Antidepressant drugs – all your queries answered

Feeling sad or depressed? Know everything about antidepressants before having them.

Shraddha Rupavate | Updated: June 4, 2014 4:55 pm

Whether you feel constantly low about your failures or you think you just can’t handle the pressure of competition, you are definitely marching on the path of clinical depression. Owing to the fast-paced lifestyle accompanied with exponentially increasing day-to-day stress, mild to major depression is very common among Indians. Report of a survey conducted by the World Health Organisation in conjunction with Biomed Central in 2011 declared that India is unfortunately the most depressed country of the world. It mentioned that about 36 percent of Indians are bound to suffer from a major depressive episode (MDE) at some phase in their lives.

What’s more, increasing incidence of depression in India has been associated with the abuse or overuse of anti-depressants, leading to a silent epidemic of drug dependence and a wide array of complications. (Read: Clinical depression is the second biggest disability in the world!)

So, if you decide to take treatment for depression, you should be aware of the way these drugs will affect your body so that you be in a better position to deal with the side effects and ensure your safety.

Read more about causes, symptoms, diagnosis and treatment of depression.

How do anti-depressants help in depression?

Our mood is affected by chemical messages sent and received by the brain cells (neurons). These chemicals are called neurotransmitters. Serotonin and norepinephrine are two neurotransmitters that mainly affect our mood. When the amount of these neurotransmitters drop at the junction of neurons, we are likely to be sad or depressed.

Antidepressants are a class of drugs that help to restore the balance of these neurotransmitters in the brain. They treat depression by influencing the production of these neurotransmitters or making them more available at the junction of neurons. They are highly effective in people with severe depression who feel better 70% of times after taking antidepressants. (Read: Exercise can vanquish depression!)

For what conditions are they used?

There are different types of antidepressants like Serotonin-specific reuptake inhibitors (SSRIs), Tricyclic antidepressants and Monoamine oxidase inhibitors (MAOIs) that may be prescribed for different conditions depending on the severity of depression. Common conditions include general and social anxiety, obsessive compulsive disorders (OCD) and post-traumatic stress disorder (PTSD). Some antidepressants are also used for hot flashes, premenstrual symptoms and bulimia nervosa (tendency of overeating).

What is the dosage recommendation for antidepressants?

Your psychiatrist will determine the dose of drugs based on your symptoms, other health conditions and your body weight. Usually, a low dose is given at first which is gradually increased if no side-effects are seen. This limits the amount of medication you take.

For how long should antidepressants be taken?

Antidepressants are slow acting drugs so you need to be patient while you are on a therapy. Many antidepressants take about 4 to 6 weeks to show their maximum effect. In some people it might even take a month. Usually people with severe depression need to take antidepressants for at least 9 to 12 months. If the symptoms relapse after withdrawal of drugs, you may have to continue the course for few more months. If antidepressants are discontinued before completion of the course, symptoms will surely relapse. (Read: Bored? You could actually be suffering from depression!)

What are the side-effects of antidepressants?

Side effects are common with all drugs, especially with antidepressants. Sometimes the side-effects are really bad and further intake has to be discontinued immediately. To avoid this, you should keep a track of whatever you feel physically and emotionally after taking antidepressants and discuss it with your doctor.

Side effects of SSRIs:

Sweating, anxiety
Nausea and dizziness
Sleeplessness or sleepiness and restlessness
Headache
Diarrhoea or constipation
Loss of appetite
Sexual dysfunction

Side effects of tricyclic antidepressants (TCAs):

Dryness of mouth
Drowsy feeling
Excessive sweating
Increased pulse rate
Blurring of vision
Constipation
Weight gain
Sexual dysfunction

Monoamine oxidase inhibitors also show similar side-effects. But, other reported effects of MAOIs include sudden rise in blood pressure resulting in stiff neck, severe headache and chest pain.

You should consult a doctor before taking antidepressants if:

You have high blood pressure. It may cause adverse reactions
You are over 65 years of age. It may increase the risk of fractures
You are pregnant
You have bipolar disorder (mood swings) (Read: Migraine sufferers twice as likely to have depression)

Drugs you should avoid taking with antidepressants:

Nervous stimulants like amphetamines should not be taken with selective serotonin reuptake inhibitors (SSRIs). It can lead to serious adverse events such as gastrointestinal bleeding.
Monoamine oxidase inhibitors (MAOIs) should not be taken along with other antidepressants. It may lead to hyperactivity of the brain resulting in coma.
MAOIs taken along with epinephrine and phenylephrine (used for other neurological conditions) may cause a hike in blood pressure.
Drugs like clonidine (used for high blood pressure) should be avoided with tricyclic antidepressants (TCAs).
Drugs like cimetidine (used for treating ulcers and gastrointestinal diseases) should not be taken with TCAs (Read: Ibuprofen — why you shouldn’t pop these pills indiscriminately)

Don’t rely on antidepressants to cure your depression completely. You need to implement other alternative therapies such as meditation, stress management techniques and relaxation techniques to keep yourself happy. (Read: Feeling anxious and depressed? Meditate daily for 30 minutes!)

References:

Global Depression Statistics. (http://www.biomedcentral.com/)
Ajit Avasthi, Sandeep Grover, Munish Aggarwal. Research on antidepressants in India
Agitated Depression. Indian J Psychiatry
Antidepressants (http://www.rxlist.com)
Depression medicines (http://www.webmd.com)
Antidepressants. (http://www.nhs.uk/)

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Published: January 17, 2014 10:11 am | Updated:June 4, 2014 4:55 pm

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