Well, it’s been a loaded few weeks for me, and I’m finally getting back into writingº. If you’ve been following the blog so far, last post we looked at a few reasons why people choose to go on medication to treat their mental illness, as well as a few reasons why people avoid the topic altogether. If you haven’t had a chance to read that post (On Medication and Mental Health I), feel free to check it out before or after this one.
In this post, we will look at a general, layman’s overview of medication for depression only. If you’re a biology/chemistry buff or are otherwise educated in the specifics, I hope I don’t make you cringe from my over-simplifications.
There are many other forms of mental illness out there, which I’ll eventually delve into, but for this post we will focus on depression treatment via medications known as antidepressants. Some of this may be information you have seen before, and some of it may be new. In any case, I hope this post is informative and helpful.
How do antidepressants work?
If you’ve ever sat down and Googled “depression”, you’ve more than likely come across depression being described as a condition stemming from chemical imbalances, deficiencies, or both. The truth is, no one really knows for sure what causes depression, however many researchers tend to agree that treating depression should involve addressing the levels of certain chemicals (called “neurotransmitters”) in the brain. Neurotransmitters, in short, are chemicals that allow the passing of electrical signals between neurons (nerve cells) in the brain, and include dopamine, serotonin, and norepinephrine. Different types of antidepressants affect the levels of different neurotransmitters in different ways.
What are some of the different types of antidepressants?
For this section, we’ll take a look at some of the main types of antidepressants, including reuptake inhibitors, Tri/tetracyclics, and MAOIs.
The first step in understanding reuptake inhibitors is to understand reuptake. This process occurs in the brain, whereby neurotransmitters are reabsorbed back into neurons after being used. A reuptake inhibitor prevents this re-absorption from happening for a period of time. The theory with these medications is that the more neurotransmitters working outside of nerve cells, the more communication happens within the brain, thus regulating mood. Reuptake inhibitors include SSRIs (selective serotonin reuptake inhibitors) such as Lexapro and Zoloft, which as the name suggests help prevent serotonin reuptake. Other examples include SNRIs (which help inhibit serotonin as well as norepinephrine reuptake) such as Effexor and Cymbalta and NDRIs (norepinephrine and domapine reuptake inhibitors) such as Wellbutrin.
Tetracyclics (such as Asendin and Remeron) help prevent reuptake in a different way. They are thought to stop neurotransmitters from binding with the nerves, causing them the neurotransmitters to build up outside of the nerve cells and effectively raising their levels.
Tricyclics (such as Elavil and Tofranil) block the reabsorption of serotonin and epinephrine. These medications can have more serious side effects, as elevated epinephrine (also known as adrenaline) levels have been known to affect people with certain heart conditions.
MAOIs (monoamine oxidase inhibitors such as Marplan and Nardil) work slightly differently, in that they block monoamine oxidase, a chemical in the body that breaks down neurotransmitters. Basically, the less chemicals that are around to break down neurotransmitters, the more neurotransmitters exist. A possible side effect of these medications however, is that MAOIs can also prevent the body from breaking down other medications and chemicals – raising risks for other complications.
How effective are they?
In doing my research, it seems the benefits of medication tend to depend on the severity of the illness. Medication seems to help more as depression becomes more serious. One of the drawbacks of depression medication, however, is that antidepressants can take a while to work (often several weeks) and initially can even make depression symptoms worse while introducing side effects.
Are there side effects/risks?
As mentioned in previous sections, there are side effects to consider when starting antidepressants. Some are mild such as dry mouth, headaches, low sex drive, etc. Some can be more serious including increased risk of suicide and organ issues such as heart and liver problems.
How long should I take one?
Some people see benefits from antidepressants after several weeks, some several months, and some may never see benefits from a certain medication and may try another form. For people that do see benefits, the time frame in which they take medication could range from several months to several years.
As with any and all medications, do your research, talk to your health care provider(s), and learn as much as you can. Ultimately, the decision to begin any kind of medication should not be taken lightly, and antidepressants should be no different.