Dr. MJ Bazos MD,
Patient Handout
Antidepressants
Medication
What are antidepressants?
Antidepressants are medicines used to help
people who have depression. Most people with depression get better with
treatment that includes these medicines.
How do antidepressants work?
Most antidepressants are believed to work by
slowing the removal of certain chemicals from the brain. These chemicals are
called neurotransmitters. Neurotransmitters are needed for normal brain
function. Antidepressants help people with depression by making these natural
chemicals more available to the brain.
How long will I have to take an
antidepressant?
Antidepressants are typically taken for 4 to 6
months. In some cases, however, patients and their doctors may decide that
antidepressants are needed for a longer time.
Do antidepressants have side
effects?
Like most medicines, antidepressant drugs can
cause side effects. Not all people get these side effects. Any side effects you
have will depend on the medicine your doctor has chosen for you. Your doctor
will talk to you about your medicine.
What are the different kinds of
antidepressants?
There are many different kinds of
antidepressants, including:
- Selective serotonin reuptake inhibitors (SSRIs)
- Tricyclic antidepressants (tricyclics)
- Others
SSRIs
SSRIs are a group of
antidepressants that includes drugs such as citalopram (brand name:
Celexa), fluoxetine (brand name: Prozac), paroxetine (brand name: Paxil) and
sertraline (brand name: Zoloft). These medicines tend to have fewer side effects
than the tricyclics. Some of the side effects that can be caused by SSRIs
include dry mouth, nausea, nervousness, insomnia, headache and sexual problems.
People taking fluoxetine might also have a feeling of being unable to sit still.
People taking paroxetine might feel tired. People taking sertraline might have
runny stools and diarrhea.
Tricyclics
The tricyclics have been used to treat
depression for a long time. They include amitriptyline (brand name: Elavil),
desipramine (brand name: Norpramin), imipramine (brand name: Tofranil) and
nortriptyline (brand names: Aventyl, Pamelor). Common side effects caused
by these medicines include dry mouth, blurred vision, constipation, difficulty
urinating, worsening of glaucoma, impaired thinking and tiredness. These
antidepressants can also affect a person's blood pressure and heart
rate.
Other antidepressants
Other antidepressants exist that have different
ways of working than the SSRIs and tricylics. Commonly used ones are
venlafaxine, nefazadone, bupropion, mirtazapine and trazodone. Less commonly
used are the monoamine oxidase inhibitors (MAOIs).
Some of the most common side effects in people
taking venlafaxine (brand name: Effexor) include nausea and loss of appetite,
anxiety and nervousness, headache, insomnia and tiredness. Dry mouth,
constipation, weight loss, sexual problems, increased blood pressure, increased
heart rate and increased cholesterol levels can also occur.
Nefazodone (brand name: Serzone) can give people
headaches, blurred vision, dizziness, nausea, constipation, dry mouth and
tiredness.
Bupropion (brand name: Wellbutrin) can cause
agitation, insomnia, headache and nausea. Mirtazapine (brand name: Remeron) can
cause sedation, increased appetite, weight gain, dizziness, dry mouth and
constipation. Some of the most common side effects of trazodone (brand name:
Desyrel) are sedation, dry mouth and nausea. MAOI antidepressants like
phenelzine (brand name: Nardil) and tranylcypromine (brand name: Parnate)
commonly cause weakness, dizziness, headaches and tremor.
Will antidepressants affect my other
medicines?
Antidepressants can have an effect on many other
medicines. If you're going to take an antidepressant, tell your doctor about all
the other medicines you take, including over-the-counter medicines and herbal
health products (such as St. John's wort). Ask your doctor and pharmacist if any
of your regular medicines can cause problems when combined with an
antidepressant. When taken together, some medicines can cause serious problems.
Taking an MAOI antidepressant at the same
time as any other antidepressants or certain over-the-counter medicines for
colds and flu can cause a dangerous reaction. Your doctor will tell you
what foods and alcoholic beverages you should avoid while you are taking an
MAOI. You should not take an MAOI unless you clearly understand what medications
and foods to avoid. If you are taking a MAOI and your doctor wants you to start
taking one of the other antidepressants, he or she will have you stop taking the
MAOI for a while before you start the new medicine. This gives the MAOI time to
clear out of your body.