Benefits Of Antidepressants For Depression

Serotonin And Norepinephrine Reuptake Inhibitors

SNRIs block or delay the reuptake of two neurotransmitters in the brain, serotonin and norepinephrine. By blocking reuptake, the neurotransmitter concentrations are increased in the nerve synapse to help elevate mood or treat other conditions.

These agents may also be selected as a first-line treatment option, especially in patients with more severe depression. Several generic SNRIs are now available.

Table 2: SNRIs Used for Depression

Pros and Cons of SNRIs:

• Once-a-day dosing with most formulations.
• SNRIs may be linked with more nausea and vomiting than SSRIs but this typically subsides within one week.
• SNRIs may be more effective than SSRIs in resistant or refractory depression.
• Duloxetine also approved to treat certain pain syndromes . Milnacipran also approved to treat chronic pain caused by fibromyalgia .
• Venlafaxine or other SNRIs may increase blood pressure.

See also: Serotonin norepinephrine reuptake inhibitors

Side Effects Of Antidepressants

Antidepressants can cause side effects at first, but these usually improve with time.

If you experience minor side effects, it’s important to continue treatment. This is because it can take several weeks before you begin to benefit from treatment. With time, you should find that the benefits of treatment outweigh any side effects.

During the first few months of treatment, you’ll usually see your doctor or a specialist nurse every 2 to 4 weeks. This will let them see how well the medication is working.

If you experience any severe side effects, you should let your specialist know.

For more information about your specific medication, see the patient information leaflet. This will be in the box with your medication.

Common side effects of SSRIs and SNRIs can include:

• feeling agitated, shaky or anxious
• feeling and being sick

What Are The Benefits

While there are differing views on how well antidepressants work, they are considered a key part of treating depression. Antidepressants are prescribed to relieve symptoms and reduce the chance that theyll come back. They help with emotional balance and reduce symptoms like restlessness, anxiety and suicidal thoughts.

As antidepressants work to help treat your depression, they, in turn, can help you sleep better. Depression can sometimes make it difficult to fall asleep or to stay asleep. Unfortunately, not getting enough sleep can then make depression worse.

Antidepressants can also restore your ability to concentrate and improve your sleep, which can suffer when you have depression, says Dr. Caputo. In this way, they help to break the cycle since not eating well and lack of sleep can make depression worse.

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Other Things To Be Aware Of

To take your medication safely:

• Tell your doctor if you are taking other medications.
• Ask your doctor if your antidepressant is affected by food.
• Store your antidepressants in a box, away from children in a cool, dry place.
• Donât share your antidepressants with other people.
• Take the recommended dose.
• Continue to take medication even when you are feeling better until you have discussed stopping with your doctor.
• Cut down or stop alcohol consumption, as this can reduce the benefits of antidepressants and in some cases can be very dangerous.

Do The People In The Studies Resemble Me

Many of the people in antidepressant trials were recruited by advert. A lot were volunteered by their doctor rather than volunteering themselves. None gave informed consent. Some didnt exist.

If you are severely depressed there were almost no people with severe depression. If you are being treated for another condition in addition to depression or anxiety, there were few people like you in the trials.

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The Elephants In The Room

First, very little information was available to describe the sample. The authors provided data on only age, sex , race and ethnicity , marital status, family income level, and insurance coverage. There was no information about clinical variables such as type of depressive disorder, duration of illness, number of previous episodes, antidepressant drugs used, adequacy of dosing, presence of medical and psychiatric comorbidities, smoking, drinking, and use of other substances, and so on, all of which could influence the outcome variable, HRQoL. Information was not even available about whether, in the antidepressant group, medications were used throughout the 2-year follow-up period. Considering that subjects in the sample had not been randomized to their respective cohorts, it is very likely that the cohorts differed substantially in important ways for example, subjects receiving antidepressants could have been more severely ill, more chronically ill, and more likely to have had life events secondary to severe or chronic depression. All of these could have prejudiced the antidepressant cohort to worse HRQoL outcomes. Therefore, in the adjusted analysis presented by the authors, there was almost no adjustment for the variables that really mattered.

Are There Interactions Between Antidepressants Depression And Marijuana Use

Many clinicians believe that marijuana use interferes with the benefits of antidepressant medication. There is an association between marijuana use and depression, but it is not clear if this is a cause-and-effect relationship. If you stop using marijuana for a while, this can help determine if it is contributing to your depression.

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If You Feel Better Can You Stop Taking Antidepressants

Once you and your provider have determined it is safe for you to stop taking your medicine altogether, you should continue to be monitored during periodic follow-up appointments to detect any signs of depression returning.

Long-term treatment with antidepressant medicine may be recommended to prevent further episodes of depression in people who have already had two or more episodes of major depression. A history of depression in ones family is another factor that supports long-term treatment.

Last reviewed by a Cleveland Clinic medical professional on 05/24/2019.

References

What Are The Benefits Of Antidepressants

Research shows that people who take antidepressants experience improvements in their depression, as well as subtle, but significant, improvements in quality of life. They report feeling less reactive to difficult life events, having fewer negative obsessive thoughts, and they can pause and consider their feelings and actions in a more balanced way. They also report they can let go of negative thought patterns more easily and they feel less haunted by past traumatic events.

People taking antidepressants may have more energy, may sleep better and may concentrate better. Antidepressants are also effective for reducing panic attacks, general worries, and anxiety.

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What Are The Different Types Of Antidepressants

There are many types of antidepressants. Each one works differently. Providers usually prescribe newer antidepressants first because they don’t cause as many side effects as older types. They also seem to help more kinds of depression and anxiety problems.

Most of the newer antidepressants belong to one of these three groups:

• Selective serotonin reuptake inhibitors
• Serotonin and norepinephrine reuptake inhibitors
• Atypical antidepressants, which are newer antidepressants that don’t fit into the other groups

If these antidepressants don’t help, your provider might suggest one of the older antidepressants. The older types include tricyclic antidepressants , tetracyclics, and monoamine oxidase inhibitors . Even though these antidepressants may cause more serious side effects, the benefits may outweigh the risks for some people.

When To Talk With A Doctor

When you first start discussing reducing your antidepressant dose with your doctor, youll also want to ask them what you can expect. Knowing possible side effects of getting off your antidepressant can help you be prepared.

Ask them about the types of symptoms that may occur that would require calling a doctor or seeking medical help.

For some symptoms, such as thoughts of self-harm or suicide, you should seek crisis interventions or emergency help right away.

Theres some evidence that suggests that suddenly stopping antidepressants can result in depression symptoms sometimes ones that are even worse than before.

If at any time youre not sure if a symptom is normal or safe, you should contact a healthcare provider. They can advise you if you should start taking your medicine again and in what dosage, or discuss an alternative plan.

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Should You Treat Your Depression With Medications

You might be asking your healthcare provider this question if you have been feeling low and your friends and family have mentioned this to you. Your provider might have mentioned medication if your mood interferes with work, family or socializing for more than two weeks. Some people with depression might even have legal troubles linked to outbursts.

Side Effects May Be Misdiagnosed

Your doctor may misdiagnose some side effects as stemming from your condition. Suicidality, anxiety, change of personality, sexual dysfunction, insomnia almost anything can be portrayed as a feature of depression. It is important to recognize the differences, which can be difficult. These side effects ambush people, the way pre-menstrual tension does often you only make the connection after the difficulty has cleared up. A trial of stopping treatment may be the only way to work out what is going on.

The same problem faces people with asthma whose drugs may cause respiratory side effects or people with bowel conditions like Crohns disease whose treatment may cause gut side effects. Even if you become convinced of a link, you may find your doctor difficult to persuade. Prescription drugs are always innocent and patients guilty. In contrast, street or over the counter drugs are always guilty.

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Can Antidepressants Give You Suicidal Thoughts

In 2004, the FDA issued a black box label warning for suicidal ideation among 18- to 24-year-olds for common antidepressant drugs. This warning is the FDAs strictest warning for labeling prescription drugs.

The effect of suicidal thoughts is most common with SSRIs, occurring in about 4% of people who take them. However, untreated depression is considered to be much more of a suicide risk than taking antidepressants.

Depression And Your Children

Like adults, children and teens can also feel depressed. You should watch your children for signs of depression. Talk to your children if you notice changes in their behavior. Talk to your childs healthcare provider if you are still concerned.

Prozac is the only medicine that is approved by FDA for use in children with depression. Prozac and Lexapro are the only FDA-approved medicines for teens with depression. Talk to your healthcare provider about important warnings for children and teens who take medicine for depression.

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Excavating The Truth About Who Benefits From Antidepressants

Peter D. KramerJuly 11, 2016

Do antidepressants ease depression and, if so, for whom? In my work as a psychiatrist, I have seen these medications work for people with all levels of depression. But because critics have cast doubt on the worth of antidepressants, I have spent five years combing through the research. One thing I have learned is that the media, consumers, and perhaps even editors of medical journals are more interested in the drugs shortcomings than their strengths.

Major depression is a common and debilitating disorder. It affects peoples ability to function at home and in the workplace. It is a progressive condition that can lead to harmful changes in organs ranging from hormone-producing glands to bone and the brain. It is linked to shortened life spans. Theres a spectrum of major depression, but even the least grave form, mild major depression, is highly debilitating.

The past 20 years have seen the severity hypothesis the notion that antidepressants have a limited range crop up in all sorts of forms. Conflicting studies have shown that medication works best for mild depression, severe depression, and midrange disorders. What made the results unconvincing was that most research focused on the gravest conditions. Few trials were designed to look directly at mild major depression.

How Long Do Antidepressants Take To Work

Antidepressants usually take 4 to 8 weeks to work, so you’ll need to be patient. You may notice that some problems, such as sleeping and eating, get better before your mood improves. That’s a good sign. You may just need to give the medicine a little more time to do its job.

Sometimes an antidepressant helps at first, but symptoms return while you’re still taking it. But there’s usually another one you can try. To get more relief from depression, your provider may suggest combining two antidepressants, using another kind of medicine with an antidepressant, or adding talk therapy or other approaches to improve your mental health.

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If You Choose To Stop You Cant Stop Abruptly

If you decide to stop taking antidepressants, abrupt stopping is not recommended, as withdrawal symptoms can occur. Dont stop taking your medication until youve talked with your doctor. They might put you on a tapering plan or switch you to a new medication. They can also monitor you for any withdrawal symptoms.

Depression: How Effective Are Antidepressants

Like psychotherapy, antidepressants are a key part of treating . They aim to relieve symptoms and prevent depression from coming back.

Opinions vary on how effective antidepressants are in relieving the symptoms of . Some people doubt that they work well, while others consider them to be essential. But, like with many other treatments, these medications may help in some situations and not in others. They are effective in moderate, severe and chronic depression, but probably not in mild cases. They can also have side effects. It is important to discuss the pros and cons of antidepressants with your doctor.

The main aim of treatment with antidepressants is to relieve the symptoms of severe , such as feeling very down and exhausted, and prevent them from coming back. They are meant to make you feel emotionally stable again and help you to follow a normal daily routine. They are also taken to relieve symptoms such as restlessness, anxiety and sleep problems, and to prevent suicidal thoughts.

This information is about using medication to treat the most common form of , known as unipolar depression. The treatment options for manic depression aren’t discussed here.

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Medical Treatments For Depression

The cornerstone treatments for depression are prescription antidepressants and talk therapy with a trained specialist — and they are often used together most effectively.

The Veterans Health Administration in their 2022 guidelines state either psychotherapy and / or single drug treatment is recommended as an initial treatment choice for most patients with uncomplicated major depressive disorder, based on patient preference.

• Drug therapy used in treatment involves medications that alter the chemical messengers in the brain.
• It generally takes four to eight weeks for most patients to feel the full effects of antidepressant medications, but partial relief may occur sooner.
• Many patients will need to continue antidepressant medications for six months to a year, or longer.

No single antidepressant medication has been found to be the best treatment for every patient. In general 40% to 60% of patients will have a positive response to the first antidepressant medication they try.

Second generation antidepressants such as selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are used preferentially over first generation antidepressants like tricyclic antidepressants or monoamine oxidase inhibitors because of a less toxic side effect profile and better patient tolerability.

In addition to depression, certain antidepressants may also be used to treat a range of other conditions, for example:

• QT prolongation

Pros and Cons of SSRIs:

Combination Of Antidepressants And Psychotherapy

Antidepressants in combination with psychotherapy are recommended for major depressive disorder by both NICE and the American Psychiatric Association, as well as other guidelines. A non-systematic review showed that adding antidepressants to psychotherapy seemed to have a statistically significant effect, but again the effect was minimal and below the NICE criteria . At long-term follow-up, no difference between psychological and combined treatments was found. Two other reviews have shown similar results. The effects of adding antidepressants to psychotherapy seem negligible just as the effects of antidepressants when used as the only therapy.

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How Is Major Depressive Disorder Diagnosed

The diagnosis of major depressive disorder in clinical practice is based on the presence of certain symptoms according to the diagnostic criteria outlined in either the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition or the International Classification of Diseases-10th Revision. These two sets of diagnostic criteria are largely comparable. The diagnosis of depression as it is defined by these diagnostic criteria does not build on any aetiological or pathophysiological framework. The assessment according to the diagnostic criteria might be supported by a structured interview, such as the Mini-International Neuropsychiatric Interview or the Structured Clinical Interview for DSM. The conduct of these interviews may take 1560min. There are no objective tests and no laboratory test for depression or for validating the diagnosis.

Are Antidepressants Really More Effective Than Placebo

Clinicians began hearing this question from patients after news articles reported on a 2002 analysis of published and unpublished studies submitted to the U.S. Food and Drug Administration as part of the approval process for several new types of antidepressant medication. This analysis concluded that the newer types of antidepressants are only marginally more effective than placebo.

However, these analyses do not reflect how antidepressants are used in actual practice. Drug trials measure only how a person responds to a single medication taken at a specific dose for a limited time. In clinical practice, however, the patient and clinician work together to find the dose and the medication or combination of medications most effective for you. Most clinicians believe that this process results in much better results than these analyses imply.

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