How Do Antidepressants Work
The nerve cells in our brain use various chemicals to pass on signals. Even though not all details are known, experts believe that is caused by an imbalance of certain chemical messengers like serotonin, which means that signals can’t be passed along the nerves properly. Antidepressants aim to increase the availability of these chemicals. The various drugs do that in different ways.
Children And Young People
Children and young people with moderate to severe depression should first be offered a course of psychotherapy that lasts for at least 3 months.
In some cases, an SSRI called fluoxetine may be offered in combination with psychotherapy to treat moderate to severe depression in young people aged 12-18.
Do I Need Antidepressants
As with many other medications, there are benefits and risks to taking antidepressants.
They are often effective for moderate to severe depression. They can help to improve mood and increase motivation for people who may have lost interest in activities they once enjoyed. They can also help improve sleep, thinking and concentration.
Antidepressants might also help people with anxiety-related disorders like generalised anxiety disorder , eating disorders, obsessive-compulsive disorder and post-traumatic stress disorder .
However, antidepressants are not particularly effective for mild depression. Lifestyle changes and psychological treatments work better for mild depression.
The decision to start an antidepressant should be made only in consultation with a doctor.
Other medicines may also be needed as well as or instead of antidepressants. These include anti-anxiety medication or sleeping tablets.
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What About The Side Effects Of Antidepressants
Different antidepressants have different side effects and risks.
- A few people experience agitation, nausea, insomnia, headaches and sexual problems when taking SSRIs. Talk to your healthcare provider if these things happen to you. Read more about SSRIs.
- SNRIs such as venlafaxine have similar side effects to the SSRIs, and may also cause loss of appetite, sweating and rashes.
- Common side effects with mirtazapine includes weight gain and drowsiness.
- Side effects are more common with TCAs, and these can include drowsiness, blurred vision, weight gain, constipation and difficulty urinating , a dry mouth and sexual problems.
Let your doctor know if you experience any side effects while on antidepressants, so they can adjust the dose or try a different medication.
Strategies To Improve Treatment Adherence
When considering ways to help improve adherence to pharmacological treatment it starts with gaining a clear understanding of the reason or reasons why the individual is not willing to take the medication. That becomes the starting point for initiating positive change. For some patients fear is the driving motivator behind treatment noncompliance.
For example, the individual may be afraid of the side effects or fear the drug changing their personality. When these perceptions are behind the resistance to taking the medication, it helps to clearly build a case for how the medication can help alleviate the symptoms of the illness as well as avoid hospitalization. By presenting a positive attitude about the benefits of taking the medication, and educating the individual about how medications can be tweaked and changed to avoid side effects, their willingness to adhere to the treatment plan is improved.
When the reason for refusing to take medication stems from a poor relationship with a mental health provider, suggest that they interview a couple of other providers in hopes of finding a better fit. When finding a provider that the person feels they can trust, and who they believe genuinely cares about the treatment outcome, it creates a positive therapeutic relationship that can significantly improve treatment adherence.
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Other Mental Health Conditions
- multiple sclerosis
- conditions where a nerve becomes trapped, such as sciatica
Antidepressants have also been used to treat cases of chronic pain that don’t involve nerves . However, they’re thought to be less effective for this purpose. As well as TCAs, SSRIs and serotonin-noradrenaline reuptake inhibitors can also be used to treat chronic non-neuropathic pain.
Conditions that cause non-neuropathic pain which may benefit from treatment with antidepressants include fibromyalgia, chronic back pain and chronic neck pain.
What Is An Antidepressant
Antidepressants, sometimes in combination with psychotherapy, are often the first treatment people get for depression. If one antidepressant doesn’t work well, you might try another drug of the same class or a different class of depression medicines altogether. Your doctor might also try changing the dose. In some cases, your doctor might recommend taking more than one medication for your depression.
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What Side Effects Can Antidepressants Cause
Most antidepressants cause minor side effects that go away or improve in the first few weeks of treatment. If you keep taking your medicine, there is a good chance that you will start to feel less depressed and that the side effects will decrease. Most people feel that the benefits of antidepressants are well worth the price of living with some side effects.
Side effects may vary depending on the medicine you take, but common ones include:
- Nausea.
- Sexual problems .
- Headaches.
- Trouble falling asleep, or waking a lot during the night.
- Weight gain.
- Feeling nervous or on edge.
- Feeling drowsy in the daytime.
Some side effects may not go away, but usually there are ways to manage them. Talk with your doctor about how to manage side effects.
Problems with sexual arousal and a lack of interest in sex are common side effects. If this happens to you, talk to your doctor. There are other medicines that may help with these problems.
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. But not treating depression can also cause problems during pregnancy and birth. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating depression.
The U.S. Food and Drug Administration has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
What If Antidepressant Medications Are Recommended
Many new antidepressant medications improve mood, energy level, steep and anxiety problems, and have few negative side effects. Antidepressant medications are not addictive or habit-forming. A doctor/nurse will decide whether a person suffering from depression should take an antidepressant drug.
There are different types of medications to treat depression. If one type does not work, another medication may work better. Therefore, it is very important for persons being treated with depression to notify their doctor/nurse if there are questions or concerns about medication. It is also important to not stop taking a medication without consulting with your doctor/nurse.
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How Effectively Do Antidepressants Relieve The Symptoms
There are a lot of different medications for treating . But it’s difficult to predict how well a particular medication will help an individual. So doctors often first suggest taking a drug that they consider to be effective and relatively well tolerated. If it doesn’t help as much as expected, it’s possible to switch to a different medication. Sometimes a number of different drugs have to be tried before you find one that works.
Studies show that the benefit generally depends on the severity of the : The more severe the depression, the greater the benefits will be. In other words, antidepressants are effective against chronic, moderate and severe depression. They don’t help in mild depression.
The various antidepressants have been compared in many studies. Overall, the commonly used tricyclic antidepressants were found to be equally effective. Studies involving adults with moderate or severe have shown the following:
- Without antidepressants: About 20 to 40 out of 100 people who took a placebo noticed an improvement in their symptoms within six to eight weeks.
- With antidepressants: About 40 to 60 out of 100 people who took an antidepressant noticed an improvement in their symptoms within six to eight weeks.
In other words, antidepressants improved symptoms in about an extra 20 out of 100 people.
Antidepressants can also relieve long-term symptoms of chronic depressive disorder and chronic , and help make them go away completely.
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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How Long Do Antidepressants Take To Work
If you have depression, you may start to feel better 2 to 4 weeks after starting an antidepressant but it can take up to 6 to 8 weeks to feel the full effect. Many side effects go away after a few weeks, so allow time.
If you have an anxiety disorder, it may take 4 to 6 weeks before you start feeling better and it may take up to 12 weeks to feel the full effect of the antidepressant.
In some people, antidepressants are not effective, no matter how long they are taken for.
Anybody who takes antidepressants should see their doctor regularly, especially in the first few weeks.
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.
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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.
When There Is A Need For More Intensive Treatment Intervention
If the individual continues to resist treatment adherence and their symptoms worsen, it is appropriate to consider a higher level of care. This becomes evident when the individual is struggling to perform even basic functions, has become isolated, or is vulnerable to exploitation, abuse, or suicide. Residential treatment provides the more intensive and targeted treatment protocols within a safe, structured setting.
Residential treatment encompasses the following interventions:
- Medication management. Medication will be prescribed depending on the specific diagnosis. Medication may include antipsychotics, benzodiazepines, antidepressants, or mood stabilizers. For some individuals these medications will be necessary to help manage the disorder on a long-term basis, and will likely be prescribed for a lifetime.
- Psychotherapy. While in a residential treatment the individual will be involved in various types of psychotherapy. The focus for therapy involves helping the individual recognize irrational thoughts and behaviors and to replace those with healthy thought-behavior patterns. Types of psychotherapy include:
- Cognitive behavioral therapy
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Speak Up About Side Effects
Some individuals may experience side effects from antidepressants. Be sure to discuss them with your doctor. Some common side effects may include increased or decreased appetite, difficulty sleeping or sleeping too much, weight gain or weight loss, or difficulties with sexual response. Some people may experience nausea. Your doctor can help you come up with solutions to handle potential side effects. If the medication makes you nauseous, taking it with food may help. If your antidepressant makes you sleepy, try taking it in the evening before bed. However, certain antidepressants are best taken in the morning. Often, side effects from antidepressants are temporary and may go away after a few weeks of being on them. If side effects are severe, your doctor can prescribe a different medication for you. Never stop taking antidepressant medication abruptly. Doing so may cause serious withdrawal symptoms and depression to return.
They Are Not The Only Thing That Helps People Get Better
Taking antidepressant medication is one important step in getting better but is rarely enough on its own. As well as medication, effective treatment for depression and anxiety-related disorders may include education about the illness and how to deal with it, and psychological therapies such as Cognitive Behavioural Therapy , for example. See the SANE Factsheet, Psychological Treatments, for more information. For some people, ongoing clinical support in the community, rehabilitation, accommodation and employment support are also helpful.
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Personal Stories About Deciding Whether To Take Antidepressants
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I didn’t even realize that I was depressed for a long time. I thought everyone felt this way at least everyone in my family seemed to. I probably would have just gone on like that if my doctor hadn’t asked one day if I had ever thought about taking an antidepressant. I was relieved to find out that it isn’t normal to feel like I do and that a lot of people are helped by medicines. I know it might take a while to find the right one, but I’m in no hurry I’ve spent my whole life feeling sad.
Jackie, age 62
I tried antidepressants about a year ago. I really was not prepared for the first few weeks, when the side effects seemed to get me down even more than the depression did. So I stopped taking them. It took me about 3 months, but I eventually started to feel better without any medicine. Then last month, I started to feel depressed again. I don’t want to wait so long to feel better this time. So I’m going to try the antidepressants again. This time, I know what to expect and am better prepared for it.
Tyrone, age 43
I guess I’m just not comfortable with taking medicine for my depression. I feel like I ought to be able to manage this on my own without needing medicine. It seems too much like taking the easy route. But maybe I just don’t feel bad enough yet.
Bob, age 50
Joslyn, age 28
What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take antidepressants
Reasons not to take antidepressants
My symptoms are keeping me from living my normal life.
My symptoms aren’t bad enough to get in the way of my life.
I’m willing to take medicine every day for at least 6 months, and maybe longer.
I don’t like the idea of taking medicine for a long time.
My symptoms are worse than the possible side effects of the medicines.
I think the side effects will be worse than my symptoms.
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Can I Stay On Antidepressants Forever
Long-term antidepressant users are risking permanent damage to their bodies, according to leading medical experts. Dr Tony Kendrick, a professor of primary care at the University of Southampton, says more urgent action needs to be taken to encourage and support long-term users to come off the medication.
SSRIs can range from about $21 a month for common variations to several hundred dollars a month for sure trademark name medicines, according to a research study from Customer News. Generic variations are readily available for all SSRIs on the market, including Prozac, Paxil, Zoloft and Lexapro. Dr Sienaert is Aide Professor at the professors of medication list of drugs for manic depression, Catholic College of Leuven and also psychoanalyst in the division of mood disorders at the College Psychiatric Facility KU Leuven in Kortenberg, Belgium. KG joined the style of the research, data collection processes, carried out the qualitative evaluation of the information required for this paper as well as prepared the draft of the paper.
Who Can Treat Depression
Some people receive depression treatment from their primary doctor/nurse. Mental health providers, such as psychiatrists, psychologists, and social workers, also treat depression. Psychiatrists are medical doctors who have the same medical training as your doctor, but specialize in mental health. Psychologists are trained to use cognitive behavioral therapies to help people with their depression symptoms. Social workers are trained to help people coordinate their medical care and manage stressful situations, as well as to assist them with other challenges such as finances or housing.
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