Understanding Depression

antidepressants

We all have moments or even days when we don’t feel quite ourselves. This is increasingly common in the wake of major life events such as death of a loved one, divorce from a spouse or in response to crippling financial loss.

However, if the sadness intensifies to the point where you continually struggle with feeling utterly worthless and/or hopeless it’s possible you could unknowingly be battling clinical depression. If you’ve noticed this extreme sadness continuing without relief for several weeks on end, you could be one of the millions who turn to professional help and prescription antidepressants to alleviate their suffering.

Some of the key symptoms and hallmarks of depression include: intense unhappiness, overwhelming sadness, feelings of helplessness, loss of interest in activity, weight loss or gain, changes in your sleep patterns (too little or too much), etc.

A doctor or professional psychiatrist can properly diagnose clinical depression and help you treat it with medication. With prescriptions like those listed below, over the course of a few weeks you should begin to see troublesome symptoms decrease their disruption of your daily life. Still, it’s important to do your research and figure out which type is right for you.

Here are some helpful background facts and possible side effects of the market’s most popular antidepressant prescription drugs.

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are prescribed more than any other class when treating depression. Not only do they produce results, they also are typically regarded as having fewer side effects. They work to combat your depressive symptoms by decreasing seratonin blockers, preventing your brain’s reabsorption or reuptake of “selective” neurotransmitters called serotonin.

The most common forms include:

Side Effects of SSRIs

Sexual dysfunction such as decreased sex drive are common while taking SSRIs. However, more serious side effects include:

  • nausea
  • vomiting
  • diarrhea
  • headaches
  • weight gain
  • anxiety
  • dizziness
  • dry mouth
  • trouble sleeping

Serious Complications

Certain SSRIs (and in fact many antidepressants) have been known to increase suicidal thoughts and do carry the potential to increase the risk of suicidal behaviors in children, adolescents, and young adults ages 18 to 24.

Other noteworthy warnings include abnormal bleeding that can occur in conjunction with some common over the counter pain relievers like aspirin, ibuprofen, and naproxen as well as blood thinners such as warfarin.

SSRIs also carry the risk of producing serotonin syndrome; a serious medical condition in which the medications alter the concentration of serotonin in your brain. The risk is increased when taking prescription pain medications like demerol, triptans and tramadol, along with natural medicines like St. John’s Wort Symptoms and street drugs like cocaine.

Symptoms of serotonin syndrome include: anxiety, restlessness, sweating, muscle spasms, shaking, fever, rapid heartbeat, vomiting, and diarrhea.

SNRIs

Serotonin norepinephrine reuptake inhibitors (SNRIs) treat depression by blocking the reabsorption two of the brain’s neurotransmitters: serotonin and norepinephrine.

cymbalta-pillThe most common forms include:

Side Effects of SNRIs

  • nausea
  • dizziness
  • sweating
  • sexual dysfunction
  • tiredness
  • constipation
  • insomnia
  • anxiety
  • headache
  • loss of appetite

Serious Complications

Much like antidepressants in the class above, serious complications such as abnormal bleeding and/or suicidal thoughts or behavior can occur. Duloxetine (which also aids in pain relief) and milnacipran can also cause contradictions in patients with certain kinds of glaucoma.

TCAs

Tricyclic antidepressants (TCAs) were discovered back in the 1950’s, and for years were the most widely used and approved antidepressants. They have since been replaced by newer antidepressants like SSRIs and SNRIs that typically come with fewer risks and side effects. They work similar to SNRIs, by improving serotonin and norepinephrine levels, while also blocking the brain’s muscarinic M1, histamine H1, and alpha-adrenergic receptors.

The most common forms include:
norpramin

Side Effects of TCAs

  • dry mouth
  • constipation
  • blurred vision
  • urinary retention
  • dizziness
  • tachycardia
  • memory impairment
  • delirium
  • orthostatic hypotension
  • weight gain
  • seizures
  • bone fractures
  • sexual dysfunction
  • increased sweating
  • fatigue

Serious Complications

In addition to the increased risk of suicidal thoughts or behaviors, TCAs have been known to induce more serious side effects such as low blood pressure, irregular heart rate, and seizures. TCAs should never be used within a two-week (14 day) span of taking a Monoamine oxidase inhibitor (MAOI).

MAOIs

Monoamine oxidase inhibitors (MAOIs) work by preventing an enzyme that breaks down norepinephrine, serotonin, and dopamine called monoamine oxidase. Like TCAs, MAOIs have newer antidepressants with fewer side effects are typically prescribed over MAOIs.

The most common forms include:
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Side Effects of MAOIs

MAOIs have several other drug and food interactions which may cause significant side effects.
• postural hypotension
• weight gain
• sexual side effects

Serious Complications

Aside from general increased risk for suicidal thoughts or behaviors, patients have also reported hypertensive crisis which is caused from MAOIs interaction with tyramine-containing foods or beverages. These can spike blood pressure levels to an unhealthy and dangerous level. Individuals taking MAOIs should stay away from wine, aged cheese, sauerkraut, cured meats, draft beer, soy products, and more.

Atypical Antidepressants

Atypical antidepressants are classified as such because they don’t meet the criteria of the other antidepressant classes. Though they do work by affecting the levels of dopamine, serotonin, and norepinephrine in the brain.

The most common forms include:
Wellbutrin

Side Effects of Atypical Antidepressants

Side effect will vary from drug to drug based on the chemical makeup of the medication itself. Some general side effects include:

Serious Complications

Like all antidepressants, there is some risk of suicidal thoughts or behavior associated with these drugs. In addition, Bupropion can conflict with certain seizure disorders and should not be used in patients who have eating disorders or within 2 weeks of using an MAOI.

Nefazodone is not recommended for patients suffering from liver disease.

Mirtazapine and trazodone may cause life threatening abnormal heart rhythms.

Ultimately, you should always talk to your doctor before starting on any sort of medication regimen to combat depression. In some cases, natural methods like increased exercise, omega-3-fatty acids, St. John’s wort, 5-hydroxytryptophan (5-HTP), SAMe, and L-theanine can help alleviate milder symptoms of depression or Seasonal Affective Discorder (SAD). In other cases, a prescription antidepressant like those listed above may be the best course of action to combat significant symptoms of clinical depression.