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Antidepressants – Types, Uses, Side effects, Advantages
Antidepressants are a class of prescription drugs used to treat depression and other mental health disorders.
Major depressive disorder (MDD) or clinical depression is characterised by persistent feelings of sorrow, emptiness, apathy, and worthlessness. Symptoms include weakness, sleeplessness, hunger changes, irritability, and persistent discomfort.
By restoring a healthy balance to certain neurotransmitters (chemical messengers) in the brain, antidepressants might alleviate these symptoms. Somewhere about one-fifth of all adult Americans are now on antidepressants. Women are more than twice as likely as males to be frequent antidepressant medication users.
Types of Antidepressants
Many distinct types of antidepressants are available. Different mechanisms of action in the brain alleviate depressive symptoms. Find out more about the typical antidepressant and how it works.
Antidepressants that work by elevating the brain’s levels of the neurotransmitters serotonin and noradrenaline are called serotonin and noradrenaline reuptake inhibitors (SNRIs).
Mood, memory, learning, and emotion are all affected by serotonin. The stress-reducing effects of noradrenaline (also known as norepinephrine) are especially useful in dangerous situations.
SNRIs are effective because they prevent serotonin and noradrenaline from being taken back up by the neurons that secreted them. They block the reabsorption of the neurotransmitters in question. Thus, the availability of serotonin and noradrenaline in the brain is raised.
The following are examples of SNRIs:
- Effexor XR (venlafaxine)
- Cymbalta (duloxetine)
- Pristiq (desvenlafaxine)
- Fetzima (levomilnacipran)
Selective Serotonin Reuptake Inhibitors (SSRIs)
The most widely used antidepressants are selective serotonin reuptake inhibitors (SSRIs). A key mechanism of action for SSRIs is the prevention of serotonin reuptake. As a result, feelings of stability and well-being are increased while depression symptoms are alleviated.
Common SSRIs include:
- Prozac (fluoxetine)
- Celexa (citalopram)
- Lexapro (escitalopram)
- Luvox (fluvoxamine)
- Paxil (paroxetine)
- Zoloft (sertraline)
Tricyclic Antidepressants (TCAs)
First-generation antidepressants, of which tricyclics are a subset, have been around for a while. Similar to SNRIs, TCAs inhibit the reabsorption of serotonin and noradrenaline. The memory and learning neurotransmitter acetylcholine’s action is similarly altered by these compounds.
In 1988, SSRIs generally supplanted TCAs in the United States due to the latter’s superior safety profile. Although newer antidepressants are often the first line of therapy, some patients may find that the advantages of TCAs, or older antidepressants, outweigh the hazards.
Examples of TCAs include the following:
- Elavil (amitriptyline)
- Anafranil (clomipramine)
- Pamelor (nortriptyline)
- Norpramin (desipramine)
- Tofranil (imipramine)
Monoamine Oxidase Inhibitors (MAOIs)
Like tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs) are a kind of first-generation antidepressant that has fallen out of favour owing to its negative side effects. Depressive disorders may be treated with MAOIs, which function by decreasing the activity of the enzymes monoamine oxidase A (MAO-A) and/or monoamine oxidase B (MAO-B) (MAO-B). Neurotransmitters including serotonin, noradrenaline, and dopamine all benefit from this kind of regulation, as do motivation and emotional stability.
Several instances of MAOIs are:
- Parnate (tranylcypromine)
- Nardil (phenelzine)
- Marplan (isocarboxazid)
Noradrenergic and Specific Serotoninergic Antidepressants (NaSSAs)
Depression may be treated with noradrenergic and selective serotoninergic antidepressants (NaSSAs) if traditional antidepressants don’t work. NaSSAs are a class of antidepressants that have some of the same mechanisms of action as the related tetracyclic antidepressants (TeCAs), while being classified as “atypical.” As the most widely used NaSSA in the USA, Remeron (mirtazapine).
Even while antidepressants have a low risk of harming the user, many individuals do suffer some unwanted effects. Common negative reactions to antidepressants include:
- Sleepiness and exhaustion
- Unwanted changes in appetite and body weight
- Sexual changes, such as loss of libido (desire to have sex) or difficulty reaching orgasm
- Indigestion, nausea, and vomiting
- Oral aridity
- Mood swings, including agitation and nervousness
- The symptoms of retaining too much water and feeling bloated
- Abnormally high levels of perspiration
Antidepressant withdrawal symptoms often improve with time. Some people believe that antidepressants’ advantages are worth dealing with the potential drawbacks. Some patients using antidepressants, however, develop more enduring or severe side effects.16 These may include, for SSRIs and SNRIs, the following:
- Dysfunction in sex life after stopping SSRI treatment (PSSD)
- Hyperserotoninemia (HS):
- Hypertension (high blood pressure)
- Hyponatremia (low blood sodium)
- Hemorrhaging in the GI tract
Some of the more common negative effects of older antidepressants like TCAs and MAOIs include: Some of them are:
- Arrhythmia (abnormal heartbeat), hypertension, and other cardiovascular issues
- liver failure
- Issues with sight
NaSSAs may cause serious adverse consequences, such as:
- Delusions and hallucinations are symptoms of psychosis, which is characterised by a loss of touch with reality.
- Tachycardia (increased heart rate)
To combat depression, antidepressants are often prescribed. They are sometimes given for the treatment of secondary mental health issues like:
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Anxiety disorders, including specific phobias and generalised anxiety disorder (GAD)
- Eating disorders
- Bipolar disorder, especially in combination with mood stabilisers
- Schizophrenia, often along with antipsychotic medication
- Borderline personality disorder (BPD)
Antidepressants are useful for more than only mental health issues; they may also be used to alleviate the symptoms of some neurological and bodily diseases by correcting chemical imbalances in the brain. The following medical disorders are sometimes prescribed antidepressants by healthcare providers:
- Chronic pain conditions
- Multiple sclerosis (MS)
Treatment of mild to severe depression with antidepressants is often successful.
Studies have shown that antidepressants may cut down on depression symptoms by as much as 67% in most people.
Over eighty-nine percent of respondents in one research who had been taking antidepressants for a while said that they felt better as a result of doing so.
All antidepressants licenced have been demonstrated to reduce depressive symptoms, although their relative efficacies are hotly debated. In comparison to Prozac and Luvox, the average efficacy of Effexor XR, Paxil, Remeron, and Elavil was determined to be higher in a recent systematic review and meta-analysis.
On the other hand, antidepressants have a high dropout rate; over 44% of patients quit taking their drug after only three months owing to adverse effects. This might cause withdrawal or a relapse. When individuals stop taking antidepressants, around 56 percent develop withdrawal symptoms that might last for weeks or months.
Stopping antidepressants requires careful planning and should only be done under the supervision of a medical professional. They may aid in a controlled and progressive decrease in dosage.
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