Not only does it take time to get an accurate depression diagnosis, finding the right medicine to treat depression can be a complicated, delicate process. Someone may have a serious medical problem, such as heart disease or liver or kidney disease, that could make some antidepressants unsafe.
The antidepressants could be ineffective for you or the dose inadequate; there may not have been enough time to see an effect, or the side effects could be too bothersome leading to a failure of treatment.
Taking antidepressants to treat depression, it is important to keep these points in mind:
Only about 30% of people with depression go into full remission after taking their first course of antidepressants. That’s according to a 2006 study funded by the National Institutes of Health. Those who got better were more likely to be taking slightly higher doses for longer periods.
Some antidepressants work better for certain individuals than others. It's not uncommon to try different depression medicines during treatment.
Some people need more than one medicine for depression treatment.
Antidepressants carry a boxed warning about increased risk compared to placebo for suicidal thinking and behavior in children, adolescents, and young adults 18-24 years old.
What is an antidepressant?
Antidepressants, sometimes in combination with psychotherapy, are often the first treatment people get for depression. If one antidepressant doesn't work well, you might try another drug of the same class or a different class of depression medicines altogether.
What are the different types of antidepressants?
Antidepressants are medications that can help relieve symptoms of depression, social anxiety disorder, anxiety disorders, seasonal affective disorder, and dysthymia, or mild chronic depression, as well as other conditions. They aim to correct chemical imbalances of neurotransmitters in the brain that are believed to be responsible for changes in mood and behavior. Antidepressants were first developed in the 1950s. Their use has become progressively more common in the last 20 years.
According to the Centers for Disease Control and Prevention (CDC), the percentage of people aged 12 years and over using antidepressant in the United States rose from 7.7 percent in 1999-2002 to 12.7 percent in 2011-2014. Around twice as many females use antidepressants as males.
Antidepressants can be divided into five main types:
Serotonin and noradrenaline reuptake inhibitors (SNRIs) are used to treat major depression, mood disorders, and possibly but less commonly attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety disorders, menopausal symptoms, fibromyalgia, and chronic neuropathic pain. Examples include duloxetine (Cymbalta), venlafaxine (Effexor) and desvenlafaxine (Pristiq). Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They are effective in treating depression, and they have fewer side effects than the other antidepressants.
SSRIs block the reuptake, or absorption, of serotonin in the brain. This makes it easier for the brain cells to receive and send messages, resulting in better and more stable moods. Examples include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft). There have been reports that people who use SSRIs and SNRIs, and especially those under the age of 18 years, may experience thoughts of suicide, especially when they first start using the drugs.
Tricyclic antidepressants (TCAs) are so named because there are three rings in the chemical structure of these medications. They are used to treat depression, fibromyalgia, some types of anxiety, and they can help control chronic pain. Examples include amitriptyline (Elavil), amoxapine- clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil) and trimipramine (Surmontil).
Monoamine oxidase inhibitors (MAOIs) - This type of antidepressant was commonly prescribed before the introduction of SSRIs and SNRIs. It inhibits the action of monoamine oxidase, a brain enzyme. Monoamine oxidase helps break down neurotransmitters, such as serotonin.
Noradrenaline and specific serotoninergic antidepressants (NASSAs). These are used to treat anxiety disorders, personality disorders and depression.
Any side effects will likely occur during the first 2 weeks, and then gradually wear off. Common effects are nausea and anxiety, but this will depend on the type of drug used, as mentioned above. Symptoms lasted from 2 weeks to 2 months and included:anxiety; dizziness; nightmares or vivid dreams; electric shock-like sensations in the body; flu-like symptoms; abdominal pain. In most cases, symptoms were mild. Severe cases are uncommon and are more likely after stopping Seroxat and Effexor. Uses of antidepressants include: insomnia, pain, migraine.