About Antidepressants

Depression and anxiety are common conditions caused by a wide range of factors. According to the Anxiety and Depression Association of America (ADAA), approximately 40 million American adults aged at least 18 years suffer from some form of anxiety disorders annually. However, only about 37% of the affected individuals are treated despite the fact that depression and anxiety disorders are treatable. Antidepressants are basically drugs used in the management of symptoms associated with various forms of depressive disorders.

Mechanism of Action

Antidepressants are believed to work by restoring chemical balance in neurotransmitters responsible for various body functioning, including mood and overall behaviors. Neurotransmitters are found in the vesicles of the nerve cells, acting as the link from one nerve to another. The most common neurotransmitters linked to depression include norepinephrine, serotonin and dopamine.

There are times when neurotransmitters are not taken up by other nerves, forcing the releasing nerves to take them back, a process known as reuptake, which may in the end lower their levels in the brain. It is on the basis of this process that antidepressants work; they basically inhibit reuptake of particular neurotransmitters by triggering the production of inhibitors such as selective serotonin reuptake inhibitors (SSRIs). With low reuptake, their levels within specific nerves in the brain is increased and enables the body maintain requisite balance.

Conditions Treated by Antidepressants

The following are some of the common conditions that are treated and/or managed by antidepressants:

  • Generalized anxiety disorder,
  • Depression,
  • Obsessive compulsive disorders (OCD),
  • Agitation ,
  • Manic-depression disorders,
  • Neuropathic pain,
  • Posttraumatic stress disorder (PTSD),
  • Major depressive disorder,
  • Childhood enuresis,

Antidepressants also have a number of off-label uses, such as the management of premenstrual symptoms, hyperhidrosis, hot flashes, binge eating disorder, Tourette syndrome, fibromyalgia, urticarial, among others. It is however recommended that you seek the guidance of a qualified doctor before using these drugs. Mote antidepressants are prescription-only, but are available in various online pharmacies or e-pharmacies. That notwithstanding, it is only safe to be guided by a doctor as it is the only way to guarantee proper use, and management of the targeted condition(s).

Different Types of Antidepressants

The effect of different antidepressants on neurotransmitters, known uses, side effects, and how they interact with other drugs differ. Their effectiveness and tolerance levels also vary from one user to another. It is for this reason that more than one medicine may be prescribed before establishing one that perfectly manages the targeted conditions.

1. Tricyclic antidepressants (TCAs)

This class of antidepressants was discovered in the 1950s and borrow their name from the three atom rings in their chemical structure. They have a close resemblance to tetracyclic antidepressants (TeCAs) which have four atom rings. While they are still commonly used for the treatment of depression, they are increasingly being replaced by other newer versions. Some side effects associated with these medicines include dry mouth, sedation, constipation, blurred vision, abnormal cramps, sexual dysfunction, and anxiety.

2. Selective Serotonin Reuptake Inhibitors (SSRIs)

These are antidepressants that work by inhibiting reuptake of serotonin, increasing their levels in the brain. They are currently very common and considered very effective with lower risks of side effects compared to TCAs. Their mechanism closely resembles that of serotonin/norepinephrine reuptake inhibitors (SNRIs). Examples include:

  • Celexa: FDA-approved for the treatment of major depressive disorders among other conditions.
  • Lexapro: Treatment of generalized anxiety disorders or major depressive disorders. Has many other off-label uses.
  • Prozac: Treats obsessive-compulsive disorder (OCD), major depressive disorder, bulimia nervosa, premenstrual dysphoric disorder, and panic disorder.
  • Paxil: Used in the treatment of depression, obsessive-compulsive disorder (OCD), panic attacks, post-traumatic stress disorder, and anxiety disorders.
  • Zoloft: Treats depression, post-traumatic stress disorder obsessive compulsive disorder, panic attacks, premenstrual syndrome, and social anxiety disorder.

However, they are associated with a number of side effects, such as agitation, dizziness, abnormal thinking, tremor, sexual dysfunction, rashes, nausea, diarrhea, and weight loss. Though in very rare cases, these drugs have also been associated with seizures, hypoglycemia and hyponatremia.

3. Monoamine Oxidase Inhibitors (MAOIs)

This class of antidepressants works by inhibiting monoamine oxidase leading to increased levels of serotonin, norepinephrine and dopamine in the brain. They are however associated with various interactions with food and drugs. Some common side effects include altered heart rhythm, drowsiness, anxiety, high blood pressure, edema, weight loss or gain and nauseas. Other side effects are hepatitis, blurred vision, rash, and seizures.

Drug Interactions

Antidepressants' drug interactions vary. You must therefore disclose information about any form medical conditions and other treatment you are undergoing to the doctor. This will not only guide the specialist in prescribing the right drugs, but also lower the risks of side effects and interactions.

Choosing the Right Antidepressant

With so many antidepressants currently available, how then do you choose the most suitable one for your condition? While most of these drugs are prescription-only, you can find them in the nearby pharmacy as well as online stores. The choice will depend on various factors, such as symptoms, likely side effects, and previous effect on a close relative, interactions, other health conditions, and their availability. Pregnant and breastfeeding mothers must consult a doctor for guidance.