Depression is an unfortunate event that most of us have faced at least once at some point in our lives. Depression is a common mental health disorder that usually begins in early adulthood and is more common in women. However, anyone at any age can suffer from depression. There are various methods to control and improve depression, one of the most important of which is drug therapy.
Antidepressants They have many variations and it can be said that their effectiveness is different in different people. Therefore, doctors consider various factors in order to find the right medication for depression for a specific patient.
Due to the fact that depression affects the activity of the brain, the drugs related to the treatment of depression are also related to the brain. It is good to know that common antidepressants are effective in reducing depression symptoms; But at the same time, there are other treatment options that can be used in some cases and based on the doctor’s discretion.
If you are wondering how exactly antidepressants work? We must say that these drugs work by regulating certain chemicals in the brain (neurotransmitters). In general, antidepressants are divided into different groups. The most common of these groups are:
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
- Quadricyclic antidepressants
- Dopamine reuptake blockers
- 5-HT1A receptor antagonists
- 5-HT2 receptor antagonists
- 5-HT3 receptor antagonists
- Monoamine oxidase inhibitors (MAOIs)
In addition to these groups, there are other antidepressants that have different mechanisms of action. Also, some natural supplements such as milk thistle are also used to treat depression. In the following, we will explain each of these drugs suitable for depression and their side effects.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are the most widely used drugs for the treatment of depression. How do this group of antidepressants work? An imbalance of serotonin (a neurotransmitter) can play an effective role in depression. In the meantime, SSRIs increase the level of this chemical substance by reducing the reabsorption of serotonin in the brain. As a result, nerve signals are transmitted more effectively and depression symptoms are improved. Types of SSRIs include:
- Sertraline (Zoloft)
- Fluoxetine (Prozac, Seraphem)
- Citalopram (Celexa)
- escitalopram (Lexapro)
- Paroxetine (Paxil, Pexeva, Brisdelle)
- Fluvoxamine (Levox)
Common side effects of SSRIs include:
- nausea
- causing sleep disturbance
- getting nervous
- shaking
- Sexual problems
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
SNRIs are another class of antidepressants. These drugs work by increasing the level of two important neurotransmitters in the brain, serotonin and norepinephrine. In fact, these two chemicals play an important role in mood regulation. By increasing the levels of these neurotransmitters, SNRIs help improve depressive symptoms such as feelings of sadness, lack of energy, and loss of interest in activities. Among the drugs that are included in the SNRI category, the following can be mentioned:
- Desvenlafaxine (Pristiq, Khedezla)
- Duloxetine (Cymbalta)
- Levomilnacipran (Fetzima)
- Venlafaxine (Effexor)
In addition to its effects on depression, duloxetine is also effective in relieving pain. In fact, by increasing the level of serotonin and norepinephrine in the brain, in addition to improving mood, this drug also helps to reduce the intensity of pain. It is good to know that chronic pain can be one of the factors that cause or aggravate depression. Also, in some cases, depressed people are more sensitive to pain, and in such cases, SNRIs can appear useful. However, this class of antidepressants also has a series of side effects, including the following:
- nausea
- sleepiness
- tiredness
- constipation
- dry mouth
Tricyclic antidepressants (TCAs)
Tricyclic antidepressants (TCAs) are prescribed when initial treatments such as SSRIs do not work. The exact mechanism of action of TCAs in the treatment of depression is still not fully understood. However, these drugs also work by increasing the level of serotonin and norepinephrine neurotransmitters in the brain. Do you know which antidepressants belong to this group? Some of them are:
- Amitriptyline (Elavil)
- Amoxapine (Asendin)
- Clomipramine (Anafranil)
- Desipramine (Norpramin)
- Doxepin (Silenor)
- Amy Pramin (Tofranil)
- Nortriptyline Pamela
- Protriptyline (Vivactil)
- trimipramine (Surmontil)
Side effects of TCAs also include the following:
- constipation
- dry mouth
- tiredness
- blurred vision
In rare cases, there is a possibility that severe side effects such as the following can be observed after taking TCAs:
- low blood pressure
- Irregular heartbeat
- convulsions
Quadricyclic antidepressants
Tetracyclic antidepressants, such as maprotiline (ludiomil), are another drug prescribed to treat depression and anxiety. The mechanism of action of these drugs is based on the balancing of neurotransmitters, thus helping to reduce the symptoms of depression. However, the selection and use of these drugs should also be done under the supervision of a specialist doctor because, like other antidepressants, they can have their own side effects. Among the side effects of this drug, the following can be mentioned:
- sleepiness
- weakness
- lightheadedness
- headache
- blurred vision
- dry mouth
Dopamine reuptake blockers
Dopamine reuptake blockers such as bupropion are other suitable drugs for depression that work by reducing the reuptake of dopamine and norepinephrine in the brain. These drugs are mainly used to treat depression, seasonal affective disorder, and smoking cessation. The side effects of this category of drugs are:
- nausea
- vomiting
- constipation
- dizziness
- blurred vision
5-HT1A receptor antagonists
Vilasdone (Viibryd) is an antidepressant of the 5-HT1A receptor antagonist class. The effective mechanism of this drug is based on balancing the level of serotonin and other neurotransmitters. However, it is good to know that vilasdone is generally not prescribed to treat depression in the first place. This drug is often prescribed when other treatments are ineffective or have significant side effects for the patient. This medicine is not without side effects and the following can be mentioned among its side effects:
- nausea
- vomiting
- sleep problem
5-HT2 receptor antagonists
Nefazodone and trazodone are two drugs that are used to treat depression. These drugs are known as 5-HT2 receptor antagonists. According to the history of the formation of these drugs, it can be said that they belong to the category of old anti-depressant drugs. The mechanism of 5-HT2 receptor antagonist drugs is based on changes in the balance of brain chemicals that help improve depression symptoms. Among the side effects of this drug, the following can be mentioned:
- sleepiness
- dizziness
- dry mouth
5-HT3 receptor antagonists
Vortioxetine (Brintlix) is an antidepressant that affects serotonin receptors in the brain. By blocking 5-HT3 receptors, this drug helps to regulate the activity of brain chemicals and thus improves the symptoms of depression. Common side effects of this drug include the following:
- Sexual problems
- nausea
Monoamine oxidase inhibitors (MAOIs)
Monoamine oxidase inhibitors (MAOIs) are among the oldest antidepressants. The way these drugs work is based on increasing the level of neurotransmitters such as norepinephrine, dopamine and serotonin, which is achieved by inhibiting the monoamine oxidase enzyme. The drugs in this category are effective for treating depression, but they are prescribed less often due to drug interactions with other drugs and some foods. Also, the combination of MAOI with other antidepressants can have serious side effects. Among the drugs of this group are:
- Isocarboxazid (Marplan)
- Phenelzine (Nardil)
- Selegiline (Emsam)
- Tranylcypromine (Parnate)
The most important side effects of monoamine oxidase inhibitors (MAOIs) include the following:
- nausea
- dizziness
- sleepiness
- sleep problem
- restlessness
Natural options for treating depression
Although there are many drugs to treat and control depression, many people are looking for natural alternatives to treat depression. Some people use these natural options as a supplement to drug treatments, while others consider them as supplements. In the following, we will introduce you two of these natural options for treating depression, of course, these items should be taken only after the doctor’s approval; These two items are:
milk thistle
One of the plants used to treat depression is milk thistle. Milk thistle has been used to treat some diseases since the past. However, it is good to know that scientific studies on the effectiveness of milk thistle in the treatment of depression have shown conflicting results. Some research indicates mild positive effects of this plant, but others have not shown such results. Note that milk thistle can interact with other medications and cause serious side effects. Among the medicines with which St. John’s wort interacts, the following can be mentioned:
- Anticonvulsant drugs
- Cyclosporine
- Some heart medications
- Some cancer drugs
- Some HIV medications
- Certain statins
- Contraceptive pills
- Warfarin (Coumadin)
- Prescription antidepressants
S-adenosyl-l-methionine
S-adenosyl-l-methionine, or SAMe, is a natural compound that is considered a supplement for the treatment of depression. Several studies have shown that SAMe is somewhat effective in improving depression symptoms, especially in mild to moderate cases. The maximum effectiveness of this supplement is observed in treatment periods of about six weeks. However, it is worth noting that the effectiveness of SAMe is not the same in all people, because it depends on various factors, including the severity of depression and individual characteristics.
Of course, despite these findings, there is still a need for more research in this field to be able to comment definitively on the exact mechanism of SAMe’s effect and its interaction with other drugs. It is also best to consult your doctor before using any supplements. Note that this supplement can also have side effects that include the following:
- nausea
- diarrhea
- constipation
- dizziness
- irritability
- anxiety
- sweating
- Mild insomnia
Choosing the right medication for depression
Finding the right antidepressant is a highly specialized issue. Note that each person responds differently to depression, and as a result, a drug that is effective for one person may not be suitable for another. As a result, choosing the right medication for depression should only be done by a specialist doctor.
Note that several factors are effective in choosing an antidepressant. A person’s general health condition, other medications taken, possible side effects, drug cost and the number or duration of use are important in this choice of depression medication.
Side effects of abuse of antidepressants
As much as antidepressants can be effective in treating this disease, if you take them arbitrarily or abuse them, you will experience various side effects. Improper use of these drugs or outside the doctor’s supervision can have many negative effects on physical health. Some of the side effects of abuse of depression drugs and their arbitrary use are:
Serotonin syndrome
Abuse of antidepressants, especially when combined with other drugs, can cause serious side effects such as serotonin syndrome. This syndrome is caused by an excessive increase in the level of serotonin in the body. Serotonin syndrome symptoms are different and can range from confusion and mild muscle contractions to seizures and irregular heartbeat and even severe anesthesia.
hyponatremia
Hyponatremia is another result of self-administration of antidepressants. In hyponatremia, the level of sodium in the blood decreases sharply. This complication is mainly observed in elderly people who use antidepressants. Symptoms of hyponatremia are also different and include headache, muscle pain, restlessness and even seizures.
diabetes
In addition to various side effects, arbitrary use of antidepressants can also bring the risks of other diseases. One of these risks is the increased risk of type 2 diabetes. Studies show that people who use antidepressants, especially in the long term, will be more at risk of developing diabetes.
Suicidal thoughts
Arbitrary use of antidepressants or their abuse, especially in the early stages of treatment, will bring unwanted side effects. One of the most important and dangerous side effects is the emergence or intensification of suicidal thoughts. Of course, these thoughts do not necessarily mean a person’s desire to commit suicide and actually occur due to chemical changes in the brain at the beginning of the treatment process.
Source: Antidepressants: Types, Side Effects, Effectiveness, and More
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