Antidepressants

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Overview: Antidepressants are a type of medication used to treat several mental health conditions. They are used mainly for Depression, though are also used for Anxiety, Obsessive-Compulsive Disorder and Post-traumatic stress disorder. In rare cases, antidepressants can help treat chronic pain. There are several classes of Antidepressants, as will be discussed.

 

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How do they work?: Unfortunately, it isn’t entirely known how antidepressants work. The most widely accepted belief is that antidepressants work by increasing levels of a group of chemicals in the brain named neurotransmitters. Some of these neurotransmitters, such as serotonin and noradrenaline, can help improve mood and emotion. How this exactly works is unknown. Antidepressants are useful in treating the symptoms of several mental health conditions, yet should be used in conjunction with therapy, as this can help provide further support.

 

How effective are they?: Research on the efficacy of antidepressants is mixed. Antidepressants have been proven to be particularly helpful for many people suffering from moderate or severe depression. Those suffering from mild depression taking antidepressants often don’t experience a benefit. It is believed around 60% of people taking an antidepressant will experience an improvement in their symptoms.

 

Treatment Course: Antidepressants generally come in tablet form, though some can be injected or taken as a liquid if required. Once prescribed, a low dose will initially be prescribed. A typical treatment course lasts six months., though it can often rise to around 18 months, or even indefinite use. Unfortunately, it takes at least two weeks for benefits to be felt. At first, your mood may start to increase again. The full benefits of antidepressants normally take up to six weeks to be felt. If after this point you haven’t witnessed an improvement, it is worth talking to your GP or mental health specialist. They may suggest switching antidepressants. Many people succeed on their second antidepressant. It is highly likely you will experience some mild side effects early in the treatment. It is crucial however to not stop taking the tablets, as these side effects will disappear quickly. Some antidepressants can only be prescribed by a mental health specialist, not a GP.

 

Types of Antidepressants: There are several types of antidepressants. Each class has its own dedicated page.

 

 

 

 

 

  • Atypical Antidepressants: These antidepressants act in an atypical manner to other antidepressants. They act quicker than other classes. They are often used as an add-on medication to other antidepressants, and are noticeable for not causing sexual side-effects.

 

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Side Effects

We recommend consulting the individual page for each antidepressant for information on side effects – as they differ from tablet to tablet. Furthermore, the leaflet that comes with each pack of tablets contains enhanced information on side effects. Side effects generally are only present in the first few days of treatment, with the body needing time to get used to treatment. You will often see a GP during the first month of treatment to see how you are reacting.

 

SSRI’s and SNRI’s are associated with headaches, shakiness, anxiety, sickness and drowsiness in the first few days. Temporary erectile dysfunction in men and low sex drive in women also often take place, as well as a difficulty in achieving orgasm. The information leaflet with each medicine will include full instructions and information on the side effects. An overdose could induce serotonin syndrome, so should therefore be avoided.

 

Tricyclic antidepressants have been known to cause a dry mouth, constipation, difficulties in urinating, drowsiness, weight gain, excessive sweating and even hearth rhythm problems. Sexual problems are again prevalent. An overdose can be lethal, due to cardiac effects, and risk of a serious seizure.

 

MAOI’s need to be carefully managed. Most importantly, foods or beverages including tyramine need to be avoided. A high level of Tyramine can cause hypertensive crisis – which is usually fatal. Foods and drink that include tyramine include meat, fish, aged cheeses, sour cream, avocados, alcohol and more. Side effects include dizziness, headaches, sedation, weight gain or loss, constipation, urinary retention, sexual dysfunction, and in extreme cases – psychosis.

 

Atypical Antidepressants generally don’t cause sexual dysfunction. However, headaches, a dry mouth, feeling faint and irregular heart beats are common. As always, it is important to read the information leaflet.

 

 

Cautions

As with any medication, you must be careful when taking antidepressants. Your GP or mental health professional should make you aware of any types of medicine or foods that you should avoid. Some frequently used medications, even over-the-counter ones shouldn’t be used with antidepressants. It is worth looking at the individual page of each antidepressant to see cautions, but an overview is provided here.

 

Other Medicines: Ibuprofen and aspirin are often not recommended when using antidepressants. Each information leaflet will provide the types of medicines not to be used. It is important NOT to combine medicines from different classes of antidepressants, or take two from one class at the same time. You should also avoid the herbal remedy St John’s Wort.

 

Alcohol: Alcohol acts as a depressant, therefore it is recommended that anyone taking an antidepressant stays away from drinking alcohol.

 

Pregnancy and Breastfeeding: Antidepressants generally aren’t recommended for pregnant women. Taking antidepressants while breastfeeding also isn’t recommended.

 

Young People: People under the age of 18 are rarely prescribed antidepressants, instead being offered therapy. The exception to this is Fluoxetine (Prozac). If therapy hasn’t worked, antidepressants can be prescribed. People under the age of 25 taking antidepressants have been shown to be vulnerable to suicidal thoughts – a serious side effect.

 

Illicit Drugs: The use of illegal or recreational drugs isn’t recommended, as they can react unpredictably with antidepressants. Cannabis, cocaine, heroin and ketamine have been known to particularly worsen symptoms.

 

Bipolar Disorder: You shouldn’t take antidepressants as they can trigger a manic or psychotic episode.

 

As always, ensure you read the information leaflet.

 

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