Antidepressants and how they work

Antidepressants are designed to reduce symptoms of depressive disorders by correcting chemical imbalances of neurotransmitters in the brain. Based on several studies, chemical imbalances may be responsible for changes in mood and behavior. Antidepressants are commonly used to treat depression, anxiety disorder, agitation, obsessive compulsive disorders (OCD), manic-depressive disorders, postpartum depression, major depressive disorder, diabetic peripheral neuropathic pain, neuropathic pain, social anxiety disorder, post-traumatic stress disorder (PTSD). Antidepressants work by inhibiting the reuptake of specific neurotransmitters thus increasing their levels around the nerves within the brain, such as selective serotonin reuptake inhibitors (SSRIs), antidepressants that affect serotonin levels in the brain.

Please always consult with your doctor before taking any medications.

Types of Antidepressants

Antidepressants differ in their effects, uses, side effects and drug interactions. Antidepressants that are used for depression can be effective. There is no evidence that one antidepressant is more effective than another. However, patients may respond to or tolerate one antidepressant, and not respond to or tolerate another antidepressant.

Their side effects

All antidepressants have many side effects. As with all medications, it is important be aware of the potential side effects for each and every one. It is also important to note that in some cases suicidal thoughts and unusual changes in behavior are common with antidepressants. They are also known to cause withdrawal symptoms when abruptly discontinued. Withdrawal symptoms include nausea, vomiting, dizziness, headache, irritability, sleep disturbance, nightmares, psychosis, and seizures. Specific side-effects vary based on the type of depression medication that you are prescribed and your own personal response. The most common side effects associated with antidepressants include:

• Nausea Weight changes
• Anxiety/agitation Drowsiness
• Dry mouth Bladder Problems
• Diarrhea or constipation Sexual health issues
• Dizziness Problems sleeping

Types of Antidepressants

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRI s and serotonin/norepinephrine reuptake inhibitors (SNRIs) are two types of antidepressants associated with abnormal thinking, agitation, anxiety, dizziness, headache, insomnia, sexual dysfunction, sedation, tremor, sweating, weight loss, diarrhea, constipation, dry mouth, rash, and nausea. Rarely, SSRIs have been associated with hyponatremia (low sodium), hypoglycemia (low blood glucose), and seizures.

• citalopram (Celexa)
• escitalopram (Lexapro)
• fluoxetine (Prozac, Sarafem)
• fluvoxamine (Luvox)
• paroxetine (Paxil)
• sertraline (Zoloft)
• duloxetine (Cymbalta)
• venlafaxine (Effexor)
• desvenlafaxine (Pristiq)

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are a class of antidepressant associated with sedation, dry mouth, blurred vision, constipation, urinary retention, and increased pressure in the eye. They are also associated with hypertension, abnormal heart rhythms, anxiety, insomnia, seizures, headache, rash, nausea, and vomiting, abdominal cramps, weight loss, and sexual dysfunction. Tricyclic antidepressants rarely cause liver failure.

• amitriptyline (Elavil)
• clomipramine (Anafranil)
• desipramine (Norpramin)
• doxepin (Sinequan)
• imipramine (Tofranil)
• nortriptyline (Pamelor)
• protriptyline (Vivactil)
• trimipramine (Surmontil)

Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant associated with postural hypotension (feeling faint upon standing due to decreased blood flow to the brain), high blood pressure, fainting, abnormal heart rhythm, dizziness, headache, drowsiness, insomnia, anxiety, constipation, nausea, diarrhea, sexual dysfunction, weight gain or weight loss, and edema. Seizures, rash, blurred vision, and hepatitis are infrequently associated with MAOIs. • phenelzine (Nardil)

• tranylcypromine (Parnate)
• isocarboxazid (Marplan)

Great sources for detailed information on antidepressants is the National Institute of Health (NIH) Medline Plus or the U.S. National Library of Medicine.