Depression is a complex and common disorder. Major symptoms are generally a feeling of sadness or anhedonia, a lack of pleasure in activities usually found pleasurable. Other psychological symptoms may include feelings of guilt or thoughts of suicide. Physical symptoms may include fatigue, sleep disturbances, an increased or decreased appetite, weight changes, attention and concentration problems. Depression can be difficult to treat and should be monitored by an experienced professional, especially because it can be caused by an underlying medical disorder, and the treatments may cause side-effects that need to be addressed.. Common treatments include psychotherapy, or counseling, and drug treatment. (See Reference 1)
SSRIs
SSRIs, or selective serotonin reuptake inhibitors, are some of the newest drugs for depression and are usually the first line drugs for treatment. They work by increasing the amount of serotonin between nerve cells in the brain. Serotonin levels are associated with depression, but the exact link is unclear. There are five marketed SSRIs in the United States. These include paroxetine, fluoxetine, citalopram, escitalopram and sertraline. Side effects may include nausea, sexual dysfunction including delayed orgasm or inability to achieve orgasm, dry mouth, nausea, headache or other effects.
Bupropion
Bupropion is a drug used for depression, smoking cessation, and relieving some of the side effects, particularly sexual side effects, of other antidepressants such as the SSRIs. It works primarily by increasing levels of the chemicals dopamine and norepinephrine in the brain. The most prominent side effect is that it can lower the seizure threshold.
Mirtazepine
Mirtazepine works by increasing levels of the chemicals serotonin like the SSRIs, plus it increases levels of norepinephrine and histamine. It is sometimes utilized for its side effects which include increasing appetite and weight gain in about 12 percent of people, and sleepiness in about 54 percent of people. These can be beneficial side effects in people with a decreased appetite or insomnia as part of their depression symptoms.
Other Drugs
Other drugs commonly used include venlafaxine and duloxetine, both are selective norepinephrine reuptake inhibitors, or SNRIs, with some effects on other chemical in the brain as well. Specific symptoms associated with the depression such as anxiety or insomnia may be addressed with benzodiazepines such as lorazepam, also known as Ativan, or alprazolam also known as Xanax. However, sedation during the day may be a prominent side effect.
