Other Medications For Depression
Medications that dont fit into the classes listed above may also treat depression by altering levels of different neurotransmitters in the brain.
Wellbutrin , one of the most well-known, targets norepinephrine as well as dopamine, and is categorized as a norepinephrine-dopamine reuptake inhibitor, or NDRI.
Wellbutrin can cause side effects similar to those of SSRIs and SNRIs, but it is less likely to result in sexual problems.
Other so-called atypical medications include:
Sign Up For A Pregnancy Registry
Pregnancy Exposure Registries are research studies that collect information from women who take prescription medicines or vaccines during pregnancy.
Pregnancy registries can help women and their doctors learn more about how depression medicines affect women during pregnancy.
The FDA does not run pregnancy studies, but it keeps a list of registries. Check to see if there is a registry for your depression medicine or other medicines at: www.fda.gov/pregnancyregistries
Serotonin And Norepinephrine Reuptake Inhibitors
Serotonin and norepinephrine reuptake inhibitors work in a similar way to SSRIs except that they inhibit the reuptake of both norepinephrine and serotonin. The first SNRI was FDA-approved in December 1993.
Increasing norepinephrine levels in tandem to serotonin levels can be particularly useful or people with psychomotor retardation .
Examples of SNRIs include:
Common side effects of SNRIs include nausea, drowsiness, fatigue, constipation, and dry mouth.
Some SNRIs, like Cymbalta, can also be used to treat chronic pain, a condition closely linked to the development of depression. They have also proven useful in treating generalized anxiety, post-traumatic stress disorder , social anxiety disorder , panic disorder, and nerve pain associated with fibromyalgia.
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How Long Will You Have To Take Antidepressants
Usually, these drugs must be taken regularly for at least 4 to 8 weeks before their full benefit takes effect. You are monitored closely during this time to detect the development of side effects and to determine the effectiveness of treatment.
In order to prevent a relapse of depression, medicines are generally prescribed for 6 to 12 months after a first-time depression. When you and your provider determine that you are better, you should expect to continue the medication for at least 4 to 6 additional months. After this, your provider may gradually taper you off your medicine.
What Can I Do To Take Antidepressants Safely
Antidepressants are generally safe when you use them correctly:
- Tell your provider about everything you take. That includes medicines, herbs, supplements, and over-the-counter medicines you take, such as pain relievers and decongestants. Be honest about recreational drugs and alcohol, too.
- Try to get all your medicines from the same pharmacy. That way the pharmacist can warn you and your provider if you take medicines that may cause problems when used together.
- Follow all instructions about how to take your medicine.
- Talk with your provider if side effects bother you.
- Never stop taking antidepressants without your provider’s help. Stopping too fast may make depression come back. You could even make your condition worse. To stop antidepressants safely, you need to give your body time to get used to being without the medicine. Your provider can tell you the safest way to go off an antidepressant.
NIH: National Institute of Mental Health
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Help For Depression And Addiction
Treatment for SUD and depression often involves a combination of behavioral therapies, medication , psychoeducation, and peer support. When seeking treatment, its crucial that patients find help at a facility equipped to treat co-occurring disorders alongside addiction. Through treatment, patients can:
- Safely withdraw from substances in medical detox.
- Learn ways to avoid and cope with triggers.
- Build healthy relationships and form a support network.
- Repair negative thought patterns that may lead to relapse.
A more detailed breakdown of how effective treatment for co-occurring depression and addiction can be found on our page on depression and substance use disorder.
With professional help, individuals can learn to manage both their addiction and their depression so they can embrace healthier, happier lives.
Sunrise House Treatment Center in New Jersey is equipped to treat patients suffering from co-occurring disorders, providing several types of addiction treatment based on patients unique needs. Upon admission, clinicians form a personalized treatment plan for each patient.
Call to speak to one of our admissions navigators to learn more about how we can help you or a loved one reach your recovery goals. Call now to learn more about your rehab payment options or verify your insurance for treatment.
Are Other Medicines Used With The Antidepressants
Other medicines may be prescribed in addition to antidepressants, particularly in treatment resistant depression. Here are examples of medicines that may be used to augment as an add-on to antidepressant treatment.
- Several specific antipsychotic medications have been shown to enhance the effects of an antidepressant when an initial response is poor. These include aripiprazole , brexpiprazole , and quetiapine . Symbyax, a combination of the antipsychotic drug olanzapine and an SSRI , is approved for treatment-resistant depression or depression in people with bipolar disorder.
- Lithium carbonate, usually thought of for its mood stabilizing effects in bipolar disorder, has also long been considered a useful add-on treatment to antidepressants for people with major depressive disorder.
- Stimulant medicines or methylphenidate ) are sometimes used “off label” as add-on treatments for some forms of depression.
- Buspirone , an anti-anxiety medicine, also is sometimes useful for depression when added to an antidepressant drug.
- Your doctor may recommend or prescribe other medications or supplements not FDA approved for use in depression.
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What Are The Differences Between Antidepressants
There are distinct differences between the different classes of antidepressants available because they all work in a different way. In addition, within each class, there are differences between individual antidepressants with regards to how long they remain in the body, how they are metabolized, and how much they interact with other medications.
What Are Natural Antidepressants
Natural antidepressants are remedies that are not prescription medications for depression. They may be helpful in improving mood but should not be used to self-manage clinical depression without the supervision of a doctor.
Exercise and pleasurable activities are natural ways to improve mood. Exercise increases the levels of endorphins which can elevate mood. Foods high in omega-3-fatty acids may increase serotonin levels in the brain and contribute to relieving depression. During the winter months, some people may suffer from seasonal depression. Increasing exposure to light alleviates seasonal depression.
Several supplements are promoted for improving depression. Examples include St. John’s wort, 5-hydroxytryptophan , SAMe, fish oil, and L-theanine. Although these supplements may have mild antidepressant properties, it is important to remember that depression is a serious condition that needs proper evaluation and treatment under the care of a physician. It is also important to note that these supplements are not regulated by the FDA their safety and efficacy have not been proven in large clinical studies, and they may interact with other drugs.
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How Well Can Antidepressants Prevent Relapses
Antidepressants are usually taken for one to two years, and sometimes longer, to prevent relapses. Relapse prevention may be a good idea for people who
- have already had several relapses,
- absolutely want to avoid a relapse, or
- have chronic .
Studies involving adults have shown that taking commonly used antidepressants such as TCAs, SSRIs or SNRIs can lower the risk of relapses, but can’t completely prevent them:
- Without preventive treatment: About 50 out of 100 people who took a placebo had a relapse within one to two years.
- With preventive treatment: About 23 out of 100 people who took an antidepressant had a relapse within one to two years.
In other words, taking an antidepressant over a long period of time successfully prevented a relapse in an average of 27 out of 100 people.
Which Type Of Antidepressant Is Right For Me
Our bodies and brains all work differently. That means one antidepressant won’t work for everyone. You may need to try two or more medicines before you find one that works for you.
Your provider will work with you to choose the best option to try first. You’ll consider questions such as:
- Which symptoms bother you most? Some antidepressants may do a better job helping specific symptoms, such as trouble sleeping.
- What other medicines and supplements do you take? Some antidepressants can cause problems if you take them with certain medicines and herbs.
- Did a certain antidepressant work well for a close relative? An antidepressant that helped a parent, brother, or sister could be a good choice for you, too.
- Do you have other health conditions? Certain antidepressants can make some other conditions better or worse. Any other conditions that you have will be part of choosing your depression treatment.
- Are you pregnant, planning for pregnancy, or breastfeeding? If so, your provider will help you find a way to treat your depression that’s safe for you and your baby.
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What Are The Different Types Of Depression Medication
More than 20 million Americans have faced depression. Mental health has become a far more prevalent topic in recent years and this is a good thing.
Depression is a treatable mental condition. If you or a loved one experiences depression or mental anxiety, there is help available.
Depression medication does help, it is not a gimmick. Reactions may vary, but medication has changed lives for the better. Many people have improved significantly due to proactive treatment.
Continue to read to learn more about depression and what depression medications are available to you.
Lifestyle Changes To Treat Depression
Exercise.Regular exercise can be as effective at treating depression as medication. Not only does exercise boost serotonin, endorphins, and other feel-good brain chemicals, it triggers the growth of new brain cells and connections, just like antidepressants do. Best of all, you dont have to train for a marathon in order to reap the benefits. Even a half-hour daily walk can make a big difference. For maximum results, aim for 30 to 60 minutes of aerobic activity on most days.
Social support. Strong social networks reduce isolation, a key risk factor for depression. Keep in regular contact with friends and family, or consider joining a class or group. Volunteering is a wonderful way to get social support and help others while also helping yourself.
Nutrition. Eating well is important for both your physical and mental health. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. While you may be drawn to sugary foods for the quick boost they provide, complex carbohydrates are a better choice. Theyll get you going without the all-too-soon sugar crash.
Sleep. Sleep has a strong effect on mood. When you dont get enough sleep, your depression symptoms will be worse. Sleep deprivation exacerbates irritability, moodiness, sadness, and fatigue. Make sure youre getting enough sleep each night. Very few people do well on less than seven hours a night. Aim for somewhere between seven to nine hours each night.
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How Is Depression Diagnosed
If your mood has been low for a while and you are having difficulty coping with day to day activities, talk to your doctor or a trusted professional. Your doctor will ask you questions about your symptoms and your medical history and may ask you to complete a questionnaire that may help to diagnose depression or refer you to a psychiatrist.
You can also call the National Suicide Prevention Hotline at 1-800-273-8255, 24 hours a day, 7 days a week, or have an online chat . All information is confidential and free.
Ssris: The Most Frequently Prescribed Antidepressants
Selective serotonin reuptake inhibitors, or SSRIs, are the most commonly prescribed antidepressant class.
Although it is not clear how these drugs treat depression, these drugs are known to prevent the uptake of serotonin into cells.
These are the SSRIs currently approved by the FDA to treat depression:
Although MAOIs can sometimes help people who do not respond to other antidepressants, they are not widely used today because of their potential side effects and interactions with certain foods and beverages as well as other drugs.
For example, for people taking MAOIs, ingesting large amounts of the compound tyramine could cause dangerously high blood pressure.
You may also experience serious reactions if you take an MAOI with various medications, including:
- Other prescription antidepressants
- Cold and allergy drugs
- Herbal supplements
On rare occasions, MAOIs and other serotonin-containing drugs can cause a potentially life-threatening condition called serotonin syndrome. You may be at risk if you take too much of a serotonin-containing antidepressant, or if you combine an MAOI with another prescription antidepressant, certain pain or headache medications, or St. Johns wort .
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Therapy And The Big Picture In Depression Treatment
One of the hallmarks of depression is feeling overwhelmed and having trouble focusing. Therapy helps you step back and see what might be contributing to your depression and how you can make changes. Here are some of the big picture themes that therapy can help with:
Relationships.Understanding the patterns of your relationships, building better relationships, and improving current relationships will help reduce isolation and build social support, important in preventing depression.
Setting healthy boundaries. If you are stressed and overwhelmed, and feel like you just cant say no, you are more at risk for depression. Setting healthy boundaries in relationships and at work can help relieve stress, and therapy can help you identify and validate the boundaries that are right for you.
Handling lifes problems. Talking with a trusted therapist can provide good feedback on more positive ways to handle lifes challenges and problems.
How Many People Take Antidepressants
According to an August 2017 report by the National Center for Health Statistics , almost 13 percent of Americans age 12 and older take antidepressants, drugs that work by acting on specific brain chemicals that are involved in regulating mood.
Antidepressant use increased nearly 65 percent between 1999 and 2014.
Women with depression are nearly twice as likely as men to be taking these medications, the NCHS found, with 16.5 percent of females using antidepressants compared with just under 9 percent of males.
The study found evidence that people frequently take antidepressants long-term, with one-fourth of those who take antidepressants doing so for 10 years or more.
Another study by the NCHS, published in May 2019, found that antidepressants are the most commonly used prescription drug type for adults between ages 20 and 59 .
In addition to depression, antidepressants are sometimes used for other health conditions, such as anxiety, pain, and insomnia. Although antidepressants have not been approved by the U.S. Food and Drug Administration as a treatment for attention deficit hyperactivity disorder , doctors sometimes prescribe them off-label to alleviate ADHD in adults.
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Depression Is Different From Sadness Or Grief/bereavement
The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being depressed.
But being sad is not the same as having depression. The grieving process is natural and unique to each individual and shares some of the same features of depression. Both grief and depression may involve intense sadness and withdrawal from usual activities. They are also different in important ways:
- In grief, painful feelings come in waves, often intermixed with positive memories of the deceased. In major depression, mood and/or interest are decreased for most of two weeks.
- In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.
- In grief, thoughts of death may surface when thinking of or fantasizing about joining the deceased loved one. In major depression, thoughts are focused on ending ones life due to feeling worthless or undeserving of living or being unable to cope with the pain of depression.
Grief and depression can co-exist For some people, the death of a loved one, losing a job or being a victim of a physical assault or a major disaster can lead to depression. When grief and depression co-occur, the grief is more severe and lasts longer than grief without depression.
What Are Serotonin And Norepinephrine Reuptake Inhibitors How Do They Work
Serotonin and norepinephrine reuptake inhibitors or SNRIs are the newest class of antidepressants. SNRIs work by increasing the levels of serotonin and norepinephrine that are active in the brain. Serotonin and norepinephrine are produced by nerves and released into the surrounding tissues where they can attach to nearby receptors on other nerves, thereby stimulating the other nerves. The released serotonin and norepinephrine then are taken up and released again by the nerves that produce them. SNRIs block the uptake of the serotonin and norepinephrine so that more of the serotonin and norepinephrine are free in the tissues surrounding the nerves.
- Urinary retention: Urinary hesitation may be treated with bethanechol .
- Visual disturbances: Visual disturbances may be treated with pilocarpine eye drops.
- Sexual dysfunction:Erectile dysfunction may be managed with sidenafil , reducing the TCA dose, or discontinuing the TCA. Yohimbine, ginkgo, bethanechol, and neostigmine have also been used for managing TCA induced sexual dysfunction in some patients.
Side effects that are more serious include:
- TCAs also cause sedation. Amitriptyline , doxepin , and trimipramine are more sedating than amoxapine and desipramine . Sedation may improve after a few weeks of treatment. Sedating TCAs may be beneficial for depressed patients who have insomnia.
- Dose dependent and reversible weight gain may occur during TCA treatment. Amitriptyline causes weight gain more often than desipramine .
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