Anti-Depression Medications by J.Bradley
There are several types of antidepressant medications used to treat depressive
disorders. These include newer medications--chiefly the selective serotonin
reuptake inhibitors (SSRIs)--the tricyclics, and the monoamine oxidase
inhibitors (MAOIs). The SSRIs--and other newer medications that affect
neurotransmitters such as dopamine or norepinephrine--generally have fewer side
effects than tricyclics. Sometimes the doctor will try a variety of
antidepressants before finding the most effective medication or combination of
medications. Sometimes the dosage must be increased to be effective. Although
some improvements may be seen in the first few weeks, antidepressant medications
must be taken regularly for 3 to 4 weeks (in some cases, as many as 8 weeks)
before the full therapeutic effect occurs.
Patients often are tempted to stop medication too soon. They may feel better and
think they no longer need the medication. Or they may think the medication isn't
helping at all. It is important to keep taking medication until it has a chance
to work, though side effects (see section on Side Effects on page 13) may appear
before antidepressant activity does. Once the individual is feeling better, it
is important to continue the medication for at least 4 to 9 months to prevent a
recurrence of the depression. Some medications must be stopped gradually to give
the body time to adjust. Never stop taking an antidepressant without consulting
the doctor for instructions on how to safely discontinue the medication. For
individuals with bipolar disorder or chronic major depression, medication may
have to be maintained indefinitely.
Antidepressant drugs are not habit-forming. However, as is the case with any
type of medication prescribed for more than a few days, antidepressants have to
be carefully monitored to see if the correct dosage is being given. The doctor
will check the dosage and its effectiveness regularly.
For the small number of people for whom MAO inhibitors are the best treatment,
it is necessary to avoid certain foods that contain high levels of tyramine,
such as many cheeses, wines, and pickles, as well as medications such as
decongestants. The interaction of tyramine with MAOIs can bring on a
hypertensive crisis, a sharp increase in blood pressure that can lead to a
stroke. The doctor should furnish a complete list of prohibited foods that the
patient should carry at all times. Other forms of antidepressants require no
food restrictions.
Medications of any kind--prescribed, over-the counter, or borrowed--should never
be mixed without consulting the doctor. Other health professionals who may
prescribe a drug--such as a dentist or other medical specialist--should be told
of the medications the patient is taking. Some drugs, although safe when taken
alone can, if taken with others, cause severe and dangerous side effects. Some
drugs, like alcohol or street drugs, may reduce the effectiveness of
antidepressants and should be avoided. This includes wine, beer, and hard
liquor. Some people who have not had a problem with alcohol use may be permitted
by their doctor to use a modest amount of alcohol while taking one of the newer
antidepressants.
Antianxiety drugs or sedatives are not antidepressants. They are sometimes
prescribed along with antidepressants; however, they are not effective when
taken alone for a depressive disorder. Stimulants, such as amphetamines, are not
effective antidepressants, but they are used occasionally under close
supervision in medically ill depressed patients.
Questions about any antidepressant prescribed, or problems that may be related
to the medication, should be discussed with the doctor.
About the Author:
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