How do antidepressants impact energy levels. Which antidepressants are known for their energizing effects. What factors should be considered when choosing an energizing antidepressant. How long does it take for antidepressants to improve energy levels. Can lifestyle changes enhance the energy-boosting effects of antidepressants.

Understanding the Link Between Depression and Energy Levels

Depression and low energy often go hand in hand, creating a challenging cycle for those affected. Many individuals experiencing depression report feeling persistently tired, lacking motivation, and struggling to engage in daily activities. This connection between mood and energy is rooted in the complex interplay of neurotransmitters and brain function.

Neurotransmitters like serotonin, norepinephrine, and dopamine play crucial roles in regulating mood, motivation, and energy levels. When these chemical messengers are imbalanced, it can lead to both depressive symptoms and a significant decrease in energy. This is where antidepressants come into play, offering a potential solution to address both mood and energy concerns simultaneously.

How Antidepressants Can Boost Energy Levels

Antidepressants work by altering the balance of neurotransmitters in the brain. While their primary goal is to improve mood, certain antidepressants can have the added benefit of increasing energy levels. This energizing effect is often due to their impact on specific neurotransmitters associated with alertness and motivation.

For instance, antidepressants that target norepinephrine and dopamine can lead to increased alertness and improved focus. Similarly, medications that affect serotonin levels may indirectly boost energy by improving sleep quality and reducing fatigue associated with depression.

The Mechanism Behind Energy-Boosting Antidepressants

The energy-boosting effects of certain antidepressants can be attributed to their unique mechanisms of action:

• Increasing the availability of norepinephrine, which is involved in arousal and alertness
• Enhancing dopamine transmission, which plays a role in motivation and reward
• Regulating serotonin levels, which can improve overall mood and sleep patterns
• Modulating the hypothalamic-pituitary-adrenal (HPA) axis, which is involved in stress response and energy regulation

Top Antidepressants Known for Their Energizing Properties

While individual responses to antidepressants can vary, certain medications are recognized for their potential to boost energy levels. Here are some of the most commonly prescribed antidepressants with energizing effects:

1. Bupropion (Wellbutrin)

Bupropion is often considered one of the most energizing antidepressants available. It works by inhibiting the reuptake of norepinephrine and dopamine, leading to increased levels of these neurotransmitters in the brain. This unique mechanism of action sets it apart from other antidepressants and contributes to its stimulating effects.

2. Fluoxetine (Prozac)

Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is known for its activating properties. While it primarily targets serotonin, some individuals report increased energy and improved motivation when taking this medication. Its long half-life also contributes to a more consistent effect throughout the day.

3. Venlafaxine (Effexor)

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that affects both serotonin and norepinephrine levels. This dual action can lead to improved mood and increased energy, especially at higher doses where the norepinephrine effects become more pronounced.

4. Sertraline (Zoloft)

Another SSRI, sertraline, is sometimes associated with increased energy levels. While its primary action is on serotonin, some individuals find that it helps alleviate fatigue and improves overall vitality.

Factors to Consider When Choosing an Energizing Antidepressant

Selecting the right antidepressant is a highly individualized process. When seeking a medication that can boost both mood and energy, consider the following factors:

1. Your specific symptoms and energy patterns
2. Potential side effects and how they may impact your lifestyle
3. Your medical history and any pre-existing conditions
4. Interactions with other medications you may be taking
5. Your preferences regarding dosing schedules and formulations

It’s crucial to work closely with a healthcare provider to find the most suitable antidepressant for your unique situation. They can help you weigh the potential benefits against any risks and monitor your progress over time.

The Role of Lifestyle Changes in Enhancing Antidepressant Effects

While antidepressants can be effective in boosting mood and energy, combining medication with lifestyle changes can lead to even better results. Here are some strategies that can complement the energy-boosting effects of antidepressants:

Exercise: A Natural Energy Booster

Regular physical activity has been shown to have significant mood-enhancing and energy-boosting effects. Engaging in exercise can:

• Increase the production of endorphins, the body’s natural mood elevators
• Improve cardiovascular health, leading to better overall energy levels
• Enhance sleep quality, which is crucial for maintaining good energy throughout the day
• Reduce stress and anxiety, which often contribute to fatigue

Nutrition: Fueling Your Body and Mind

A balanced diet plays a vital role in maintaining stable energy levels. Consider the following nutritional strategies:

• Eat regular, balanced meals to avoid blood sugar fluctuations
• Include complex carbohydrates for sustained energy release
• Ensure adequate protein intake to support neurotransmitter production
• Stay hydrated, as even mild dehydration can lead to fatigue
• Consider supplements like omega-3 fatty acids, which may have mood-enhancing properties

Sleep Hygiene: The Foundation of Energy

Optimizing your sleep patterns can significantly impact your energy levels. Try these sleep hygiene tips:

• Maintain a consistent sleep schedule, even on weekends
• Create a relaxing bedtime routine to signal your body it’s time to wind down
• Ensure your sleeping environment is dark, quiet, and cool
• Limit exposure to blue light from electronic devices before bedtime
• Avoid caffeine and alcohol close to bedtime, as they can disrupt sleep quality

Managing Expectations: The Timeline for Energy Improvement

When starting an antidepressant regimen, it’s important to have realistic expectations about when you might start noticing improvements in your energy levels. The timeline can vary depending on several factors:

Initial Response Period

Most antidepressants require several weeks to reach their full therapeutic effect. During the first few weeks of treatment, you may experience:

• Fluctuations in energy levels as your body adjusts to the medication
• Potential side effects that may temporarily impact your energy
• Gradual improvements in mood, which can indirectly boost energy

Full Effect Timeline

While some individuals may notice improvements in energy within the first few weeks, for others, it may take 4-8 weeks to experience the full benefits of the medication. Factors that can influence this timeline include:

• The specific antidepressant and its mechanism of action
• Your individual body chemistry and metabolism
• The severity of your depression and associated fatigue
• Adherence to the prescribed medication regimen

Monitoring Progress and Adjusting Treatment

Tracking your energy levels and overall well-being is crucial when starting a new antidepressant. Consider the following strategies:

Keeping a Mood and Energy Journal

Maintaining a daily log of your mood, energy levels, and any side effects can help you and your healthcare provider assess the effectiveness of the medication. Include details such as:

• Your energy level throughout the day on a scale of 1-10
• Any notable changes in motivation or ability to complete tasks
• Sleep patterns and quality
• Physical symptoms like headaches or changes in appetite

Regular Check-ins with Your Healthcare Provider

Schedule follow-up appointments to discuss your progress and any concerns. Your healthcare provider may recommend adjustments to your treatment plan, such as:

• Changing the dosage of your current medication
• Switching to a different antidepressant if the current one isn’t providing sufficient energy-boosting effects
• Adding supplementary treatments or therapies to enhance overall outcomes

Potential Side Effects and How to Manage Them

While energizing antidepressants can be beneficial, they may also come with side effects. Being aware of potential issues and how to address them can help you navigate your treatment more effectively:

Common Side Effects of Energizing Antidepressants

• Insomnia or sleep disturbances
• Increased anxiety or restlessness
• Headaches
• Nausea or gastrointestinal discomfort
• Changes in appetite
• Sexual side effects

Strategies for Managing Side Effects

If you experience side effects, consider these approaches:

• Discuss timing of medication intake with your healthcare provider to minimize sleep disturbances
• Practice relaxation techniques to manage increased anxiety
• Stay well-hydrated and maintain a balanced diet to combat nausea
• Engage in regular exercise to help regulate sleep and appetite
• Be patient, as many side effects tend to subside as your body adjusts to the medication

Remember, never adjust your medication dosage or stop taking your antidepressant without consulting your healthcare provider first.

Combining Antidepressants with Other Energy-Boosting Strategies

While antidepressants can be effective in improving energy levels, combining them with other energy-boosting strategies can lead to even better results. Consider incorporating the following approaches:

Light Therapy

Exposure to bright light, especially in the morning, can help regulate your circadian rhythm and boost energy levels. This can be particularly beneficial for individuals with seasonal affective disorder (SAD) or those who struggle with low energy during winter months.

Mindfulness and Meditation

Regular mindfulness practice or meditation can help reduce stress, improve focus, and increase overall energy levels. These techniques can complement the effects of antidepressants by promoting mental clarity and emotional balance.

Cognitive Behavioral Therapy (CBT)

CBT is a form of psychotherapy that can help you identify and change negative thought patterns and behaviors that may be contributing to low energy and depression. When combined with antidepressant treatment, CBT can lead to more substantial and lasting improvements in mood and energy levels.

Herbal Supplements

Some herbal supplements, such as St. John’s Wort or Rhodiola rosea, have been studied for their potential mood and energy-boosting properties. However, it’s crucial to consult with your healthcare provider before adding any supplements to your regimen, as they may interact with antidepressants or other medications.

By combining these strategies with your antidepressant treatment, you can create a comprehensive approach to boosting your energy levels and improving your overall quality of life. Remember, the key to success is working closely with your healthcare provider to develop a personalized plan that addresses your unique needs and goals.

Boost Your Energy and Mood: Finding the Best Antidepressants

Hey there, my friend! Are you feeling down and lacking the energy to get through your day? You’re not alone. Many of us face challenges with our mood and energy levels at some point in our lives. The good news is that there are effective solutions available, including antidepressant medications that can help lift your spirits and restore your energy.

Understanding Antidepressants and Energy

Antidepressants are medications commonly prescribed to treat depression and related conditions. While they primarily work to improve your mood, some antidepressants can also have an energizing effect. These medications can boost your overall energy levels and help you regain your zest for life.

It’s important to note that not all antidepressants have the same impact on energy. Each individual’s response to medication can vary, so finding the right antidepressant for you may involve some trial and error. Here are a few antidepressants known for their energizing properties:

• 1. Bupropion (Wellbutrin): Wellbutrin is often prescribed for its stimulating effects. It acts on dopamine and norepinephrine, two neurotransmitters associated with energy and motivation.
• 2. Selective Serotonin Reuptake Inhibitors (SSRIs): While SSRIs are primarily known for their mood-enhancing effects, some of them, such as fluoxetine (Prozac) and sertraline (Zoloft), can also provide an energy boost.
• 3. Modafinil: Although not classified as an antidepressant, modafinil is a medication used to treat narcolepsy and excessive sleepiness. It can promote wakefulness and improve cognitive function, making it a potential option for individuals struggling with low energy.

Remember, these are just a few examples, and it’s crucial to consult with a healthcare professional who can guide you in choosing the best antidepressant based on your unique needs and medical history.

Nao Medical: Your Partner in Mental Health and Energy Restoration

At Nao Medical, we understand the importance of comprehensive care for your mind and body. Our dedicated team of healthcare professionals specializes in mental health, and we go beyond traditional urgent care by offering services that address the root causes of low energy and mood imbalances.

With our personalized approach, we provide a range of treatment options to help you regain your energy and live your best life. Whether it’s through medication management, therapy, or lifestyle adjustments, we’ll work closely with you to develop a customized plan that suits your needs.

Don’t let low energy and a lack of motivation hold you back. Take the first step towards a happier and more energized life by booking an appointment with Nao Medical today. Let us support you in your journey to improved mental health and overall well-being.

Frequently Asked Questions

1. Are there any side effects of antidepressants that can affect energy levels?

Like any medication, antidepressants may have side effects. While some antidepressants can increase energy, others may cause temporary feelings of fatigue or drowsiness. It’s essential to discuss potential side effects with your healthcare provider to understand how they may impact your energy levels.

2. How long does it take for antidepressants to start working?

The response to antidepressants varies from person to person. It can take several weeks for the full effects of the medication to be felt. During this time, your healthcare provider will closely monitor your progress and make any necessary adjustments to your treatment plan.

3. Can lifestyle changes enhance the effects of antidepressants on energy?

Absolutely! While antidepressants can be a helpful tool, incorporating lifestyle changes can further boost your energy levels. Engaging in regular exercise, maintaining a balanced diet, getting sufficient sleep, and practicing stress-reducing techniques like meditation or yoga can all contribute to improving your overall energy and well-being.

Remember, everyone’s journey towards finding the right antidepressant and restoring energy is unique. At Nao Medical, we’re here to support you every step of the way. Book an appointment with us today and let’s embark on your path to renewed vitality!

Boost Your Energy and Mood Today!

Ready to take control of your energy levels and improve your mood? Book an appointment with Nao Medical and discover how our personalized approach can make a difference in your life.

Disclaimer: The information presented in this article is intended for general informational purposes only and should not be considered, construed or interpreted as legal or professional advice, guidance or opinion.

Most Energizing Antidepressant – Choosing the Right Medication

If you’re thinking about using antidepressants, it’s a good idea to consider whether you need an energizing or relaxing medication. The most energizing antidepressant will affect you much differently than a sedating one.

Deciding whether you need an energizing antidepressant involves a few key points. Firstly, you’ll have to assess your depression. This is, of course, much safer to do with the assistance of your doctor. Never make changes to your medical regimen without asking or informing your doctor.

Different Types of Depression

Before deciding whether or not you need the most energizing antidepressant in the world, you should assess your depression. Major depressive disorder can come in several forms.

The form of your depression depends on the characteristics and symptoms that you experience. The groups of symptoms can be broken up, broadly, into two groups.

• Symptoms of excess energy, such as anxiety and insomnia.
• Symptoms of depleted energy, such as lethargy, excessive sleep, and low motivation.

As you can imagine, people who struggle with the first group of symptoms aren’t going to need an energizing antidepressant. Instead, they will want to use an antidepressant that is more relaxing or sedating.

If you struggle with symptoms from the second group, however, you may be interested in a more stimulating antidepressant. These medications can help provide energy and motivation so that you can accomplish your daily tasks.

What Is the Most Energizing Antidepressant?

Many antidepressants present different benefits and side effects. Certain antidepressants are more energizing than others.

Here are some common examples of antidepressants of different types.

• Energizing antidepressants include Prozac (fluoxetine) and Wellbutrin (bupropion), both of which are known to stimulate the mind and body.
• Sedating antidepressants include Paxil (paroxetine) and Celexa (citalopram), both of which promote relaxation.

Deciding on the best antidepressant is up to you and your doctor or psychiatrist.

Precautions & Things to Be Aware of

When you start taking a new antidepressant, you should take note of the following:

Side Effects

Many patients experience side effects within the first few days or weeks of using an antidepressant. In many cases, these side effects tend to resolve themselves within a couple of weeks. However, if side effects persist, you may want to ask your doctor to switch you to a different medication.

Drug & Supplement Interactions

Another thing to be cautious about is whether or not your new antidepressant will interact with supplements or drugs you’re already taking.

Your doctor will be able to tell you right away if your medications will interact. They will most likely avoid co-prescribing medications that have adverse interactions. Tell your doctor if you are taking any dietary supplements. They will be able to warn you of any potential interactions.

Conclusion

There are many antidepressants, some of which are more energizing than others. Of these, Prozac and Wellbutrin are considered the most stimulating.

It’s important that you remain aware of your needs, but it’s also important to take care of yourself and be aware of the potential of antidepressant addiction. Groups like Surviving Antidepressants can help you find a way to thrive and survive without using antidepressants.

Like it? Share it!

Antidepressants antidepressants,  depression,  energy

Get Updates Right to Your Inbox

Sign up to receive the latest and greatest articles from our site automatically each week (give or take)…right to your inbox.

Blog Updates

Email Address
*

How to stop being afraid and love antidepressants

It is impossible to get an orgasm on antidepressants, what to do if the weight increases sharply from drugs, why side effects on depression drugs indicate “increased suicidal moods”, how a psychiatrist should be examined — we asked questions expert and figured out how to get closer to the mental norm with the help of pharmacology.

We have collected the most common and disturbing questions that people have before their first appointment with a psychiatrist and when they need to take antidepressants. Many people feel uneasy even when reading the instructions for drugs, usually a list of side effects from taking SSRIs (selective serotonin reuptake inhibitors) – a group of third-generation antidepressants designed to treat anxiety disorders and depression. looks intimidating enough.

If I go to a psychiatrist, will I not be able to get a driver’s license?

This is not true. Private clinics do not transmit information anywhere. If you have concerns about the state clinic, then they also do not transfer information to general databases, because they simply do not exist in Russia .

If you go to a psychiatrist in one city, it will not affect whether there will be difficulties in obtaining a driver’s license in another city. Moreover, if you are observed in a private clinic, then in a local psychiatric dispensary they may not recognize that you have a mental disorder.

However, obtaining a driving certificate depends on the disease and the position of the commission. A commission is collected when a patient with a severe mental illness or suspicion of it comes for help. Such decisions are not made unilaterally.

There will be no difficulty in depressive anxiety disorders. With a chronic mental disorder like bipolar affective disorder or schizophrenia, there may be more questions. The commission in some cases may, for example, not allow driving a car, guided by the safety of the patient and other road users.

Can a psychiatric diagnosis be an important point, for example, in court?

A psychiatric diagnosis could theoretically come up during a trial. However, it is important to understand that by itself it does not mean that a person is incapacitated, and is not a limitation. Both lawyers and doctors pay attention to specific manifestations of the disease.

Will I be able to get a normal job? And if I get registered with the PND (psycho-neurological dispensary)?

Many people work even with severe diagnoses. Medical information is not transferred from region to region: if there is a diagnosis in one region, it is lost when moving to another. Dispensary observation is established for patients with severe mental disorders and depends on the manifestations of the disease.

Doctors do not currently register with the PND, this form of observation disappeared in the 1990s. Now treatment by a psychiatrist exists only in the form of dispensary observation or advisory assistance. It does not affect the patient’s life in any way.

In itself, the fact of observation by specialists in a psychiatric institution does not mean anything and does not entail any consequences.

Can I get addicted to antidepressants?

Antidepressants are not addictive drugs in the true sense of the word (what we mean by drug addiction). Because the mechanisms of drug addiction are based on two factors: the effect occurs very quickly, within minutes, and it is mediated through stimulation of the dopamine system. The connection between the introduction of a substance and the sensations from it is formed in the brain very quickly. The second factor in the emergence of addiction to a narcotic appears from the effect of the drug itself – either a euphoric effect or a strong sedative (this is why there may be dependence on benzodiazepines – sedatives).

In the case of antidepressants, this is not possible: they begin to work at best after a few days, and usually the effect is felt after a few weeks of use. Therefore, the brain cannot establish a connection and dependence does not arise.

Is antidepressant withdrawal syndrome scary?

It is important to remember that not everyone experiences withdrawal symptoms. And usually this is an exception to the rule. There are antidepressants that more often cause a withdrawal syndrome, but in this case, the doctor simply reduces the dosage more slowly than usual, monitors the condition and does not rush. Withdrawal is not a life-threatening condition and it is always possible to slow down the rate of drug withdrawal.

The doctor prescribed me the drug, but the instructions say that it is for epilepsy and schizophrenia. But I don’t have epilepsy. Or is there? Is this the wrong assignment?

Patients are used to thinking that different drugs exist for different purposes. But the same drug can act in therapy for the treatment of a wide variety of symptoms. Like, for example, painkillers: they bring down the temperature and remove inflammation. Because the processes of pain and inflammation are based on similar biochemical mechanisms.

In psychiatry, the same drugs are often used in different cases, but in different dosages. For example, quetiapine at low doses can be used to correct sleep disorders, and at higher doses as a drug for bipolar disorder, and at even higher doses as an antipsychotic, against hallucinations and delusions.

If you don’t understand why your doctor prescribes something, be sure to ask. Treatment should not be entirely in the hands of a doctor. Your right to know what you are ill with and what is being treated.

How many days does it take for the body to adapt to an antidepressant? I have been sleeping twenty hours a day for almost a month now, I am suffering from shortness of breath, weakness and stomach problems – are the pills not suitable for me?

A month is a very long time. Usually, side effects from antidepressants go away in the first three to four days or the first week. If discomfort persists for a long time, then changes in therapy should be discussed with the doctor. You need to actively participate in the treatment, this is your comfort, the doctor may not guess that you feel bad if you do not say so.

The psychiatrist talked to me for ten minutes and prescribed a bunch of medications. Did he take a good look at me? But what about other specialists?

For an initial inspection, ten minutes is very short. During this time, it is impossible to collect an anamnesis and it is impossible to explain the treatment strategy. The initial inspection should take at least half an hour. It often takes an hour for a thoughtful conversation with the selection of drugs, diagnostics and forecasts.

Sometimes psychiatrists refer the patient to other specialists to exclude pathologies, but this is not necessary if the picture of the disease is typical.

How should an appointment with a psychiatrist go?

There is no single instruction that everyone follows. A standard examination includes acquaintance with medical documentation, if any, collection of complaints, collection of anamnesis.

In psychiatry, the most detailed history taking: the doctor asks about the place of birth, family, development in childhood, about school, interests, marriage, work.

The psychiatrist must make a complete impression of the patient and his lifestyle in order to present risk factors. There are a lot of risk factors: this is physical or sexualized violence, drug addiction, cases of mental disorders in the family. A good history taking takes a lot of time, especially if a person has had many hospitalizations, a long illness and the first appointment with a doctor.

Neuropsychological testing may be involved – then you will be asked to write or draw something. And then a treatment plan or additional diagnostics is drawn up.

And already after the first meeting, you can prescribe treatment for the syndrome that has been identified in a person. It is normal practice to prescribe treatment quickly, especially if the situation is quite acute.

The doctor prescribes pills for my psychosis, but the diagnosis was announced as bipolar disorder. Did he mix up appointments?

No, the doctor did not mix it up, he prescribed pills that can be suitable for both bipolar disorder without psychotic symptoms and psychotic disorders. In bipolar disorder in the manic phase, there are psychotic symptoms that antipsychotics work against. This is not a mistake, this is a problem in communication with the doctor, because the doctor must explain his prescriptions in detail.

The doctor does not tell me the diagnosis, but prescribes drugs and says that I will have to take them all my life. What’s happening?

This is a fairly typical situation for Soviet and post-Soviet psychiatry. Information about the diagnosis is hidden from you, and you do not understand what is happening.

Most likely, the doctor decided that you could not stand the information about your mental diagnosis, and he protects you in this way, although you did not even ask him about it. This is one of the most common situations in which patients’ rights are violated.

You have a right to information and you must know your diagnosis. Psychiatrists very often keep silent about this and do not consider it necessary to talk about this topic. If the doctor refuses to talk about your diagnosis, you have the right to request an extract from the card in writing. If the doctor refuses to name the diagnosis, you can contact the prosecutor’s office. Your appeal will threaten a fine for the medical institution.

When I go to see a doctor, I almost always feel good, even if before the appointment I could hardly get out of bed or I had panic attacks.

This is a typical situation. We all try to hide our condition when we feel bad or in order not to cause inconvenience to other people. This is a very common reaction: patients seem to gather before a doctor’s appointment. This is not a problem, this is a psychological defense, perhaps you are not ready to hear that something is wrong. But this is normal and rather a reason to work with a psychologist.

Are there objective tests that can confirm a psychiatric diagnosis?

It all depends on the diagnosis. In the established classifications, the criteria for mental disorders are an objective confirmation, because in studies they have shown their stability over time and their relationship with the violation of other mental functions, that is, they themselves are objective in modern psychiatric science and practice.

Other pathologies can be excluded – a problem with the thyroid gland, anemia. There are brain MRI neuroimaging programs that make it possible to determine if a person has Alzheimer’s disease, because it also gives similar symptoms to a number of mental illnesses.

But in general there is no test for depression. Because the brain is too complex and depression is a complex condition. It is important to understand that there are objective methods of monitoring the patient and that the condition can be validated using diagnostic scales, which have also confirmed their objectivity in many studies – and they can be trusted.

I don’t understand if antidepressants work. Nothing seems to be changing. How to understand if they work or not?

In general, we are talking about improving the condition, everyday functioning: sleep improves, appetite increases, activity increases, the ability to concentrate, read more, watch, communicate with other people. You can focus on reducing anxiety.

The side effects of my antidepressant are increased paranoia, increased suicidal tendencies. Why was I assigned this at all?

You are not being treated with a drug that will increase suicidality or increase paranoia, you are being treated with a drug that has a benefit that outweighs the side effects.

Side effects are a probabilistic situation. So it may or may not occur. You can read the probability of a side effect in the instructions, it calculates the frequency with which certain effects appear. It’s scary when you read instructions like this and you’re confused. But the drug is not at all dangerous if it has shown its effectiveness. Side effects are monitored during communication with the doctor.

I am actively gaining weight on an antidepressant – is this a reason to change it?

You need to change your antidepressant, just like any other drug that causes a side effect that you don’t like. Treatment should be comfortable. If you are concerned about weight gain, then you can discuss this with your doctor and look for an alternative. Weight gain is a risk factor for certain diseases and it can damage your health.

Is it true that you can’t have an orgasm while using SSRIs? And that there will be no more libido at all?

No, that’s not true. Indeed, getting an orgasm while using SSRIs may be more difficult, but this is also a probabilistic thing. If this happens and it worries you, then it is important to discuss everything with your doctor.

It makes sense to change the drug because there are certain drugs that are more likely to cause loss of orgasm. You can discuss certain strategies – lower the dose, add other drugs.

However, you must first get used to the drug and wait for its effect. Many depressed patients complain of a loss of interest in sex, but on antidepressants, libido, on the contrary, is restored, because strength and energy appear, interest in life returns.

Does it happen that antidepressant treatment does not help? What to do then?

There are no magic pills or surgeries. All methods of treatment that mankind has come up with are limited in their effectiveness. Sometimes it happens that a person is depressed and antidepressants do not help. Then doctors change regimens. And if the drugs do not help, then we are talking about resistant depression – then you can use tactics to enhance antidepressant therapy: add mood stabilizers and antipsychotics, try ECT (electroconvulsive therapy), it is quite effective especially in case of resistant depression, and it has a good effect. There are patients who do not take drugs, but visit maintenance ECT once a week. Usually, ECT is performed under anesthesia, and it does not hurt. ECT is used if antidepressants and psychotherapy have not been able to cope with the disease. If antidepressant treatment does not help, then it is important not to give up and continue to look for other ways.

Is it true that the only thing that helps with a psychiatric diagnosis is pharma?

It all depends on the diagnosis. Mild depressive disorder does not require drug treatment and can be managed with cognitive behavioral therapy. You can do without drug therapy for mild OCD symptoms, isolated (i.e. rare) panic attacks that do not affect your life.

But quite often people come with such problems when drug therapy is needed, and in some cases it is support so that the patient can get to psychotherapy, because he already has difficulty simply functioning during the day. Not all diagnoses require pharmaceuticals, but in many cases it is simply impossible to move forward without pills, this is a vital necessity.

I am planning a pregnancy. But I seem to have depression or an anxiety disorder. Does this mean that you can’t get pregnant?

If you want to exclude the disorder, then you need to be examined by a specialist, but whether or not to have a child is your decision, and no diagnosis can influence this. Indeed, in Russia there is a serious prejudice against the use of psychopharmacotherapy during pregnancy and breastfeeding. However, there are also fairly safe drugs for use during pregnancy and breastfeeding.

what are antidepressants and do you need them at all? / Habr

Depression is not only when you are sad all day and there is no desire to work. You may not know about it at all and be treated for another, not realizing that we are talking about a hormonal imbalance that can be corrected. And since going to a neurologist is “embarrassing,” there is every chance of living a long, miserable life with a lack of a couple of hormones.

About ten years ago, it was customary to hide any problems with the nervous system more complicated than a twitching eye. People almost with a false beard went to see a private psychiatrist on the other side of the city and were afraid that they would be registered, reported to work or relatives. Now, in my subjective opinion, the situation has begun to change for the better, and neurological disorders are less and less perceived as something shameful.

Today we’re going to talk about depression, which isn’t really about being sad in any way. Disturbances in the synthesis, release and reuptake of neurotransmitters can manifest themselves not only in the desire to sit and watch the carpet all day long, but in completely sudden things like severe problems with the gastrointestinal tract, chronic pain and other things.

With the invention of a wide variety of substances from the group of antidepressants, doctors have the opportunity to treat and significantly improve the quality of life of many patients who may not have guessed that their problems begin with the nervous system. But, as usual, even “magic pills” require very careful selection of the drug, dose and side effects. Today we will talk about how our synapses function, how the triad of key neurotransmitters affects our body, and which doctor to go to if something went wrong.

How synapses work

Nerve cells are very similar in concept to the quartz elements of a clock. They can generate electrical impulses by changing the concentration of ions outside and inside the cell membrane. Nevertheless, in the form of an electrical impulse, the signal is transmitted only within the framework of one element – the cell. To transmit a signal to the next neuron, you need a specific port (similar to USB) for interaction – a synapse.

Synapses are very different in structure and mechanism of action, but today we are interested in chemical synapses that use biogenic amines for signal transmission: serotonin, norepinephrine and dopamine. The neuron synthesizes them and stores them in special synaptic vesicles. In order to inform a neighboring cell about its excited status, a neuron must throw a neurotransmitter into the synaptic cleft – those same biogenic amines. As soon as the concentration of the neurotransmitter in the contact zone – the synaptic cleft – becomes sufficient, the receptors of the second neuron will begin to capture it, transmitting the chemical signal further.

It would be too expensive for the body to produce tons of conditional serotonin just like that, and besides that, it would also be harmful: the intercellular space would resemble a dump of neurotransmitters. That is why all the neurotransmitters that fell off the receptor after its activation and went back into the synaptic cleft are vacuumed back by the neuron using active reuptake pumps. The pumps consume some ATP, so it’s much more economical than synthesizing a neurotransmitter molecule from scratch. The biogenic amines collected in this way can be recycled many times at minimal cost.

If there is too much serotonin or dopamine, then a simple reuptake is no longer enough. This is where MAO, the enzyme monoamine oxidase, comes into play. He knows how to break down key neurotransmitters into their constituent fragments. MAO-A specializes mainly in epinephrine, norepinephrine, serotonin and histamine. MAO-B – on phenylethylamine and dopamine.

When everything is in order, the neurotransmitter is exactly as much as needed. Neurons produce it in the normal mode, slowly capture it back, use it again and destroy the excess. If the balance is shifted for various reasons, then the transfer of excitation to the neighboring neuron becomes difficult or, conversely, too intense. And that’s when the problems begin. Let’s take a closer look at the key triad of neurotransmitters.

Serotonin

Serotonin molecule: the hormone of happiness, digestion and the feeling of unloading train cars at night

Serotonin is often called the “happiness hormone”, but in fact this is a strong simplification. This amine has a huge number of physiological effects, not only in the central nervous system, but also on the periphery of the body. In particular, it is serotonin receptors that are one of the key in the regulation of intestinal motility, stimulating its activity and secretory activity. In part, this process is stimulated by the bacteria themselves, which can convert the amino acid, tryptophan, into serotonin with their enzymes – but this serotonin cannot enter the brain because of the barrier through which these large molecules do not pass. Therefore, simply adding tryptophan to food will not improve the situation.

In the CNS, this neurotransmitter plays a very important role in the regulation of pain sensitivity. With a decrease in its amount, the pain threshold is significantly reduced. This is one of the factors in the formation of a pronounced sensitivity to pain when a person is overtired. In addition, depending on its shortage or excess, human behavior changes greatly. If serotonin is conditionally low, then the person becomes depressed, apathetic and irritable. He is not sad, but rather “no way.” At the same time, the mood is bad even when normally it would be worth rejoicing. Thus, one can sit sadly on a tropical island and munch fresh fruit in disgust under the rustle of the ocean.

If there is little serotonin, then, upon waking up, one might think that there was no sleep, and all night you unloaded the wagons. There is no feeling of relaxation and freshness.

The reverse situation is also possible when there is a lot of serotonin. Most often, it occurs as a temporary side effect of antidepressants or as a result of the wrong combination of them. And then the opposite effect occurs. Hypomania sets in at first. She is pleasant. Very pleasant. The mood is abnormally good, even if there are no special prerequisites for this. You sit in a crowded office with the full feeling that you have been sent on vacation. Energy overflows, I want to do something actively. There is a feeling of incredible efficiency. The problem is that this efficiency is strongly reminiscent of the old joke.

A girl comes to get a job as a secretary.

The boss asks, “How fast can you type on a typewriter?”

Girl: “Well… 1000-1200 characters per minute.”

Chief: “Is it possible to print at such a speed?”

Girl: “You can print, but it turns out such a game!”

So it is here. Thousands of ideas are swarming in my head, but it all comes at the expense of a loss of criticality. What used to be discarded at the planning stage seems like a good option in a manic episode. In mild hypomania, this can even be a useful effect in solving creative problems. If hypomania turns into mania, then everything becomes bad: criticality is completely lost and a person can shave his head, paint his car pink and drive off into the sunset, and the like. In its most severe form, this can lead to serotonin syndrome with trembling hands, but simultaneously with euphoria, agitation, mania, hallucinations and coma in the final.

Norepinephrine

Norepinephrine molecule

Norepinephrine is closely related to serotonin. They have very similar metabolic pathways, similar receptors and intracellular metabolism. This leads to the formation of a bunch of negative feedbacks between them, when one suppresses the effects of the other. For example, when taking antidepressants that increase serotonin and norepinephrine at the same time, at first there may be an imbalance between these neurotransmitters. Often, norepinephrine builds up faster than serotonin, and side effects like wet hands and feet and agitation begin to creep in. Then serotonin also rises to the desired level, and they again balance each other.

Norepinephrine also has the same effects as adrenaline, but from the side of the nervous system. When stressed, the adrenal glands release adrenaline into the blood, and you immediately feel this unpleasant feeling, as if everything in your stomach is shrinking and getting colder, your heart beats faster, your palms and feet become wet. This is a manifestation of humoral regulation. There is also neurogenic, which is realized through the sympathetic nervous system. Here, norepinephrine already ensures the functioning of synapses and the transmission of a signal from the central nervous system to organs. Nothing is thrown into the blood, and the effects are almost the same.

Mentally, noradrenaline suppresses pain sensitivity, provides positive reinforcement and a sense of “victory”, even if bleeding from a wound after a duel. The very stress against the backdrop of bright positive events, when emotions overwhelm.

It is this neurotransmitter that is the key target for a neurologist when a patient complains of chronic pain that is not relieved by conventional non-steroidal anti-inflammatory drugs.

Dopamine

Dopamine molecule

Mesocortical and mesolimbic pathways

Contrary to popular belief, dopamine does not produce feelings of pleasure on its own. Current research suggests that it provides a sense of anticipation for the result that is about to be achieved. This is a very important mechanism. Without it, we would just sit in the corner and occasionally try to crawl away from whatever hurts. Almost any intrinsic motivation is somehow connected with this neurotransmitter. That is why it encourages us to perform evolutionarily fixed actions like sex, getting delicious food and other pleasures. This contributes to successful survival and reproduction. You take away dopamine and you get poorly breeding pandas who don’t understand why they need this sex at all.

Neurobiological research suggests that dopamine is released not only when a pleasurable goal is achieved, but also when memories of past experiences are recalled. This allows you to firmly reinforce key memories and encourage the repetition of positive experiences. Unfortunately, it is this mechanism that underlies all addictions of a modern person. We suffer at the memory of juicy fat cheburek and dream of sweet chocolate cake, with a delicate layer of salted caramel, in the middle of the night. And we get drug addiction very quickly if the substance affects dopamine. So, for example, addiction to cocaine, which stimulates the release of norepinephrine and dopamine, is quickly formed. Invigorates, stimulates and very much praises for the next dose. After some time, it becomes more and more difficult for a person to refuse to receive a new dose of the drug, since his motivation system simply screams that he needs it. Moreover, such substances, when abused, can irreversibly break the motivation system as a whole, after which a person does not want anything but the next dose.

A rat presses a lever, stimulating the release of dopamine for a virtual reward

Most drugs that affect dopamine levels carry the risks of recreational use and addiction in one way or another. Therefore, the same amphetamine derivatives are banned in many countries, although they can be used as a medicine under strict control for certain pathologies.

In addition to the motivation system and the emotional sphere, dopamine regulates automatic motor activity. These are movements that we perform unconsciously, such as maintaining a posture, rearranging our legs in the right order when walking, and so on.

If it is lacking, we get parkinsonism. Outwardly, this is very similar to the behavior of some older people: stiffness of movements, lethargy, shuffling gait, tremor of the limbs. With excessive stimulation, on the contrary, involuntary grimaces, obsessive muscle movements.

In general, due to the peculiarities of the physiological effects of dopamine, neurologists and psychiatrists try not to touch it without a strong need, limiting themselves to more selective drugs.

So, everything is broken

For starters, don’t get discouraged. There is nothing to be ashamed of. A person with equal success may experience gastritis, acute hemorrhoids or clinical depression. The brain is also an organ and can get sick. For some reason, with gastritis, we already calmly go to the gastroenterologist, we try not to mention visits to the proctologist once again, and we often don’t even talk about neurological treatment even to close people. This is a very big mistake, since it is the help of a loved one from the outside that can greatly help the treatment.

What kind of depression is there? It can be depression provoked by some external traumatic factor. It is completely natural to be depressed for a while, having experienced the loss of a loved one or losing your job. In such cases, there is a clear connection between the external factor and the state of the person. As a rule, this should pass by itself, as soon as the external traumatic factor loses its relevance. In this case, the neurologist, most likely, will be able to help only slightly extinguish anxiety and negative emotions with anxiolytics.

Sometimes the cause of depression cannot be found. Everything seems to be fine, there is work, the family loves, and the patient sits and watches the carpet. One of the main theories of the last century suggests that there is such a type of depression as endogenous, associated with a lack of norepinephrine, serotonin and dopamine. Nevertheless, now such a term does not exist, and modern research does not allow us to reliably state that the reason is strictly related precisely to the lack of serotonin that has come from nowhere. And usually there is a factor that provokes this lack: lack of sleep, a large amount of work, a constant focus on a large number of details, 24-hour stress tolerance. And with all this – the impossibility and lack of time to restore strength.

Depression is characterized by the classic triad:

• Asthenia – weakness, increased fatigue, which does not go away for a long time.
• Apathy is a detached emotional state, when neither good nor bad.
• Anhedonia – the inability to rejoice in what used to please. This state includes the reluctance to have sex, the reluctance to please yourself with your favorite dish or your favorite trip to the theater.

Very often, this condition can progress slowly, over months, and be invisible from the inside. It is worth listening to your loved ones if they say that you have changed a lot and become somehow bleak and withdrawn. It’s time to go to the doctor for a consultation.

How to diagnose depression

As I said, the main problem of depressive states is that they are very difficult to recognize from the inside. This is the classic problem of a crowbar to open a box that lies inside the box.

It is extremely rare that a person will come with the words “I have depression”. Or “I have anxiety.” Most often, he will talk about memory loss, a decrease in concentration, an internal feeling of anxiety or a feeling of a “tight string”. He will tell that he cannot fall asleep at night, simply because there are a lot of thoughts in his head. He will complain that during the descent on the escalator his head began to spin and there is a feeling of fear that he will not stay on his feet.

If you have a suspicion that something is wrong with you emotionally, you can try the classic Beck questionnaire. It was developed in 1961 and is still considered one of the main tools in the diagnosis of depression. Also, the reason for self-diagnosis can be not only a psychological condition, but also some chronic conditions that cannot be treated with standard therapy. For example, various variants of chronic pain syndrome that make the patient go in circles from the urologist to the proctologist in search of a problem that has a neurological cause.

As I said above, neurotransmitters are not only about sad/happy, but also about the direct regulation of the functions of internal organs due to the autonomic nervous system. Neurological changes associated with biogenic amines can cause gastrointestinal disturbances: nausea, constipation, or vice versa diarrhea.

Antidepressants

If the patient does go to the neurologist, the doctor may find it necessary to prescribe antidepressants. There is no need to be afraid of this group of drugs: this is a huge class of substances that can effectively help in the treatment of neurological and somatic disorders.

Above, we have already analyzed the ways of reuptake and destruction of excess neurotransmitters. If their regulatory mechanisms have failed, then the appointment of antidepressants can help solve this problem.

Non-selective MAO inhibitors

Older and less selective classes of antidepressants inhibit MAO – monoamine oxidase. As a result, excess biogenic amines begin to accumulate, and their concentration in the synaptic cleft begins to grow. This non-selectivity leads to a large number of side effects in comparison with modern narrow groups. Currently, this group of drugs is not used as the first line. That is, therapy will definitely not begin with it. There are more effective groups with fewer side effects.

Neurotransmitter reuptake inhibitors

Current classes of antidepressants tend to work by inhibiting the reuptake of neurotransmitters without interfering with the utilization of the excess throughout the body. There are both non-selective tricyclic antidepressants, which simultaneously block the capture of all three neurotransmitters, and selective ones, which selectively block the capture of one or two neurotransmitters.

A typical non-selective reuptake inhibitor is amitriptyline. It was originally used to treat severe depression, but has been superseded by more modern drugs for many cases. Although it still works great in small doses in the treatment of chronic pain syndromes:

• Tension headache.
• Migraine.
• Neuropathic pain.
• Chronic pain in cancer patients.
• Rheumatic pains.

Selective ones are divided depending on the neurotransmitter whose concentration they increase:

• SSRIs – serotonin.
• SSRIs – serotonin + norepinephrine.

The doctor selects the best option depending on the clinical situation and then monitors the patient’s condition, adjusting the dose and, possibly, the drug itself. In the treatment of pain syndromes, drugs that increase the level of norepinephrine are most often used. They are more likely to cause negative side effects than SSRIs, but are much more effective in treating pain.

Anxiety disorders

Very often, patients come with a complex complex problem, and not depression in its purest form. This includes various variants of anxiety disorders, which are also treated with SSRI antidepressants, but, as we remember, they do not begin to work immediately. Therefore, in the treatment of such patients, it is most often necessary to start work with lowering anxiety using anxiolytics (they are also tranquilizers).

Also, antidepressants often have an increase in anxiety in the first 1-2 weeks, as a manifestation of one of the side effects. So imagine.

The person has anxiety, possibly panic attacks, but is simultaneously shackled by a depressive state. He sits in a corner and suffers in silence. You can’t just take and give him an antidepressant. If he has a severe anxiety disorder, then on an antidepressant, his anxiety and motor activity may become even more active, and he will have the strength to do something. What is most unpleasant is that there will be strength to do the wrong things, which in the end can even lead to suicide.

Therefore, the first time such patients are usually covered with anxiolytics. And they are watching closely. When anxiety goes away, they begin to gradually withdraw from the state of depression and return to normal activity.

It is reasonable to ask a question: why not just prescribe anxiolytics to everyone, since they have fewer side effects and the effect comes faster? Anxiolytics do not affect serotonin, they temporarily suppress anxiety, but do not repair this complex mechanism of serotonin metabolism. And more often than not, they are addictive. Therefore, they cover the intake of antidepressants for the first time – 2-3 weeks, no more.

Terminals

The most important thing is that you don’t have to sit and watch the carpet, closed in on your problem. Almost always, the problem can be solved with the right selection of drugs. But there are a few important points:

• I’ll have to go to a neurologist. It is possible that a neurologist can refer you to a psychiatrist if you need clarification on the diagnosis and the appointment of different combinations of drugs. This is normal, there is no need to be afraid of this.
• Any psychotropic drugs should be taken strictly according to the scheme agreed with the attending physician. Usually the doctor explains how to carefully adjust the dose of treatment depending on how you feel.
• Tune in to the fact that there will be no quick result. Anxiety with anxiolytics is usually removed quite quickly, but the repair of these components – anxiety and depression – is months of therapy with a possible change or reselection of the drug. Typical waiting times: first effects after 7-14 days, initial evaluation of effectiveness – 3 months. The duration of the course is at least 6 months, more often longer.
• Antidepressants should not be abruptly discontinued, as with any psychotropic medication. Withdrawal and side effects can be very severe. Only a very slow dose reduction under the supervision of a physician and possibly covered with anxiolytics.
• Hence the consequence is to always have a supply of the drug with you. In no case should you be left without medicine while traveling or on vacation. When flying overseas, take a prescription from your doctor if asked. Abroad, there is a different attitude towards antidepressants – in the pharmacy they are released calmly and with understanding.
• Many antidepressants like fluvoxamine are completely incompatible with alcohol. Even just a little. Side effects can be the most unpredictable, up to trying to catch leprechauns in the night park and leaving for the next world.
• Keep a mood diary. It can be paper, it can be in the form of an application. This will help you with dose adjustments and your doctor to evaluate the effectiveness. From time to time, you can take the Beck questionnaire.
• If the therapy was correct, not interrupted prematurely, then the remission can be very long, without repeated episodes of depression.
• Let there always be someone close, or rather a specialist, who is aware of your problem. That makes it much easier to deal with it.

Thanks to edogs for the nice comment about transporting drugs across the border:

When flying abroad, and abroad, one should really remember the attitude towards antidepressants in particular and prescription drugs in general.
But it is not enough just to “take the recipe” and “show if asked” relying on the “kindness of foreign countries.”
When crossing the border, you must definitely go through the red corridor and declare. At the same time, a certified doctor’s prescription and a certified copy of the prescription (if it is one-time) must be presented and they must be translated into at least English, and at most be in the language of the countries from/where you are flying to. The recipe itself should contain the name of the active substance (and not the branded name) in Latin. Moreover, before the trip, it would be nice to check whether this drug is allowed in the country of destination in principle, if not, you cannot enter with it even if you have all the papers. In addition, there is often a requirement to have a supply of no more than 1 month / 1 course.
Yes, in most cases it will “carry over”, because. Customs officers rarely check pills unless they are transported in bulk. But if they suddenly check or the detectors catch or the dogs sniff out, the consequences can be very serious. And not only in Thailand and the Emirates (where landing is almost guaranteed, but in completely innocent countries such as Bulgaria, Estonia, Turkey, Belarus (sic!), Germany, etc.