Depression Treatment with Medication

Medication used to treat depression works by relieving the symptoms of depressed mood – acting on certain chemicals in specific areas of the brain especially serotonin and noradrenaline which are chemical messengers that allow certain nerves in the brain to work.

Anti-Depressants is the name given to the drugs used to treat depression. These are grouped into various sub groups because of the chemical formula. It is this formula which allows each substance to have the effect it does on this chemical imbalance which causes depression. Chemical imbalances would have been occurring for a lengthy period before the person would have needed treatment. Therefore, in the same way, treatment will need to be continued for weeks, months or longer to improve this imbalance.

Sub-groups of anti-depressants: One group of antidepressants has been available for years whereas others are more recent research discoveries. Each new group of drugs aims to maintain the good effects and reduce side effects. Unfortunately, although drugs have the desired good effects, all have some side effects. One group of antidepressants (MAOI’s) are rarely used due to their ‘incompatibility with certain foods and the need for restrictive diets.

1. The newest group of antidepressant are called SSRI’s (Selective serotonin re-uptake inhibitors). These have virtually replaced the older antidepressants as a first choice of treatment as there are fewer side effects.

Examples: This group includes paroxetine (Aropax), fluoxetine (Prozac Zactin), sertraline (Zoloft), citaloprom (Cipramil), fluvoxamine (Luvox).

How it works: The drug selectively inhibits the re-uptake of seretonin. (a chemical in the brain) It is usually given in low doses and then the dosage gradually increased until the correct dosage is found. This usually avoids any side effects.

Side Effects: The main side effects include drowsiness or insomnia, loss of appetite and weight loss, dizziness or light headedness, tremor, sweating, headache, nervousness and anxiety, dry mouth, nausea.

One advantage is that these drugs do not cause weight gain.

2. Serotonin-noradrenaline reuptake inhibitor. (SNRI)

Example: Venlafaxine (Efexor).

How it works: The action of this drug is unclear at this time. Most probably the action is to inhibit the uptake of specific chemicals in the brain namely seratonin and nor adrenalin.

Side effects: These include nausea, weakness, drowsiness, constipation, loss of appetite, dizziness, dry mouth.

3. Reversible inhibitor of mono-amine oxidase. RIMA’s

Example: Moclobemide (aurorix)

How it works: The metabolism of dopamine, adrenaline and serotonin (chemicals in the brain) is decreased by this effect, and this leads to increased extra-cellular concentrations of these neuronal transmitters.

Side effects: These include sleep disturbances, dizziness, nausea, headache.

4. Tricyclic anti depressants (TCA’s)

Examples include Imipramine (Tofranil ), Amitytriptilene (Tryptonol) Nortriptyline (Nortab) Dothiepin (Prothiaden) Doxepin (Sinequan) and tetra cyclic Mianserin (Tolvon, Lumin).

These drugs are now used less frequently. The effect of these drugs will not be apparent for 3 – 4 days and can take much longer (30 days).

Tricyclic Antidepressants side effects include impaired reaction time (machinery precaution), sedation, dry mouth, blurred vision, sweating, dizziness, faintness, weight gain, constipation , impaired concentration.

General Information

It is always best to avoid alcohol and marijuana while taking antidepressants as you will get drunk more quickly. You may become dizzy and risk injury by falling. Your judgement will also be affected. Be aware of potential side effects that may affect your ability to drive a motor vehicle or handle machinery including power tools.

Take time to allow your medication to work. It takes time for depression to develop and takes time for the medication to take effect.