action. This risk decreases as soon as the chemical effects of the drug catch up to the physical effects.
References
- "Clinical Handbook of Psychotropic Drugs"; Mood Stabilizers; Bezchlibnyk-Butler and Jeffries (Eds.); 2005
- Journal of the American Medical Association: National Trends in the Outpatient Treatment of Depression
- American Journal of Psychiatry: Suicide Risk During Antidepressant Treatment
