Depression and Anti-depressant Information

TSR Wiki > Life > Health and Relationships > Health > Mental Health > Depression

Please note that all advice here is unprofessional and DEFINITELY should not replace advice from your doctor or pharmacist.

Depression is a very common feeling which will affect virtually all of us in our lifetime. Depression is treatable, and in this thread there will be information on 'talking treatments' and certain common anti-depressant drugs. Don’t worry if your prescription isn’t on the list. As you can appreciate it there is so much information to write down. If something is missed or if the is some information on a treatment excluded, feel free to add it in.

Antidepressant medication is usually prescribed for moderate to severe cases of depression, or milder depression in adults if it is their treatment of choice. Some antidepressants are also commonly prescribed for other disorders, such as anxiety disorders, PMDD, eating disorders and also non-psychiatric complaints.

What is depression?

For more information on depression, see the Depression article.

Read on for information on medication.

It is important to realise that depression is often caused by social conditions. That is, if you feel depressed, there are likely certain conditions in your life that are leading you to be depressed. Therefore, the most effective cure for depression is to change those conditions which led you to become depressed in the first place. Nevertheless, in some instances, depression has no outward cause however in both situations medication may be prescribed. Such medication may be effective, but this will vary according to the type of medication prescribed. Sometimes one medication may not work but this does not mean that another will not. Doctors will sometimes try you on one anti-depressant at first and change it if it is not working. However before attempting medication, it is advisable to seek other help methods such as councilling. Anti depressants should only be taken if you are aware of the risks and should not be relied on as a permanent solution.

SSRIs

SSRI stands for Selective Serotonin Re-uptake Inhibitors. Serotonin is a chemical in the brain, and decreased levels of it are believed to cause depression in some people. They have fewer side effects than some other classes of anti-depressant medication. They are the most common first line of treatment for depression, particularly in young people. It is likely that your GP or psychiatrist will prescribe them for you before trying other kinds of anti-depressant.

As the SSRIs all have a very similar mechanism of action, the side effects tend to be quite similar. You shouldn't worry if you have a lot of side effects in the first few weeks of taking one of these medications, as they will tend to get better as you continue to take the drug. Common side effects include: indigestion or nausea (which can normally be helped by taking the tablet with food), loss of appetite, loss of libido, dry mouth.

Types of SSRI:

Citalopram (Celexa, Cipramil)

Doses tend to be about 20mg a day but can be higher (up to 60mg) for severe cases. It can also be used for anxiety and body dysmorphia. It does have side effects, but these are quite rare - sweating, hallucinations, sleep disturbance, nausea etc. It does cause some dizziness when taken but this is fairly mild and generally accompanies the natural mood boost created by the increase of free seratonin levels to stimulate nerve cells. Its one of the more commonly prescribed medications when dealing with depression.

Fluoxetine (Prozac)

Escitalopram (Lexapro, Cipralex)

This is a relatively new SSRI and so is not usually prescribed for those deemed to be in development, such as the majority of under-18s. It's quite a popular SSRI because of its minimal associated weight gain and because it doesn't cause too much fatigue. In most cases it's deemed as pretty effective, and is also one of the main choices when depression is present alongside personality disorders such as Social Anxiety Disorder. In most cases 5mg is the advised dose for the first two weeks, and then doubled to 10mg thereafter. If personality disorders are seen as a contributary factor for the depression then a higher dose is usually needed, which tends to be 15mg, usually after a month of medication, and never above 20mg.

Fluvoxamine (Faverin)

Paroxetine (Seroxat)

Sertraline (Lustral, Zoloft)

SNRIs

SNRI stands for Serotonin and Noradrenaline Reuptake Inhibitors. These drugs work like SSRIs but slow the re-uptake of noradrenaline, another neurotransmitter, as well as seratonin.

Common side effects of these medications include headache, nausea, dry mouth, sweating, sleepiness or insomnia, and diarrhea or constipation.

Types of SNRIs:

Venlafaxine (Efexor)

Duloxetine (Cymbalta)

TCAs

TCA stands for Trycyclic Anti-Drepressant.

The trycyclics are an older class of anti-depressant that can be very helpful in treating depression in some people.

Common side effects from these drugs are: a dry mouth, a slight tremor, fast heartbeat, constipation, sleepiness, and weight gain.

Types of TCA:

Amitriptyline (Elavil)

Amoxapine (Ascendis)

Clomipramine (Anafranil)

Dosulepin/dothiepin (Prothiaden, Prepadine, Dothapax)

Rarely used due to the high mortality associated with overdose

Doxepin (Sinequan)

Imipramine (Tofranil)

Lofepramine (Gamanil, Lomont)

Nortriptyline (Allegron)

Trimipramine (Surmontil)

Noradrenergic and Specific Serotonergic Antidepressant (NaSSA)

Mirtazapine

Mirtazapine is a NaSSA medication. It works in a similar way to the tricyclics, but should have fewer side effects. Mirtazapine is usually perscribed to patients whose bodies resist the main anti depressants such as fluoxetine, setraline etc. It is a strong medication; which is advised to take at night due to the main side effect being that it causes drowsiness. However, it also can make you feel faint, gain weight, have vivid dreams, increase appetite etc.

Patients on this drug predominantly start at a low dosage and like other anti depressants this is increased should it not work. There are rumours that its success rate changes with condition; (for example being low for sufferers of post traumatic stress, however increased results for depression).

MAOIS

MAOIS stands for Monoamine Oxidase Inhibitors. This class of anti-depressant is very rarely used these days, as you have to avoid a number of foods if you are taking one.

Other drugs used to treat depression

A number of other drugs are also used to treat depression. These include flupentixol (an anti-psychotic medication), lithium (for depression associated with bipolar disorder), and a number of other drugs.

Where can I find more information?

A number of organisations produce helpful leaflets about anti depressants. These include:

The MIND guide to making sense of anti-depressants

The Royal College of Psychiatrists Information Sheet: Antidepressants

You should ask your doctor or pharmacist if you have any questions relating to the medication you've been prescribed, and always read the Patient Information sheet!