Antidepressant Medicines

What is an antidepressant?

Antidepressant medicines are drugs that may provide relief from conditions such as:

• depression
• anxiety and panic
• obsessive compulsive disorders
• PMS
• seasonal affective disorder.

Antidepressants are not "uppers." They help you feel the way you did before you became depressed.

Are there different kinds?

There are many different kinds of antidepressants:

• selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil)
• tricyclic antidepressants such as imipramine (Tofranil), nortriptyline (Aventyl HCl, Pamelor), amitriptyline, doxepin (Sinequan), and desipramine (Norpramin)
• monoamine oxidase inhibitors (MAOIs) such as tranylcypromine (Parnate), and phenelzine (Nardil)
• other antidepressants such as mirtazapine (Remeron), venlafaxine (Effexor), duloxetine (Cymbalta), and bupropion (Wellbutrin).

How do they work?

The brain is made up of billions of neurons (cells) that communicate with each other. This affects other parts of the body. Neurotransmitters are chemical substances in the brain. The kinds and amounts of these substances control how neurons communicate. Too much or too little of these neurotransmitters may lead to depression. Using medicines to treat these imbalances may help to improve your mood.

Not all antidepressant medicines affect your brain chemistry in the same way. Different medicines affect different neurotransmitters. Certain medicines such as isotretinoin (Accutane), levofloxacin (Levaquin), mefloquine (Lariam), benzodiazepines, and some beta blockers can add to the symptoms of depression. Your healthcare provider will work with you to carefully select the right medicine for you. Be sure that your healthcare provider knows about all of the medicines, vitamins and supplements you are taking.

What are the risks and benefits?

Antidepressants may make other kinds of treatment more effective. If you are too depressed to talk, you may not seek psychotherapy or counseling. The right medicine may help you get the treatment that is most effective for you.

You may notice improvement in the first couple of weeks. You must take these medicines daily for 3 to 6 weeks to get full benefit from them. Most people benefit most from taking these medicines for at least 6 months.

Antidepressant dosages must be carefully adjusted to lessen troublesome side effects. Some side effects may be serious, such as severe nervousness, loss of appetite, rapid heartbeat, or diarrhea. Some side effects, such as dizziness, drowsiness, dry mouth, and bad taste are minor. They may decrease as your body adjusts to the medicine. Your provider may change your medicine to avoid some side effects. Tell your healthcare provider if you have any side effects that continue or get worse.

Do not stop taking these medicines unless your healthcare provider tells you to do so. If you take them for a long time, you may have withdrawal symptoms if you stop taking them too quickly.

When should I call my healthcare provider?

Seek professional help if:

• Symptoms of depression do not improve after a few weeks.
• The symptoms get worse.
• You have side effects that you think may be caused by the medicine.

If you have questions or problems related to your medicine, talk with your healthcare provider or pharmacist.