What Are Monoamine Oxidase Inhibitors What Are The Side Effects
Monoamine oxidase inhibitors or MAOIs were the first class of antidepressants to be developed. They fell out of favor because of concerns about interactions with certain foods and numerous drug interactions. MAOIs elevate the levels of norepinephrine, serotonin, and dopamine by inhibiting an enzyme called monoamine oxidase. Monoamine oxidase breaks down norepinephrine, serotonin, and dopamine. When monoamine oxidase is inhibited, norepinephrine, serotonin, and dopamine are not broken down, increasing the concentration of all three neurotransmitters in the brain.
Monoamine oxidase also breaks down tyramine, a chemical present in aged cheese, wines, and other aged foods. Since MAOIs inhibit monoamine oxidase, they decrease the breakdown of tyramine from ingested food, increasing the level of tyramine in the body. Excessive tyramine can elevate blood pressure and cause a hypertensive crisis. Patients treated with MAOIs should adhere to recommended dietary modifications that reduce the intake of tyramine. Interestingly, the 6 mg/24 hour dose of selegiline transdermal system does not require dietary restrictions because at this dose EMSAM does not substantially inhibit tyramine. Higher selegiline transdermal system doses require dietary restrictions.
What are the side effects of MAOIs?
Symptoms of hypertensive crises include
Other side effects and adverse events of MAOIs include:
Sexual side effects may diminish with time or a reduction in dose.
Overview Of Antidepressant Medications
Antidepressant medications are kinds of medication used to treat clinical depression in affected patients.
These antidepressant medications have been utilized for over-the-counter usage which means that these medications have been used to treat other psychological disorders other than depression and these are the following psychological disorders.
- Some obsessive symptoms of obsessive-compulsive disorder
- Symptoms of restlessness in generalised anxiety disorder
- Some re-experiencing symptoms in post-traumatic stress disorder
Some of these kinds of medications such as amitryptiline are used to cure chronic back pain in some affected people.
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.
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Interactions That Increase The Risk Of Side Effects
Taking certain medications with sertraline may result in increased side effects. These drugs include:
- Nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen, aspirin and warfarin. Taking these drugs with sertraline increases your risk for bleeding or bruising.
- Triptans such as sumatriptan. Your risk for serotonin syndrome is increased when you take these drugs with sertraline. Your doctor should watch you closely if you take these drugs together.
- Lithium. Taking this drug with lithium increases your risk for serotonin syndrome.
- Serotonergic medications such as fentanyl, tramadol, and St Johns wort. Taking these drugs with sertraline increases your risk for serotonin syndrome.
- Cimetidine. Taking cimetidine with sertraline may cause a build-up of sertraline in your body. Your dose of sertraline might need to be lowered if you take it with cimetidine.
- Tricyclic antidepressants such as amitriptyline, desipramine, and imipramine. Taking sertraline with these drugs may cause these drugs to build up in your body. Your doctor may need to adjust your dosage of tricyclic antidepressants while you take sertraline.
Sertraline oral tablet comes with several warnings.
How Soon Will I Feel Better
If you have depression, it will probably be one to 2 weeks after starting the medicine before you begin to feel better, so do not be discouraged if things do not improve straight away. It may take 6 weeks or longer for you to feel the full benefit of antidepressant treatment. Also, some of your symptoms might get better sooner than others if you have sleeplessness, for example, this might go away before another symptom, such as your mood improves.
If you think your antidepressant medicine is not working for you, see your doctor. Your doctor may recommend increasing the dose. If there is still no improvement after a few weeks, youll most likely need to try a different antidepressant. To avoid interactions between the different antidepressants, you may have to wait a couple of days to 2 weeks before switching to your new antidepressant, depending on the medicines used. This is called a washout period. Some people may need to try several different medicines and doses before they find the one that works for them.
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Dosage For Premenstrual Dysphoric Disorder
Adult dosage
The typical starting dose is 50 mg per day, throughout your menstrual cycle.
Child dosage
The use of this drug to treat children with this condition has not been studied. It should not be used in people younger than 18 years.
Senior dosage
The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk for side effects. Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Sertraline May Interact With Other Medications
Sertraline oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs youre taking. To find out how this drug might interact with something else youre taking, talk to your doctor or pharmacist.
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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
What Are Mood Stabilizers
Mood stabilizers are used primarily to treat bipolar disorder, mood swings associated with other mental disorders, and in some cases, to augment the effect of other medications used to treat depression. Lithium, which is aneffective mood stabilizer, is approved for the treatment of mania and the maintenance treatment of bipolar disorder. A number of cohort studies describe anti-suicide benefits of lithium for individuals on long-term maintenance. Mood stabilizers work by decreasing abnormal activity in the brain and are also sometimes used to treat:
- Depression
- Schizoaffective Disorder
- Hair loss
These medications may also:
- Cause damage to the liver or pancreas, so people taking it should see their doctors regularly
- Increase testosterone levels in teenage girls and lead to a condition called polycystic ovarian syndrome
Medications for common adult health problems, such as diabetes, high blood pressure, anxiety, and depression may interact badly with anticonvulsants. In this case, a doctor can offer other medication options.
For more information about the risks and side effects for each medication, please see .
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Side Effects Of Antidepressant Medications
All medications can have side-effects. Some people experience no side-effects. Others may find the side-effects distressing. In most cases, side-effects lessen as treatment continues.
Treatment is usually started at a low dose, to minimize side-effects, and then slowly increased until the ideal dose is found. The ideal dose is one that provides the greatest benefit with minimum side-effects.
If you are experiencing side effects, check the information given to you by your doctor or pharmacist on the specific effects of any drug you have been prescribed. If side-effects are not mild and tolerable, it is best to continue taking your medication as prescribed but let your doctor know as soon as possible. Your doctor may:
- encourage you to wait a little longer for the side-effects to fade
- adjust your dose
- suggest you take the medication at a different time of day
- prescribe other medications to help control side-effects
- change your medication
- stop medication treatment and suggest a different type of treatment approach.
Side-effects vary depending on the type of medication. More information on side-effects is included for each type of types of antidepressant.
You can help to control possible side-effects on your own by:
Do antidepressants increase the risk of suicide?
Before starting treatment, prepare for the possibility of feeling worse before you feel better. Know what supports are available to you and who you can call.
The Government Of Canada’s Role
Health Canada regulates drugs like antidepressants under the Food and Drugs Act. We review scientific information about the safety and efficacy of drugs before they are allowed to be sold in Canada.
Health Canada also monitors the safety of health products after they have been approved for sale in Canada. Manufacturers must provide Health Canada with reports of serious side effects for the health products they sell in Canada and maintain the most up-to-date information on their health products. Important drug safety information is available in its official Canadian product monograph, available by search of Health Canada’s Drug Product Database.
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Selective Norepinephrine Reuptake Inhibitors
Serotonin norepinephrine reuptake inhibitors work by blocking the reabsorption of the neurotransmitters serotonin and norepinephrine in the brain. They may also have an effect on other neurotransmitters.
Serotonin-Norepinephrine Reuptake inhibitors include desvenlafaxine , duloxetine , venlafaxine , venlafaxine XR , milnacipran , and levomilnacipran .
Side effects most common to the class of SNRIs include nausea, dizziness, and sweating. SNRIs, particularly duloxetine, venlafaxine, and desvenlafaxine may cause sexual dysfunction. Other side effects include tiredness, constipation, insomnia, anxiety, headache, and loss of appetite.
Significant Warnings
- Abnormal bleeding
- Suicidal thoughts or behavior: All antidepressants may increase the risk of suicidal thoughts or behavior in children, adolescents, and young adults .
Contraindications
Duloxetine and milnacipran should not be used in patients with uncontrolled narrow angle or angle-closure glaucoma.
First Top 10 List For Antidepressants
Doctors hope to cut out the guesswork in prescribing antidepressants.
Now, a few psychiatrists have set out to bring some order to this educated guessing game. By looking at 117 studies of the 12 most popular antidepressants, researchers ranked the top 12 drugs in the journal The Lancet.
To view their results, click here.
Zoloft and Lexapro came in first for a combination of effectiveness and fewer side effects, followed by Prozac , Paxil , Cymbalta, and Luvox among others.
“We were surprised because we found a difference among antidepressants,” said Dr. Andrea Cipriani of the University of Verona, Italy, and a co-author on the study.
“What we usually said was that all antidepressants worked the same,” said Cipriani, who explained that doctors often compare different side effects while choosing an antidepressant.
“So, is there a rationale, is there a hierarchy?” Cipriani asked.
Now, he hopes the ranking will offer more guidance for doctors choosing the first antidepressant for a patient.
Although many psychiatrists are leery of the list, patients who’ve gone through years of distressing trial and error might find it comforting.
“When I first was diagnosed with depression, they tried all sorts of medication,” said Paul Letourneau, 67. “It was terrible.”
His rollercoaster emotions landed Letourneau in the hospital on suicide watch four times in two years.
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Common Side Effects Of Antidepressants
Antidepressants can improve the symptoms of depression, but, like all medications, they can also cause side effects. The frequency and severity of these side effects vary depending on the class of medication you’re taking.
Common side effects of antidepressants include:
- Constipation
- Sleep disturbances
- Weight gain
Antidepressants may also increase the risk of suicidal thinking and behavior , especially during the first few months of treatment, or when your dose is increased or decreased. Teens and young adults are especially at risk and should be monitored closely.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
Side effects tend to be mild and go away as your body adjusts to the medication. If your side effects are severe or last for longer than a few weeks, your doctor may adjust your dosing or recommend a different antidepressant.
If and when you and your doctor decide to stop your medication, it’s important to wean off of most antidepressants slowly. If you suddenly stop taking one you can have withdrawal symptoms, such as mood swings, dizziness, flu-like symptoms, and headaches.
How Antidepressants Are Thought To Work
Chemicals like serotonin, norepinephrine and dopamine are naturally present in our bodies. They are needed for normal brain function. In people with depression, it is thought that there may be an imbalance of these chemicals in the brain. Antidepressants are believed to work by bringing one or more of these chemicals back into balance.
There are many types of antidepressants on the market. Talk to your health care provider to see if taking antidepressants is the best choice for you, and if so, which one you should take.
Many people see an improvement with the first antidepressant they use. But you may need to try another type, a higher dose or a combination of drugs to find what works best for you. Also, it may take up to a month to notice the full benefit of the drug.
Even once you start to feel better, keep taking the antidepressant as directed by your health care provider. Most people take antidepressants for at least 6 to 12 months, and some for longer. Make sure you talk to your health care provider before you stop using yours.
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More Common Side Effects
The adult side effects for this drug are slightly different from the side effects for children. Side effects for adults and children can include:
- nausea, loss of appetite, diarrhea, and indigestion
- change in sleep habits, including increased sleepiness and insomnia
- increased sweating
- aggressiveness
- heavy menstrual periods
- slowed growth rate and weight change. You should closely watch your childs height and weight while they take this drug.
If these effects are mild, they may go away within a few days or a couple of weeks. If theyre more severe or dont go away, talk to your doctor or pharmacist.
Are There Differences Among Antidepressants
Antidepressants differ in their effects on neurotransmitters, established uses, adverse effects and drug interactions. All antidepressants that are used for depression are 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.
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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
Managing The Unwanted Side Effects Of Antidepressants
Some side effects, such as nausea, settle after a few weeks of being on medication. Others can be helped by making small adjustments, such as the time of day you take the medicine. Let your doctor know straight away if you are experiencing side effects, as they should be able to help.
When younger people with depression first start taking antidepressants, there can be a slightly increased risk of suicidal thoughts and behaviours. Close monitoring by your doctor is important, especially during the first few weeks of treatment.
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Antidepressants And Suicide Risk
Concerns have been raised about an increased risk of suicidal thoughts and acts when people first start taking antidepressants, or when they stop taking them.
Suicidal thoughts and acts are a common symptom of depression and may also be associated with anxiety disorders. Often, someone is at their lowest point when they first start taking an antidepressant. It can also take a few weeks for an antidepressant to work. This makes it difficult to assess whether people who think about suicide when they first start taking an antidepressant do so because of the medicine or the underlying condition.
There may be a small increase in suicidal thinking or behaviour in children, adolescents and young adults when they first start taking an antidepressant. This risk is thought to be highest in people with depression and people under the age of 30 years. However, the overall risk is small and treating depression and anxiety disorders can prevent suicidal thoughts and behaviours.
Antidepressants have only a small role in treating children, and they should be used only under the supervision of a child psychiatrist. Antidepressants should only be prescribed for adolescents by doctors with training in this area, who are very familiar with the side effects, and are able to provide close monitoring for suicidal thinking, particularly in the first 4 weeks.
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