Antidepressants help people with severe depression by altering brain chemicals to change moods. Doctors can prescribe several types of antidepressants. Patients may use one type of medication and switch to another if it does not bring improvement. They work with their doctors until the medication that works best is found. Doctors may prescribe two or more antidepressants for a patient or combine antidepressants with mood-stabilizing drugs, stimulants or anti-anxiety medications, depending on the patient and the condition.
Types
Selective serotonin reuptake inhibitors, called SSRIs, are among the newest antidepressants and usually prescribed when starting off depression treatment, the Mayo Clinic reports. They have fewer side effects than older antidepressants. Sexual dysfunction may occur. Other side effects, such as headache and restlessness, may fade as the body adjusts to the medication. SSRIs include fluoxetine, paroxetine and sertraline. Serotonin and norepinephrine reuptake inhibitors, or SNRIs, are closely related to SSRIs and have similar side effects. In high doses, they may cause dizziness. The drugs include duloxetine and venlafaxine. Norepinephrine and dopamine reuptake inhibitors, called NDRIs, include bupropion, which does not cause sexual side effects. At high doses, however, it may increase the risk of seizures.
Sedative Effects
Depression may bring on extreme difficulty sleeping. Antidepressants that do not fit into a particular class of medication for depression include the atypical antidepressants trazodone and mirtazapine, which have a sedative effect and help patients sleep.
Considerations
Older antidepressants treat patients when other medications do not work. Tricyclics and monoamine oxidase inhibitors, or MAOIs, have severe side effects. Tricyclics may cause low blood pressure, fast heartbeat and confusion. MAOIs can interact with certain foods and must be used with a strict diet. Some reactions can be deadly, the Mayo Clinic says. A new MAOI skin patch may cause fewer side effects.
Time Frame
Antidepressants may start working on a patient after a few weeks, MedlinePlus notes. Many patients may take medication for several months before they find improvement. Higher doses, changes in medication or combined medications are usually prescribed until the patient is feeling better. Patients often take antidepressants while undergoing behavioral therapy.
Benefits
Patients with severe depression benefit substantially from antidepressants, researchers at the University of Pennsylvania in Philadelphia found after examining data on 718 adults, according to Psych Central. People with mild or moderate depression may see little improvement from antidepressants, the researchers conclude. Some people with severe depression cannot take antidepressants for health reasons. They include older adults or women who are pregnant. Such options, as electroconvulsive therapy, or ECT, in which electrical currents are passed through the brain, are available if conditions are serious enough.
