All about antidepressants
Key takeaways
Antidepressants increase neurotransmitters in the brain to help relieve symptoms of anxiety and depression. Types of antidepressants include SSRIs, SNRIs, MAOIs, TCAs, and NaSSAs.
Potential side effects range from sexual dysfunction and nausea to more severe issues, including increased suicidal thoughts and serotonin syndrome. Side effects may vary depending on the type of antidepressant.
People should speak with a medical professional for advice on managing depression. Non-pharmaceutical remedies may include lifestyle changes, light therapy, and psychotherapy.
Antidepressants work by increasing neurotransmitters in the brain. Experts believe these brain chemicals are responsible for changes in mood and behavior.
This article covers the types of antidepressants, how they work, their side effects, other uses, and alternative options. Types 1389369787 blackCAT/Getty Images Doctors tend to divide antidepressants into different types.
These include: Selective serotonin reuptake inhibitors (SSRIs) SSRIs are a first-linetreatment option for depression.
Examples of SSRIs include: citalopram ( Celexa ) escitalopram ( Lexapro ) fluoxetine ( Prozac , Sarafem) fluvoxamine (Luvox) paroxetine ( Paxil ) sertraline ( Zoloft ) Serotonin-norepinephrine reuptake inhibitors (SNRIs) SNRIs are a newer class of antidepressants compared with SSRIs. However, they work similarly.
Doctors may prescribeSNRIs for: attention deficit hyperactivity disorder (ADHD) obsessive-compulsive disorder (OCD) anxiety disorders menopausal symptoms fibromyalgia chronic neuropathic pain Examples of SNRIs include: duloxetine ( Cymbalta ) venlafaxine ( Effexor XR ) desvenlafaxine ( Pristiq ) Tricyclic antidepressants (TCAs) Doctors may recommend TCAs for: depression fibromyalgia some types of anxiety insomnia ## chronic pain Examples of TCAs include: amitriptyline amoxapine clomipramine (Anafranil) desipramine (Norpramin) doxepin (Sinequan) imipramine (Tofranil) nortriptyline (Pamelor) protriptyline (Vivactil) trimipramine (Surmontil) Monoamine oxidase inhibitors (MAOIs) Due to their adverse side effects and drug interactions , doctors do not typicallysuggest MAOIs as a first-line treatment option for depression. However, they may be an option in the case of treatment-resistant depression.
Examples include: phenelzine (Nardil) tranylcypromine (Parnate) isocarboxazid (Marplan) selegiline (Emsam, Eldepryl) Noradrenaline and specific serotoninergic antidepressants (NaSSAs) Doctors prescribe NaSSAs to treatanxiety disorders and depression. Examples include mirtazapine (Remeron, Avanza, Zispin) and mianserin (Tolvon).
Mianserin is not available in the United States. Side effects All drugshave side effects, not just antidepressants.
Different antidepressants have different side effects. However, not everyone experiences them.
SSRI and SNRI side effects SSRIs and SNRIs can lead to : nausea indigestion headache sexual dysfunction SNRIs can also increaseblood pressure. A person with a serious heart condition should not take the SNRI venlafaxine.
TCA side effects TCAs may have the following side effects: dry mouth tremor fast heart rate constipation insomnia weight gain MAOI side effects MAOIs can interact with other drugs. For example, if a person combines an MAOI with an SSRI, it could leadto serotonin syndrome.
Serotonin syndrome is a serious condition in which a person has too much serotonin in their body. MAOIs can also lead to: dry mouth diarrhea nausea drowsiness constipation dizziness insomnia lightheadedness sexual dysfunction MAOIs prevent the breakdown of tyramine.
If a person consumes foods that contain tyramine, such as sausages, dried fish, and overripe fruit, it can leadto a hypertensive crisis. This is a severe increase in blood pressure that can lead to a stroke.
Learn more about tyramine-free foods. NaSSA side effects These antidepressants can lead to side effects similar to SSRIs and SNRIs.
NaSSAs can also cause drowsiness and weight gain. They are less likelyto cause sexual dysfunction.
Rarer side effects Rarer side effects of antidepressants include: Suicidal thoughts: According to the United Kingdom’s National Health Service (NHS) , young adults and children may have a higher risk of suicidal thoughts when they first start taking antidepressants. If side effects are very unpleasant or include thinking about suicide, the person should speak with a doctor immediately.
Withdrawal symptoms: Some people who take SSRIs and SNRIs experience some withdrawal ## symptoms when they stop taking the medication. Withdrawal symptoms can last for 1–2 weeksand include: anxiety dizziness nightmares or vivid dreams electric shock-like sensations in the body flu -like symptoms abdominal pain Help is out there If you or someone you know is in crisis and considering suicide or self-harm, please seek support: Call or text the 988 Lifeline at 988 or chat at 988lifeline.org.
Caring counselors are available to listen and provide free and confidential support 24/7. Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
Not in the United States? Find a helpline in your country with Befrienders Worldwide.
Call 911 or your local emergency services number if you feel safe to do so. If you’re calling on behalf of someone else, stay with them until help arrives.
You may remove weapons or substances that can cause harm if you can do so safely. If you’re not in the same household, stay on the phone with them until help arrives.
Effectiveness Antidepressants tend to be effective. However, everyone responds to medication differently.
According to the Institute for Quality and Efficiency in Health Care, 40–60%of people who took an SSRI or SNRI for depression noticed some symptom relief within 6–8 weeks. The research notes that the more severe the depression, the greater the benefits of antidepressants may be.
Alternative options People may wish to try the following: Therapy People with depression may wish to undergo therapy. Types of therapy that can help treat depression include : cognitive behavioral therapy (CBT) interpersonal therapy problem-solving therapy Learn more about available mental health resources.
St. John’s wort Hypericum, made from the herb St.
John’s wort , might help relieve depression in some people. It is available over the counter as a supplement.
However, there are some possible risks associated with taking hypericum: If combined with certain antidepressants, it can lead to a potentially life threatening increase in serotonin.
It can worsen symptoms of bipolar disorder and schizophrenia. It might reduce the effectiveness of some prescription medications, including antidepressants, birth control pills, some heart medications, warfarin , and some therapies for HIV and cancer.
If a person plans to take St. John’s wort, they should first talk with a doctor or pharmacist.
Light box People who experience seasonal affective disorder may benefit from light therapy. It involves sitting in front of a light box first thing in the morning for 30–45 minutes.
Diet and exercise The Centers for Disease Control and Prevention (CDC) notes that regular physical activity can reduce a person’s risk of depression. People may wish to try three exercise sessions per week for 12–24 weeks.
Learn more about exercise as a treatment option for depression. People may also benefit from eating a balanced, nutritious diet full of fresh and whole foods.
They may wish to avoid or limit refined and processed foods. Learn more about foods to eat with depression.
How do antidepressants work? While different antidepressants work in different ways, they all affect neurotransmitters.
Neurotransmitters are chemicals brain cells use to communicate with each other. Antidepressants work in the following ways: SSRIs: These prevent serotonin from returning to where it came from, also known as preventing serotonin reuptake.
This encourages serotonin to bind to its receptor to transmit a signal in the brain. SNRIs: These work the same as SSRIs, except they work on both serotonin and norepinephrine.
TCAs: These work the same as SNRIs, except they are less effective at blocking norepinephrine reuptake than serotonin reuptake. MAOIs: These target the brain enzyme monoamine oxidase, which helps break down neurotransmitters such as serotonin.
This can lead to more stabilized moods and less anxiety. How long will it take for them to take effect?
According to the NHS, people may begin to feel the benefits of an antidepressant after 1–2 weeks if they have not missed a dose. Some people may stop taking their antidepressant because they believe the medication is not working.
However, it is important to keep taking the medication exactly as a doctor prescribes.
If a person has not noticed any benefit after 4 weeks, they should speak with a doctor. MORE: Get a refill for your medication in as little as 15 minutes with Optum Now Online Care.
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Learn more.
Frequently asked questions
Below are some commonly asked questions about antidepressants. Which antidepressant is right for me?
There are many types of antidepressants.
They all work differently and have different benefits, risks, and side effects. A person can speak with a doctor about their individual circumstances.
The doctor can help them find the best treatment option for them. Are antidepressants safe during pregnancy?
The CDCnotes there is a link between taking SSRIs during pregnancy and congenital abnormalities. However, this risk is very low.
For some people, the risks associated with stopping the medication are higher than those associated with continuing to take it. If a person is pregnant and wishes to continue or begin taking antidepressants, they should speak with a doctor.
Tiny amounts of some antidepressants can enter breast milk. However, the CDCstates most antidepressants will have no effect on milk supply or the child’s well-being.
How long should I stay on antidepressants? According to the NHS, doctors typically suggest a person takes antidepressants for at least 6 months.
People should take their antidepressants exactly as their doctor has prescribed.
Summary
Antidepressants can help relieve symptoms of conditions such as depression and anxiety disorders. They work by increasing neurotransmitters in the brain.
Examples of antidepressants include SSRIs, SNRIs, TCAs, and NaSSAs. MAOIs may also be an option, though doctors prescribe these less often due to the risk of adverse side effects.
It can take several weeks for antidepressants to start working. People may experience side effects.
Alternatives to antidepressants include therapy, diet and exercise, and St. John’s wort.
However, depression is a serious condition that may need professional treatment.
Anyone who experiences the symptoms of depression should speak with a doctor.
