|
Basic InformationMore InformationTestsLatest NewsQuestions and AnswersHusband Sexting With a Mutual FriendSexFearWhy do I Have These Mood Swings?Violent When DrunkAngry All The TimeEating Disorder or Overreacting?What Is Wrong With Me ?Classify My Mental DisorderOCD, DepressionI'm Going Crazy?Please Help. I Criticize Myself Too Much and I Need to Stop. Trying to ForgetWhat's Wrong With Me?How to Overcome Depression Caused when Boyfriend Ditched Me?New Boyfriend Lying About Belongings That Are His Ex Girlfriend'sHow to Help my Delusional Son?Is Any of This Real?What is This, and What do I do About it?I Have Everything I Ever Wanted. Why am I so Miserable?How Can I Convince My Suicidal MD Husband To Be Evaluated?Sexual Abuse, What Should I do Now?Bipolar or Depressed or Neither?DepressionFeel Like Something's WrongToo Much SorrowVery EmptyReally Desperate..Please HelpMy Health?DepressionBipolar, Depression, Grief & AnxietyIs This a Flashback?Help Us With Our Son!No Clue What To Do. Help?Am I Going Crazy?Do I Suffer From Depression?Why Is He Doing This To Me?Am I Commitment-Phobic?I Don't Care For Anything, I Feel as Though I'm Wasting my Life.Anxiety Has Taken Over My Life...Not Able to be Happy With my HusbandHow Do I Get My 24 Year Old Son To A CounselorBipolar TeenI Have This IssueAm I Depressed?Fear of ChokingHelpIn Love With a Man Who Does Not Love MeI Think I Have a Mental Disorder?Stress and Loss of Feeling or Emotional DeadnessPlease Help MeOCD or Not OCD, That's The QuestionHow Can I Move Past This- A Question for StaffDoes Romance Lead to Aggression?Am I Depressed?Depressed, Anxious and Dead Inside...Please Help!BrokenWhy do I Feel Like Everyone is Trying to Upset me?My Husbands Roller Coaster of Proper Hygiene: Is it Depression?I Feel Like a Complete Waste of a Human LifeAm I Always Going to Feel Like This?Is He Changed???I Can't Stop CryingHopelessAnxious and Depressed SonIs There Any Hope For Me, or am I Destined to be Damaged?Falling ApartIs There Such a Thing as Happiness? JoylessWorrying Too Much About Anything.Helping and Watching a Friend's Recurrent Depression?Homesick and Feeling Stuck.Insanely Jealous HusbandPOCDCan Prescription Drug Use Lead to Delusional Beharior? Social Anxiety, Depression and More...SadSame Views On So Much, but Can't Get Along As A CoupleSuicidal ThoughtsHypothyroid 23 Year Old GirlIt's Me or It's My Mother?Is He a Narcissist?Help For Aging Human Service Professionals?DepressionIf There's Nothing New, There's Nothing Good.Please Respond, I Need Help Need To Ask SomeoneIs it Okay to Give Up?I'm Cheated By My Girlfriend..... I Just Want to Die.....How Can It Help?Everyone Says He is depressed, Is He? Or Does He Really Want a Divorce??Help! Please!I Think I Need Some HelpI Feel So Lost.Scared and LonelyPlease Help Me OutHow Much Should a Therapist Care or Reach Out?I Never Experience Happiness Mystery SymptomsI Think I'm DepressedBorn to Lose, or Nurtured to Lose?Help!Quadruple Bypass SurgeryAdviceI am an 18 Year Old Mom Diagnosed With Severe Depression And AnxietyExtremely Scared: I Felt Indifferent Toward an ObsessionSuffering with Treatment-Resistant DepressionMy Fiance May Have a Sexual, Nude Photo AddictionInfections and The BrainMy Girlfriend's Family Is Ruining Our RelationshipWorthlessI Need Help And Am At The End of My RopeHow Can I Cope With My Husband´s Depression and Its Sexual Consequences?What Is The Difference Between Mental Illness and Depression?Am I Over Thinking This, or Am I Right?AngerDo I Need Help?What Is It?Why Am I Thinking Like This?Why Does My Mother Hoard Everything, Including Garbage?Right in the middle of a nervous breakdown; What's wrong with me? Huge Disapointment With My HusbandI Don't Really Care About Anything. What Should I Do?Is Post Traumatic Stress Disorder Curable? Is it Really a Problem?I am Terrified of Death. AnhedoniaDetached: I Feel Guilty, But I Can't Help it.My Father, The Sociopath...I Feel Like a Question MarkAm I Not Normal!?Our 23 Year Old Son Refuses to Get Help for His Anxiety Attacks and Depression. What is Wrong? Husband Abandoned MeD.I.D. Diagnosis, How do I Accept This?I Don't Know Anymore. Please Help.Breaking up With Bipolar Depression - Blacking OutHe's Distant. Is he Leaving me?My Boyfriend Saved Pictures of his Ex-Girlfriend on His Computer.Restroom PhobiaWhat Is Wrong with Me?Should I Seek Help?When to Leave Therapy?Help Me Please. What is Going On With Me?I'm Afraid I'm Going CrazyI Don't Know What To DoAm I Wallowing in Depression?AngerSexual Abuse and Its Effects on Relationships AfterwardsWhat Is Wrong with Me, Doc? HelpDBSAm I Suffering a Kind of Psychological Problem?Attention Deficit and DepressionDo I Have an Eating Disorder?Do you think I sound depressed? I don't understand what is going on Is This Bi Polar?Depressed 19 year old college studentThoughtsDepression helps to contribute to my unemployment! - Paula Will I ever feel normal?I feel like I am going crazyWhat is wrong with me?I'm ScaredWhat Is Wrong with Me?Cyclical DepressionFrightening thoughts - fear losing control - please help!Anxious, depressed, confused, angry....the typical...Giving Up - Dad of three - Sep 15th 2008Counting ritual - Zami - Aug 30th 2008dont understand meExercising violence in dreamsSwallowing fear My husband wants to leave me Is there help for a person who has always been a 'little depressed'Depression TreatmentPlease help. Lovely, however... - Julie C. - Jul 14th 2008I am really worried about my mental health (19yr old female)Am I depressed?Identity Confusion: I don't know what personality disorders I haveDo I Have Bipolar Dsorder?Is there something wrong with me?Will I Ever? Worried about my sonIs There Help Out There? Lonely Mother of ThreeAm I Depressed?Help?Major Depressive Disorder Severe with Psychotic FeaturesOCD- No feelingHelp!!!: LaciIs the memory of my father dooming my relationship?Worried about thoughtsHow long will i be on medication for treatment of my depressionMy Mother Won't Go For Depression Treatment!Where do i start to get on the road to recoveryWhat is wrong with me?Stuck in an on-again, off-again relationship for 10 yearsDepression TreatmentHow do I get my dr.s to understand and help me?STUCK IN A RUTWhat treatments are available after you've tried the medicines of last resort?no one will help!Should I seek help?A fighting coupleDo I have a mental health problem?Whats wrong with me?depression and employmenthow do you treat depression in teenager males?Is it ok to feel this way?Have DID: Getting Worse Not BetterCan we contact my mother's doctor?anxiety or going crazy?ADD, Tourettes or both?DepressedI think i'm lost?Don't want to take medsWill this ever endGet SupportedStages of DepressionIs there any help?Can you help?Dark FantasiesBlood testsIs it illusion or truth?should a depressed person marry?Dementia and DepressionAnger?What type of exams can proven that a person has bipolar disorder?Stuck in a mental rut...Loss of Patiencei can't seem to get over any of thisIntrusive humiliating memoriesIs there some way to deal with depression without meds?losing personality wholnessWhat is the point of life?No change is normal mood (e.g., Depression)Lack of Personal HygieneDiagnosing DepressionDoes untreated depression pass on to a fetus?A Request for HelpRegular thoughts of killing myselfHow do I help my depressed, unemployed motherAngry at my doctor for prescribing so carelesslyI become very hostile towards myselfComing to Terms With My Own Pathetic ExistenceDo environmental factors hold a person back?Tired of this DepressionStruggling With Feelings And ThoughtsGreatly DepressedIs Depression Getting More Prevalent?An Empty ShellHelping My HusbandInability To Express MyselfNon-medication Help For DepressionSuicidalSick Of Feeling This WayUntrusting PatientDepressed and Not DatingCongenital LazinessMoody BoyfriendElectroconvulsive TherapyDesperateFrustrated and Sucked DryToo Young For MedsDepressed HusbandParanoid DepressionSelf-Harming Attention SeekerDid My Parents Make Me Like This?Wild Mood SwingsA Wonderful ManHow Can I Become Less Depressed?18, Sad and HopelessShould I Continue With Therapy?Childhood DepressionCan I Help My Wife With Depression?Prozac QuestionsApproaching My Tightly Wound Depressed Attorney BrotherBrain Injury and DepressionNo Compassion For DepressionRecurrent DepressionMeds Don't Seem To Work So Now What?Pleasure-blindDo People Recover From Depression?Shy DancerCrying Is BehaviorMed ConsultFeeling Depressed and InsecureShyness And The Post Partum BluesThe Aftermath of AbuseDo I Tell My Children I'm Depressed?Now What?Medicine Doesn't Work AnymoreDepressedThe First TimeDepressed BoyfriendHow Do I Leave?Potentially Suicidal BoyfriendAlternative TreatmentBereavement and GriefParanoid DadDepression Affects The Entire FamilyHow Can I Stop Depression From Recurring?Crohn's Disorder Side EffectsIs Paranoia A Destiny?Post-Drinking DepressionSecurity Clearance and DepressionCan I Inherit Depression?Two CliniciansDepressed SpouseDepression 101Hypnosis?Controlling, Disabled HusbandAre These Just Mood SwingsDrifting Apart?Drinking. . .A Mother Struggles with DepressionMarijuana and DepressionOverburdened MomTrashed HouseBeautiful DreamerPMS WoesSeverely DepressedMiss LonelyUnhappy and In TherapyHe Won't Tell Me Why...LonelyDepression Affecting My RelationshipLonesomeMy Children Aren't Speaking..My Wife is DepressedMy Boyfriend Is DepressedParlante writes: LinksBook Reviews |
| |
Antidepressants for Depressive DisordersRashmi Nemade, Ph.D., edited by Kathryn Patricelli, MARecall our earlier discussion of neurotransmitters, synapses and receptors? This may be a good point to review that information (by clicking here), as in the following sections we will be discussing how the various families of antidepressant medications are thought to affect these neuronal systems.
Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These medications are safer and generally cause fewer bothersome side effects than other types of antidepressants. They are thought to work by slowing down the reuptake of serotonin neurotransmitter molecules by neurons that are found before the tiny gaps (synapses). Because serotonin reuptake is prevented, serotonin molecules end up staying in the gap longer than they normally would, and get more of a chance to activate the neuron found after the gap. There are several types of serotonin receptors, and some medications work on specific receptors better than others. SSRIs include fluoxetine (Prozac, Selfemra), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). Increasing the amount serotonin in the brain of a person with depression does not always improve their depression. Some people with depression also need help increasing levels of additional neurotransmitters such as norepinephrine. Often, people who don't respond to SSRI's will receive a trial of other antidepressants that also target other neurotransmitters that impact mood.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) affect serotonin, as well as norepinephrine and other neurotransmitter systems such as dopamine. SNRIs work like SSRIs in that they inhibit the reuptake of neurotransmitters at the junction between the transmitters. Examples of SNRI medications include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima).
Norepinephrine and dopamine reuptake inhibitors (NDRIs) work in the same way as the other neurotransmitter reuptake inhibitors, but target norepinephrine and dopamine. Bupropion (Wellbutrin, Aplenzin, Forfivo XL) falls into this category. It's one of the few antidepressants not frequently associated with sexual side effects.
Tricyclic antidepressants. Although these are the oldest antidepressants on the market, they are typically second or third choice treatments. Because of the long list of side effects associated with this family of medication, including weight gain, sedation, visual disturbances (e.g., problems focusing), anxiety, and sexual dysfunction, there is little interest in further research or development of TCAs. In addition, these medications are potentially toxic at high levels, making them a problem from an overdose perspective. Blood monitoring of medication levels is sometimes used to help ensure that helpful rather than toxic (harmful) blood levels are maintained. The tricyclic medications are mostly used today when other newer medications have failed. Some common TCAs are imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil).
Monoamine oxidase inhibitors (MAOIs) are enzymes that break down serotonin, norepinephrine, and dopamine. By preventing these enzymes from working, MAOI medications allow neurotransmitters to remain in the synaptic gap longer. This gives them more opportunity to activate the post-synaptic neuron's receptors and create greater stimulation of the post-synaptic recipient neuron. Increasing someone's serotonin, norepinephrine, and/or dopamine levels tends to have an antidepressant effect. Using an MAOI requires a strict diet because of dangerous (or even deadly) interactions with foods, such as certain cheeses, pickles and wines. It can also interact with some medications, including birth control pills, decongestants and certain herbal supplements. MAOIs, such as tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan) may be prescribed, often when other medications haven't worked, because they can have serious side effects. Selegiline (Emsam), a newer MAOI that you stick on your skin as a patch, may cause fewer side effects than other MAOIs. These medications cannot be combined with SSRIs.
Atypical antidepressants. These medications don't fit neatly into any of the other antidepressant categories. They include trazodone (Oleptro), mirtazapine (Remeron) and vortioxetine (Brintellix). These make a person very tired and are usually taken in the evening. A newer medication called vilazodone (Viibryd) is thought to have a low risk of sexual side effects.
Other antidepressants. There are many other substances used for their antidepressant effects such as lithium, Omega-3 fatty acids, stimulants, thyroid replacement therapies, and herbal remedies. There are also alternative medicines such as Traditional Chinese Medicine, Ayurveda, and Homeopathy that are used. However, more research is needed to understand and use these treatments effectively. These therapies are not without their own side effects and should always be used under the supervision of a doctor.
Other medications may be added to an antidepressant to enhance their effects. A doctor may recommend combining two antidepressants or medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications might also be added for short-term use.
|