How To Know Which Antidepressant Is Best For You
When your doctor prescribes any medication, be it an antidepressant or another type of medicine, there are several considerations behind the decision.
The selection criteria are extensively diverse, given that antidepressants can have varying effects on different patients.
Below are some of the factors that can help shape the decision of your physician.
How To Use Fluoxetine Oral
Read the Medication Guide provided by your pharmacist before you start using fluoxetine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth as directed by your doctor, usually once daily in the morning. If you are taking this medication twice a day, your doctor may direct you to take it in the morning and at noon.
If you are taking fluoxetine for premenstrual problems, your doctor may direct you to take it every day of the month or just for the 2 weeks before your period through the first full day of your period. To help you remember, mark your calendar.
If you are using the liquid form of this medication, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctorâs instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.
Keep taking this medication even if you feel well. Do not stop taking this medication without first consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.
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What Are The Side Effects Of Antidepressant Medications
The provider prescribing your medicine will discuss its potential side effects with you. He or she will try to prescribe drug with the least number of side effects for your health condition. Sometimes, more than one medicine may be tried before the desired benefits are achieved.
You will be monitored closely so that your provider can detect the development of harmful side effects and make the necessary changes.
All medications not just antidepressants can cause side effects. Keep in mind that your provider prescribes the medication only if its expected benefits outweigh the risk of side effects.
Side effects, if they occur, are usually mild. Some side effects decrease after you have taken the drug for a while. However, if side effects don’t go away, they will once the drug is stopped. Be sure to discuss your concerns with your provider before taking any medicine.
Classes of antidepressant medications and common side effects
Currently there are six different classes of medications approved to treat depression. These are:
- Selective serotonin reuptake inhibitors .
- Serotonin and noradrenaline reuptake inhibitors .
- Tricyclic antidepressants .
- Norepinephrine and dopamine reuptake inhibitors .
- Non-competitive N-methyl-D-aspartate receptor antagonists.
Selective serotonin reuptake inhibitors
- Agitation.
- Increased sweating.
Non-competitive N-methyl-D-aspartate receptor antagonists
- Dizziness.
- Feeling drunk.
- Lack of energy.
Which Benzodiazepines Are Used For Anxiety
They can also be used with antidepressants initially while antidepressants take time to work.
“They’re a powerful tool,” says Duckworth, “but you have to be really smart about their use.”
- Light-headedness
- Trouble sleeping
Beta-blockers can be very helpful but in a limited way, says Dr. Salcedo. They are most commonly used for performance anxiety. They are really good for the physical symptoms such as heart racing, sweating, shakiness, but they work less well for the anxious thoughts that might be causing the symptoms.
Additional reporting by Carlene Bauer.
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Consider First Seeing A Psychiatrist
For certain new patients, there is a tendency to see a counselor or psychologist rather than a doctor for their initial mental health assessment. For certain people, this can be helpful, particularly if your case is not serious, but its sometimes not enough for others.
Health doctors are mostly just psychiatrists, which means they are qualified to administer drugs.
If your depression comes from a chemical imbalance, it wont be enough to treat you with talk therapy. Its better to see a doctor for your first visit, who can also prescribe drugs and give you psychotherapy if appropriate. This two-pronged drug and talk therapy approach are also the most helpful to patients.
Psychotherapy is a general term for a range of different verbal and therapeutic methods that are used through their mental health disorder or cause of underlying stress to help a person function. Psychoanalytic counseling, occupational therapy, cognitive therapy, and cognitive behavioral therapy are but are not limited to these strategies . Often, other practitioners in the area of mental health, such as psychologists and social workers, will rely on psychotherapeutic approaches and use them on their clients.
If your doctor is eligible to give you psychotherapy services, dont be surprised if, while focusing on fine-tuning your prescription, they refer you to a clinical psychologist, therapist, or certified mental health counselor.
What Type Of Doctor To See For Anxiety And Depression
In general, any physician or psychiatrist can prescribe anti-anxiety medication.
However, you must see a doctor in person for anxiety medications that are classified as controlled substances. Online doctors cannot prescribe benzodiazepines, such as Xanax.
That said, online doctors can prescribe antidepressants, which are the first line of treatment for anxiety and have been proven to be highly effective. They also have less side effects and risk factors than benzodiazepines.
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Serotonin Norepinephrine Reuptake Inhibitors
Serotonin Norepinephrine Reuptake Inhibitors or SNRIs are another type of antidepressant medication, according to an article published in the journal,
They are typically prescribed to treat depression, but also can be used for anxiety and certain pain disorders.
Like SSRIs, SNRIs block the reabsorption of serotonin and raise the level of active serotonin in your system. Additionally, they stop the reabsorption of norepinephrine, a neurotransmitter.
Commonly prescribed SNRIs include Cymbalta® and Effexor® . Talk to your healthcare provider about prescribing an SNRI for the treatment of anxiety and about any side effects.
Pharmacotherapy Of Anxiety Disorders: Current And Emerging Treatment Options
- 1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- 2Silver Hill Hospital, New Canaan, CT, United States
- 3Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- 4Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- 5Department of Psychiatry and Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- 6Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- 7Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
- 8Department of Psychiatry, New York University School of Medicine, New York, NY, United States
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Who Can Prescribe Anxiety Medication
If you’re looking to get a prescription for anxiety medication, no matter what type of anxiety you have, it may be more available to you than you’d think. A licensed psychiatrist or your general healthcare provider can prescribe the medication for you if they feel the fit is right.
You also have the option of online psychiatry right here on the Hims platform.
Ssri For Anxiety And Depression
Selective serotonin reuptake inhibitors are a class of medications most commonly prescribed to treat depression. They are often used as first-line pharmacotherapy for depression and numerous other psychiatric disorders due to their safety, efficacy, and tolerability.
SSRI for anxiety medications works on serotonin, an important neurotransmitter that plays a role in feelings of well-being and happiness, as well as thinking, memory, sleep, digestion, and circulation.
SSRI for Anxiety currently has FDA labeled indications to treat the following conditions:
- Major depressive disorder
- Post-traumatic stress disorder
- Social anxiety disorder
Other off-label uses include but are not limited to: Binge eating disorder, Body dysmorphic disorder, fibromyalgia, premature ejaculation, paraphilias, autism, Raynaud phenomenon, and vasomotor symptoms associated with menopause.
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Other Conditions Or Medications
Some medications can interact with antidepressants, so your doctor will need to know what other medicines youre taking including over-the-counter drugs, prescription medications, vitamins, or supplements before prescribing a drug to treat depression.
In addition, your doctor will consider if you have any other conditions that may react or counteract the prescriptions. Some antidepressants might aggravate existing conditions such as Type 1 or Type 2 diabetes, cardiovascular disease, or liver problems.
I Need Relief And I Need It Now
So where does that leave you if youre suffering? Even when anxiety relief comes with side effects and dangers, that can still sound like a fair trade when panic and fear are ruling your life.
The bottom line is that theres a time and place for anxiety medication. If you have severe anxiety thats interfering with your ability to function, medication may be helpfulespecially as a short-term treatment. However, many people use anti-anxiety medication when therapy, exercise, or other self-help strategies would work just as well or better, minus the drawbacks.
Anxiety medications can ease symptoms, but theyre not right for everyone and theyre not the only answer. Its up to you to evaluate your options and decide whats best for you.
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Why Anxiety And Depression Are Linked
Are anxiety and depression the same? No, but they share many similarities and connections.
Anxiety and depression often occur together. According to the Anxiety and Depression Association of America, nearly 50 percent of people with depression also have an anxiety disorder. Co-occurrence is prevalent because anxiety frequently causes depressed states and major depressive disorder can result in anxiousness.
Drug Interactions And Overdose
While benzodiazepines are relatively safe when taken only occasionally and in small doses, they can be dangerous and even deadly when combined with other central nervous system depressants. Always talk to your doctor or pharmacist before combining medications.
Dont drink on benzodiazepines. When mixed with alcohol, benzodiazepines can lead to fatal overdose.
Dont mix with painkillers or sleeping pills. Taking benzodiazepines with prescription pain or sleeping pills can also lead to fatal overdose.
Antihistamines amplify their effects. Antihistaminesfound in many over-the-counter sleep, cold, and allergy medicinesare sedating on their own. Be cautious when mixing with benzodiazepines to avoid over-sedation.
Be cautious when combining with antidepressants. SSRIs such as Prozac and Zoloft can heighten benzodiazepine toxicity. You may need to adjust your dose accordingly.
Paradoxical effects of benzodiazepines
The benzodiazepines work because they slow down the nervous system. But sometimes, for reasons that arent well understood, they have the opposite effect. Paradoxical reactions are most common in children, the elderly, and people with developmental disabilities. They include:
- Increased anxiety, irritability, agitation, aggression, and rage
- Mania, impulsive behavior, and hallucinations
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Different Types Of Depressive Disorders
While there are many types of depressive disorders, they all share certain signs and symptoms. Different types of depressive disorders can be classified according to their severity, duration, and symptoms. The most common types of depressive disorders are major depression, dysthymia , bipolar disorder, seasonal affective disorder , postpartum depression, and premenstrual dysphoric disorder .
Serotonin And Noradrenaline Reuptake Inhibitors
If SSRIs don’t help ease your anxiety, you may be prescribed a different type of antidepressant known as a serotonin and noradrenaline reuptake inhibitor .
This type of medicine increases the amount of serotonin and noradrenaline in your brain.
Examples of SNRIs you may be prescribed include:
SNRIs can also increase your blood pressure, so your blood pressure will be monitored regularly during treatment.
As with SSRIs, some of the side effects are more common in the first 1 or 2 weeks of treatment, but these usually settle as your body adjusts to the medication.
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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
Medications For Depression: Which Is Best
There are many medications that can be used to treat mood disorders. But finding the right one can be a lengthy process, and the choice can be more complicated than you might imagine. Just because a particular drug worked for a friend doesn’t mean it will work for you. Psychiatrists and doctors who prescribe antidepressants choose a particular drug and dosage based on many factors, including the following:
To learn more strategies for battling depression, check out Understanding Depression, a Special Health Report from Harvard Medical School.
Image: Getty Images/eternalcreative
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On And Off Label Uses
The off-label use of an approved drug is used to treat a condition that it is not intended for. Physicians who prescribe a medication that the FDA has approved for a given condition are considered to be using it on-label.
Some doctors are more likely to prescribe off-label medications than others. Your doctor will try to find one with the fewest side effects. Remember that Off-label does not mean that medication will not be helpful.
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- Inhale into a soft belly, taking in light, love, and healing energy. Picture this as clear, bright, or sparkling. Feel yourself becoming brighter as you fill with light and joy.
- Exhale fully, releasing any negative states or feelings. You may picture it as darkness or a fog. If you have anger, fear or sadness, breathe them out. If you have tension, anxieties, or worry, release them as you exhale.
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Should You Think About Online Therapy Top Rated Anxiety Depression Medications
Online therapy is a fairly new fad in mental health care. Nevertheless, some of one of the most respectable organizations in the United States, including Harvard University as well as Johns Hopkins University, are now being provided.
Similar to any kind of new modern technology, both advantages and also dangers are related to online therapy. On the one hand, it may be easier for some people that work lengthy hours or have mobility concerns. It may likewise be cheaper for those without insurance protection. Nevertheless, on the other hand, there are concerns concerning personal privacy as well as discretion that include these sessions particularly if your specialist lives outside of your nation or you stay in a nation where online therapy is illegal.
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Escitalopram May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- constipation
- drowsiness
- difficulty falling asleep or staying asleep
- increased sweating
- problems with thinking, concentration, or memory
- difficult or painful urination
Escitalopram may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
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What Are The Warnings/precautions/side Effects Of Anti
Antidepressants
Anxiolytics
- Benzodiazepines should not be abruptly stopped because of the risk of seizures and other serious side effects. It is dangerous to combine benzodiazepines with other central nervous system depressants, including alcohol. Doing so may cause profound drowsiness and/or impair breathing. Those who have breathing difficulties such as sleep apnea or chronic obstructive pulmonary disease should not use benzodiazepines.
- Benzodiazepines frequently cause drowsiness therefore, care should be taken when operating machinery or motor vehicles.
- Side effects of antihistamines include drowsiness and dry mouth.
Anticonvulsants
Beta-Blockers
- Beta-blockers should not be withdrawn suddenly because severe cardiac problems, including heart attacks, may occur. Beta-blockers also should not be used in patients with certain breathing disorders, including bronchitis and emphysema.
- Beta-blockers can mask signs and symptoms of hypoglycemia and overactive thyroid disease. Dizziness and drowsiness can occur with beta-blockers.
Alpha-Blockers
- The alpha-blocker prazosin can cause dizziness and lightheadedness, both common side effects. Early in treatment, fainting can occur, especially when standing up.
- The alpha-blockers clonidine and guanfacine may cause dry mouth, drowsiness, dizziness, constipation, sedation, and weakness.
Antipsychotics