ANTIDEPRESSANT MEDICATIONS
Major depression, the kind of depression that will most likely benefit from
treatment with medications, is more than just "the blues." It is a condition
that lasts 2 weeks or more, and interferes with a person's ability to carry
on daily tasks and enjoy activities that previously brought pleasure. Depression
is associated with abnormal functioning of the brain. An interaction between
genetic tendency and life history appears to determine a person's chance of
becoming depressed. Episodes of depression may be triggered by stress, difficult
life events, side effects of medications, or medication/substance withdrawal,
or even viral infections that can affect the brain.
Depressed people will seem sad, or "down," or may be unable to enjoy their
normal activities. They may have no appetite and lose weight (although some
people eat more and gain weight when depressed). They may sleep too much or
too little, have difficulty going to sleep, sleep restlessly, or awaken very
early in the morning. They may speak of feeling guilty, worthless, or hopeless;
they may lack energy or be jumpy and agitated. They may think about killing
themselves and may even make a suicide attempt. Some depressed people have
delusions (false, fixed ideas) about poverty, sickness, or sinfulness that
are related to their depression. Often feelings of depression are worse at
a particular time of day, for instance, every morning or every evening.
Not everyone who is depressed has all these symptoms, but everyone who is
depressed has at least some of them, co-existing, on most days. Depression
can range in intensity from mild to severe. Depression can co-occur with other
medical disorders such as cancer, heart disease, stroke, Parkinson's disease,
Alzheimer's disease, and diabetes. In such cases, the depression is often
overlooked and is not treated. If the depression is recognized and treated,
a person's quality of life can be greatly improved.
Antidepressants are used most often for serious depressions,
but they can also be helpful for some milder depressions. Antidepressants
are not "uppers" or stimulants, but rather take away or reduce the symptoms
of depression and help depressed people feel the way they did before they
became depressed.
The doctor chooses an antidepressant based on the individual's symptoms. Some
people notice improvement in the first couple of weeks; but usually the medication
must be taken regularly for at least 6 weeks and, in some cases, as many as
8 weeks before the full therapeutic effect occurs. If there is little or no
change in symptoms after 6 or 8 weeks, the doctor may prescribe a different
medication or add a second medication such as lithium, to augment the action
of the original antidepressant. Because there is no way of knowing beforehand
which medication will be effective, the doctor may have to prescribe first
one and then another. To give a medication time to be effective and to prevent
a relapse of the depression once the patient is responding to an antidepressant,
the medication should be continued for 6 to 12 months, or in some cases longer,
carefully following the doctor's instructions. When a patient and the doctor
feel that medication can be discontinued, withdrawal should be discussed as
to how best to taper off the medication gradually. Never discontinue medication
without talking to the doctor about it. For those who have had several bouts
of depression, long-term treatment with medication is the most effective means
of preventing more episodes.
Dosage of antidepressants varies, depending on the type of drug and the person's
body chemistry, age, and, sometimes, body weight. Traditionally, antidepressant
dosages are started low and raised gradually over time until the desired effect
is reached without the appearance of troublesome side effects. Newer antidepressants
may be started at or near therapeutic doses.
A list of Antidepressant Drugs
Antidepressant Paxil