I will write about the medication-assisted treatment used to treat depression, but especially about what you need to know about how the treatment is given to be effective: How are antidepressants given? When do they take effect? What are the side effects? How long should you take the treatment? When and how do you stop treatment?
Antidepressants and brain biochemistry
Primary antidepressants act on the chemistry of the brain represented by neurotransmitters, especially serotonin and norepinephrine. Other antidepressants act harshly on another neurotransmitter called dopamine. Researchers have found that these neurotransmitters are involved in mood regulation but do not know exactly how they work.
The newest and most popular antidepressants
Some of the newest and best-known antidepressants are called selective serotonin reuptake inhibitors (SSRIs).
The most popular SSRIs used in the treatment of depression are fluoxetine (Prozac), sertraline, Zoloft, escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa). In the standardized edition, several of them are valid. The SSRI antagonists of serotonin and norepinephrine reuptake (SNRIs) include venlafaxine (Effexor) and duloxetine (Cymbalta).
SSRIs and SNRIs cause fewer side effects than older generation antidepressants but can sometimes cause headaches, nausea, nervousness, or insomnia when patients start taking them. These symptoms tend to fade over time. Some people have sexual problems when taking SSRIs or SNRIs, which can be removed by adjusting doses or switching to another medication.
Bupropion is a common dopamine antidepressant (Wellbutrin). Yet Bupropion appears to be less prone to induce side effects in attractiveness than SSRIs and SNRIs. But the likelihood of seizures will increase.
Tricycles
Antidepressants in older age. They are potent, but they are not used too much today because their side effects are much more severe. In individuals with heart attacks, it may impact cardiac health. Often, particularly in the elderly, they can induce dizziness. Can contribute to somnolence, dry mouth, and rise in weight. The modification of the dosage or the shift to another drug will correct these side effects. Another significant factor with respect to tricycles is the inherent threat involved with probable overdose. Imipramine and nortriptyline contain tricyclics.
MAOIs
The oldest class of antidepressant drugs is monoamine oxidase inhibitors (MAOIs). In cases of “atypical depression, such as enhanced appetite and increased sleep need instead of reduced appetite and insomnia, they may be particularly successful. They may also lead to minimizing terror, panic, and other symptoms.
If MAOIs are given, certain foods and beverages (such as cheese and red wine, for example) containing a substance called tyramine should be avoided. Certain medications, such as certain contraceptives, painkillers, or pills for colds and allergies, herbal nutritional supplements, should also be avoided during the administration of MAOIs. The reason: these substances can interact to cause an increase in blood pressure. If you are taking MAOIs, your doctor should give you a complete list of foods, medications, and substances to avoid.
MAOIs can interact with SSRIs producing a serious effect called “serotonin syndrome”, which can cause confusion, hallucinations, sweating, muscle aches, tremors, changes in blood pressure and heart rate, and other potentially threatening effects. MAOIs should not be taken with SSRIs!
How should I take my medication?
It is important to know that all antidepressants must be taken for at least 4-6 weeks before they have full effect. You will also need to keep taking your medication even if you start to feel better to prevent your depression from returning. The treatment’s positive effects will begin to be seen only after 7-10 days of administration. Unfortunately, during this period, there are side effects, not all, not the same, not the same in all people, but it is possible that you may feel discouraged at first by the unpleasant sensations that you may feel.
It is good to know that they will disappear over time and give way to treatment’s positive effects. Just be patient, don’t make decisions in your head, and don’t give up!
Medication must be discontinued only under the strict supervision of a psychiatrist!
Some medications will gradually stop to give the body time to adjust to the new situation.
Although antidepressants are not addictive, their sudden cessation can cause withdrawal or recurrence. Those who suffer from chronic or recurrent depression will need drug treatment for a longer period, sometimes even a lifetime.
It is also important to know that if one drug does not have the desired result, you will have to try another.
Studies have shown that those who do not feel well after trying the first antidepressant drug are more likely to fight depression after changing treatment or adding another drug to the initial ones.
It only takes a lot of patience and perseverance in the fight against depression. On the contrary, it is not a pleasant experience, extremely frustrating, most of the time, but the disease is much more frustrating and painful!
Sometimes, stimulants, anti-anxiety medication, or other medications are used in conjunction with an antidepressant, especially in people who have another disorder along with depression. However, neither anxiety medication nor stimulants are effective against depression if taken alone.
Both types of medication should only be taken under the strict supervision of a specialist!
Find the doctor with whom you can establish a relationship of trust, to be able to openly tell him everything that upsets you, to ask for his guidance, to feel that he understands you and adapts the treatment to your body’s response. Talk to him about all the side effects whenever they occur, don’t be embarrassed to ask him. You need to know everything that is the problem you face to know how to deal with it as well as possible! Dare! It is your responsibility to fight for your recovery!
Alarm signals regarding antidepressants
While SSRIs and other depresives are reasonably safe and common, studies have indicated that certain individuals may be at risk of side effects, in particular teens and young adults. Both of these things should be understood to keep away from risk.
In 2004, the FDA (US Food and Drug Administration) conducted a detailed analysis of controlled clinical trials on the effects of antidepressants published or not and involved nearly 4,400 children and adolescents. This analysis showed that 4% of those who took the studied antidepressants had suicidal thoughts and attempts (but did not take action) than 2% of those who received a placebo treatment.
As a result of these results, in 2005, the FDA adopted a way of signaling through a label called “black box” (black box), placed on the bottles of antidepressant drugs, which were to alert the population to the possible risk of growth. Of suicidal ideation or attempts to do so in children and adolescents taking antidepressants.
In 2007, the FDA proposed that all antidepressant manufacturers extend the warning to include adulthood, young people to 24.
The warning highlights that antidepressant patients of all ages, particularly within the first weeks of therapy, should be watched carefully.
Possible side effects that need to be closely monitored are worsening depression, suicidal ideation or suicide attempts, any unusual changes in behavior such as lack of sleep, agitation, withdrawal, or isolation from normal social situations.
The warning is also addressed to the families of the affected persons who are under treatment. Families need to know how necessary it is to carefully observe and report to the doctor any suspicious changes in the patient’s behavior.
No one wants to be exposed to unnecessary risks, especially those that can be avoided if known, so it is good to be careful, aware, and responsible. Depression is not a game, and we can’t joke about it! It can cost us our lives or the lives of our loved ones!
The results of an extensive study on the effects of antidepressants, conducted between 1988 and 2006, show that the benefits of antidepressant medication, especially if these treatments are taken as directed, outweigh the risks in children and adolescents with major depressive disorder and anxiety.
The Unique Journal 