What are the main categories of antidepressants. How do SSRIs work to treat depression. Which SSRI medications are considered most effective. What are the key benefits and side effects of common antidepressants.

Understanding Depression and Treatment Options

Depression is a complex mental health condition characterized by persistent feelings of sadness, emptiness, and loss of interest or pleasure in activities. Unlike normal fluctuations in mood, clinical depression significantly impacts daily functioning and quality of life. Effective treatment often involves a multifaceted approach, including:

• Antidepressant medications
• Psychotherapy (individual and group)
• Dietary supplements
• Nutritional interventions
• Complementary and alternative therapies

Selecting the right antidepressant medication is a crucial component of managing depression symptoms and promoting overall well-being. However, it’s important to note that the most suitable medication varies from person to person, and should be determined in consultation with a healthcare provider.

Categories of Antidepressant Medications

Antidepressants are classified based on their mechanism of action and the specific neurotransmitters they target. The main categories include:

• SSRIs (Selective Serotonin Reuptake Inhibitors)
• SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)
• MAOIs (Monoamine Oxidase Inhibitors)
• Tricyclic Antidepressants
• Atypical Antidepressants

Each category works differently in the brain, and the choice of medication depends on various factors such as the specific symptoms experienced, potential side effects, and individual patient characteristics.

SSRIs: A Closer Look at a Popular Antidepressant Class

SSRIs are among the most commonly prescribed antidepressants due to their effectiveness and generally favorable side effect profile. These medications work by increasing the availability of serotonin, a neurotransmitter that plays a crucial role in mood regulation, in the brain.

How do SSRIs function in the body? SSRIs block the reabsorption (reuptake) of serotonin in the brain, allowing more serotonin to remain available for neurotransmission. This increased serotonin activity is believed to help alleviate symptoms of depression and improve overall mood.

Top SSRI Medications for Depression Treatment

While the efficacy of antidepressants can vary from person to person, some SSRI medications have shown particularly promising results in treating depression. Four of the most widely prescribed and effective SSRIs include:

1. Citalopram (Celexa)
2. Sertraline (Zoloft)
3. Escitalopram (Lexapro)
4. Paroxetine (Paxil, Paxil CR)

Each of these medications has its own unique profile of benefits and potential side effects. Let’s explore them in more detail.

Citalopram (Celexa): Benefits and Considerations

Citalopram, marketed under the brand name Celexa, is a widely used SSRI for treating depression and major depressive disorder. Its effectiveness in managing depressive symptoms has made it a popular choice among healthcare providers.

Key Benefits of Citalopram

• Effective in treating depression and related mood disorders
• Generally well-tolerated with fewer side effects compared to older antidepressants
• Can be taken once daily, improving medication adherence
• May also help with anxiety symptoms associated with depression

How long does it take for citalopram to work? Patients typically begin to notice improvements in their symptoms within 2-4 weeks of starting treatment. However, it may take up to 6-8 weeks to experience the full therapeutic effects of the medication.

Important Precautions and Side Effects

While citalopram is generally safe and effective, patients should be aware of potential side effects and necessary precautions:

• Heart-related issues: Citalopram has been associated with heart rhythm abnormalities in some patients. Seek immediate medical attention if you experience palpitations, chest pain, or dizziness.
• Drug interactions: Citalopram should not be taken concurrently with monoamine oxidase inhibitors (MAOIs).
• Pregnancy and breastfeeding: Discuss the risks and benefits with your healthcare provider if you are pregnant or breastfeeding.
• Discontinuation: Never stop taking citalopram abruptly without consulting your doctor, as this can lead to withdrawal symptoms.

Common side effects of citalopram may include:

• Nausea and decreased appetite
• Drowsiness or insomnia
• Dry mouth
• Increased sweating
• Sexual side effects (e.g., decreased libido, difficulty achieving orgasm)

If you experience severe side effects or worsening depression symptoms, contact your healthcare provider immediately.

Sertraline (Zoloft): A Versatile Antidepressant Option

Sertraline, commonly known by its brand name Zoloft, is another popular SSRI used in the treatment of depression. Its versatility in addressing multiple mental health conditions has made it a valuable tool in psychiatric care.

Conditions Treated by Sertraline

In addition to major depressive disorder (MDD), sertraline is approved for the treatment of:

• Social anxiety disorder (SAD)
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Panic disorder
• Premenstrual dysphoric disorder (PMDD)

This broad range of applications makes sertraline a versatile choice for patients experiencing comorbid mental health conditions alongside depression.

Effectiveness and Dosage Considerations

How effective is sertraline in treating depression? Clinical studies have shown that sertraline is as effective as other SSRIs in managing depressive symptoms, with some research suggesting it may have a slight edge in terms of overall efficacy and tolerability.

Sertraline is typically started at a low dose and gradually increased to achieve the optimal therapeutic effect. The dosage range for depression treatment is usually between 50-200 mg per day, taken once daily. However, the specific dosage should be determined by a healthcare provider based on individual patient factors.

Potential Side Effects and Precautions

While generally well-tolerated, sertraline can cause side effects in some patients. Common side effects may include:

• Nausea and gastrointestinal disturbances
• Headache
• Sleep disturbances (insomnia or excessive sleepiness)
• Sexual dysfunction
• Dizziness
• Dry mouth

As with other SSRIs, sertraline carries a black box warning regarding an increased risk of suicidal thoughts and behaviors, particularly in children, adolescents, and young adults. Close monitoring is essential, especially during the initial weeks of treatment or following dosage changes.

Escitalopram (Lexapro): A Highly Selective SSRI

Escitalopram, marketed under the brand name Lexapro, is known for its high selectivity in targeting serotonin receptors. This characteristic may contribute to its effectiveness and relatively favorable side effect profile.

Key Features of Escitalopram

• Highly selective for serotonin receptors, potentially reducing off-target effects
• Effective in treating both depression and generalized anxiety disorder (GAD)
• May have a faster onset of action compared to some other SSRIs
• Available in both tablet and liquid formulations for flexible dosing

How does escitalopram compare to other SSRIs in terms of efficacy? Some studies suggest that escitalopram may have a slight advantage in terms of overall effectiveness and tolerability compared to other SSRIs, although individual responses can vary significantly.

Dosing and Administration

Escitalopram is typically prescribed at an initial dose of 10 mg once daily, which can be increased to 20 mg daily if necessary. The medication can be taken with or without food, and at any time of day, although taking it at the same time each day can help establish a routine.

Potential Side Effects and Considerations

While escitalopram is generally well-tolerated, potential side effects may include:

• Nausea
• Dry mouth
• Somnolence or insomnia
• Increased sweating
• Sexual side effects
• Fatigue

As with other SSRIs, escitalopram carries a risk of serotonin syndrome, a potentially serious condition caused by excessive serotonin activity. Patients should be aware of the symptoms, which may include agitation, hallucinations, rapid heart rate, and severe dizziness.

Paroxetine (Paxil, Paxil CR): A Potent SSRI Option

Paroxetine, available under the brand names Paxil and Paxil CR (controlled release), is known for its potency among SSRIs. It is effective in treating depression and several anxiety disorders.

Unique Features of Paroxetine

• High potency, potentially allowing for lower doses
• Available in immediate-release and controlled-release formulations
• Effective for treating multiple anxiety disorders alongside depression
• May have a sedating effect, which can be beneficial for patients with sleep disturbances

How does paroxetine differ from other SSRIs in its effects? Paroxetine tends to have a more sedating effect compared to other SSRIs, which can be advantageous for patients experiencing insomnia or anxiety alongside depression. However, this sedation may be undesirable for some individuals.

Dosing Considerations

The typical starting dose for paroxetine is 20 mg once daily, usually taken in the morning. Depending on the patient’s response and tolerability, the dose may be adjusted up to a maximum of 50 mg daily for depression treatment. The controlled-release formulation (Paxil CR) is designed to provide a more consistent drug level throughout the day and may be associated with fewer side effects for some patients.

Potential Side Effects and Precautions

Common side effects of paroxetine may include:

• Nausea and gastrointestinal disturbances
• Drowsiness or fatigue
• Sexual dysfunction
• Weight gain
• Dry mouth
• Sweating

Paroxetine may have a higher likelihood of causing withdrawal symptoms if discontinued abruptly compared to some other SSRIs. Therefore, it’s crucial to work closely with a healthcare provider when adjusting or discontinuing the medication.

Choosing the Right Antidepressant: Factors to Consider

Selecting the most appropriate antidepressant is a complex process that should be guided by a healthcare professional. Several factors are taken into account when determining the best medication for an individual:

• Specific symptoms and severity of depression
• Presence of co-occurring mental health conditions (e.g., anxiety disorders)
• Medical history and current health status
• Potential drug interactions with other medications
• Individual tolerability and response to previous treatments
• Family history of response to specific antidepressants
• Cost and insurance coverage

How do healthcare providers determine which antidepressant to prescribe? The selection process often involves a careful evaluation of the patient’s symptoms, medical history, and individual circumstances. In some cases, genetic testing may be used to help predict how an individual might respond to certain medications.

The Importance of Personalized Treatment

It’s crucial to remember that what works well for one person may not be as effective for another. The journey to finding the right antidepressant often involves some trial and error. Patients should maintain open communication with their healthcare providers, reporting any side effects or changes in symptoms to help guide treatment decisions.

Beyond Medication: Comprehensive Depression Treatment

While antidepressants play a crucial role in managing depression, they are most effective when combined with other therapeutic approaches. A comprehensive treatment plan may include:

• Psychotherapy: Various forms of talk therapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy, can help address underlying thought patterns and behaviors contributing to depression.
• Lifestyle modifications: Regular exercise, a balanced diet, adequate sleep, and stress management techniques can significantly impact mood and overall well-being.
• Social support: Engaging with family, friends, or support groups can provide valuable emotional support during the recovery process.
• Complementary therapies: Some individuals may benefit from approaches such as mindfulness meditation, acupuncture, or light therapy, depending on their specific symptoms and preferences.

How can patients maximize the effectiveness of their depression treatment? Adhering to prescribed medications, actively participating in therapy sessions, and implementing lifestyle changes can all contribute to better outcomes. Regular follow-ups with healthcare providers allow for ongoing assessment and adjustment of the treatment plan as needed.

The Role of Patient Education and Empowerment

Understanding depression and its treatment options empowers patients to take an active role in their recovery. Key points for patients to remember include:

• Antidepressants may take several weeks to reach full effectiveness
• Side effects often improve over time as the body adjusts to the medication
• Never discontinue or adjust medication dosage without consulting a healthcare provider
• Regular communication with healthcare providers is essential for optimal treatment outcomes
• Depression is a treatable condition, and recovery is possible with appropriate care and support

By combining effective medication management with other therapeutic approaches and lifestyle modifications, many individuals with depression can achieve significant symptom improvement and enhanced quality of life. The journey to finding the right treatment may require patience and persistence, but with proper guidance and support, it is possible to navigate the path towards recovery successfully.

4 of the Best SSRI Medications for Treating Depression

Depression is a condition causing ongoing emotions that can feel overwhelming. People who are depressed feel sad, empty, and without joy. This is different from the everyday ups and downs that everyone feels. Instead, depression is a regular and underlying part of each moment.

For people with this condition, having a treatment plan is crucial to healing. Successful plans typically include a combination of the following:

• Antidepressant medications
• Psychological counseling (individual and group therapy)
• Supplements
• Specific food choices
• Homeopathic options

Knowing the best medicine to include will help the patient manage their symptoms. Then they can move forward into a fulfilled life. Doctors determine the best option on an individual basis.

All medications should be taken as prescribed. Patients should not stop or start a medicine without discussing it with their doctor.

Categories of Antidepressants

Antidepressants are categorized by their effect on specific neurotransmitters. The most common classifications are:

• SSRIs (selective serotonin reuptake inhibitors)
• SNRIs (selective serotonin and norepinephrine reuptake inhibitors)
• MAOIs (monoamine oxidase inhibitors)
• Tricyclic antidepressants
• Atypical antidepressants

SSRIs (selective serotonin reuptake inhibitors)

SSRI drugs are designed to impact the body’s serotonin level. Serotonin is vital in multiple body functions, including mood and energy level. When serotonin is off balance, it changes how a person manages life’s stresses.

The role of the SSRI drug is to moderate serotonin neurotransmitters. In this way, depression can be managed, and a patient may function fully in their life.

There are many SSRI medications available. Doctors will prescribe the best medicine individually, according to the patient’s needs.

Examples of 4 of the best SSRI medicines for depression are:

1. Citalopram (Celexa)
2. Sertraline (Zoloft)
3. Escitalopram (Lexapro)
4. Paroxetine (Paxil, Paxil CR)

Citalopram (Celexa)

Citalopram is a medication prescribed by doctors. It is also sold under its brand name, Celexa. This medicine is an SSRI antidepressant. It is used as a treatment for depression and major depressive disorder.

Citalopram should always be taken as instructed, without interruption. It may take up to a month to see improvement in symptoms. Sudden stopping of this medicine can result in agitated confusion. Do not stop taking citalopram without consulting a doctor.

Cautions

When using citalopram, the following cautions should be considered:

• Before beginning this medication, doctors should know a complete list of your medications. Also, review your medical history to avoid complications.
• This drug has been linked to severe heart problems. Contact a medical professional immediately if you experience heart palpitations, chest pain, or dizziness.
• Citalopram should not be taken at the same time as an MAOI.
• If you have negative thoughts of self-harm or suicide, seek immediate help.
• Do not breastfeed while taking citalopram.
• Missed doses should be taken as soon as possible. However, do not double a dose; skipping one dose is better than taking two at once.

Side Effects

As with any medication, citalopram may have side effects. Be aware of any physical changes that need a doctor’s attention.

Seek immediate help if:

• Allergic reaction – Do not ignore symptoms like hives, blisters, fever, difficulty breathing, or swelling of the throat or tongue.
• Behavior and mood changes – worsened depression, irritability, restlessness, and more.
• Seek emergency assistance for any thoughts of suicide or self-harm.

Common side effects include:

• Dizzy or drowsy
• Increased thirst
• Decreased appetite or increased nausea
• Anxiety or agitation
• Increased weakness
• Insomnia
• Bloody noses
• Symptoms of a cold (congestion, sneezes)

Other side effects are possible. Ask your doctor or pharmacist for a complete list. Also, discuss any symptoms you think may be related to taking citalopram.

Sertraline (Zoloft)

Sertraline is a medicine used by doctors in the treatment of depression. It is also known by its brand name, Zoloft.

An SSRI antidepressant, helps patients manage the condition of depression. It can also treat other illnesses, like:

• MDD (major depressive disorder)
• SAD (social anxiety disorder)
• OCD (obsessive-compulsive disorder)
• PTSD (post-traumatic stress disorder)
• Panic disorder

Patients should always tell their doctor about their medications and supplements. Once taking sertraline, follow instructions carefully. Do not stop taking this medication suddenly, as it may cause serious reactions. Consult a doctor or pharmacist with any questions or concerns.

Cautions

As with any prescription medication, sertraline may cause some unwanted effects. Be aware of the following cautions and seek help if needed:

• Do not take sertraline while also taking MAOIs, pimozide, or methylene blue injections.
• Be vigilant of any thoughts of suicide or self-harm. Seek immediate medical care if having these thoughts.
• Do not give to children under the age of 6.
• Avoid using this medication if you are pregnant – but do not stop taking it without a doctor’s close supervision.
• Ask a doctor if breastfeeding while taking sertraline is a safe option.
• If a dose is missed, take it as soon as possible. Never take a double dose of sertraline.

Side Effects

While taking this medication, patients may experience varying side effects. Contact a medical professional as needed.

Emergency medical attention may be needed if:

• Allergic reaction (like trouble breathing, swelling, hives)
• Extreme mood or behavior changes (like increased agitation, depression, or anger)
• Seizure
• Uncontrolled bleeding
• Changes in vision
• Signs of low sodium
• Manic behavior

Common side effects include:

• Gastrointestinal problems (like nausea, diarrhea, or indigestion)
• Excess sweating
• Unexplained tremors
• Problems sexually

Escitalopram (Lexapro)

Escitalopram (also known by its brand name, Lexapro) is an antidepressant. It is classified as an SSRI. This medication is used in the treatment of depression and MDD (or major depressive disorder). It is intended for people over the age of 12. It is also used to treat adults’ anxiety.

Patients prescribed escitalopram should give their doctor a complete list of other medications. This includes supplements and over-the-counter medicines. Patients should also share an accurate medical history to get the best care.

A person who takes escitalopram should not stop without first consulting their doctor. Sudden stopping of this medicine can cause serious side effects.

Cautions

When taking escitalopram, be aware of the following cautions. Seek medical care if needed.

• Do not take if also taking citalopram or pimozide.
• Do not take if also taking MAOI drugs.
• If thoughts of self-harm or suicide worsen, get immediate help from a doctor. This is a serious situation and should not be ignored.
• If the patient is pregnant, discuss whether escitalopram is the right medication. This medicine can be detrimental to the fetus.
• Do not breastfeed until you speak with your doctor about possible side effects.

Side Effects

Even when patients take escitalopram correctly, there can be side effects. Be aware of the possible reactions to taking this medicine.

Seek immediate help at an emergency room if you experience the following:

• Allergic reactions (including difficulty breathing, swelling in the face or throat, or hives)
• Extreme changes in mood and behavior (such as increased hostility or aggression)
• Changes in vision (including blurring and seeing a halo light)
• Discomfort when urinating
• Thoughts racing
• Headache or slurred speech (can be signs of low sodium)

Common side effects of escitalopram can include:

• Pain when urinating
• Feeling dizzy, weak, more tired
• Anxiety and agitation
• Shaky muscles
• Sleeping problems
• Dry mouth or extra thirsty
• Nauseous or constipated
• Bloody noses
• Sexual dysfunction (including change in sex drive)

Paroxetine (Paxil)

Paroxetine is a prescription medication. It is used in the treatment of depression and MDD (or major depressive disorder). Other conditions that can also be treated with this medication are:

• Panic disorder
• OCD (obsessive-compulsive disorder)
• PTSD (post-traumatic stress disorder)
• Anxiety

Paroxetine is classified as an SSRI. As an antidepressant, this drug helps balance brain chemicals. In this way, conditions like depression can be managed.

Patients should inform their doctor of a complete list of their medicines. This, along with an accurate medical history, helps the doctor treat the condition.

Cautions

Before taking paroxetine, patients should discuss any relevant warnings about this drug. Any changes in symptoms or behavior should be reported to a medical professional.

Some cautions to be aware of include:

• Do not suddenly stop taking this medication. Once prescribed, it is crucial to take it as instructed. Stopping suddenly can cause complications.
• Do not take if also taking thioridazine, pimozide, or MAOIs.
• Seek medical help if experiencing a change in mood or behavior.
• Seek emergency help if you are having hallucinations, dizziness, violent vomiting, or seizures.
• If the patient has feelings of suicide or self-harm, get immediate medical help. This is a serious situation and should not be ignored.
• Pregnant patients should discuss with their doctor whether paroxetine is the best option. Fetuses may experience serious complications, such as lung deficiencies.
• Do not breastfeed while taking this medicine.
• Do not take this medication if you are under the age of 18.
• If possible, do not miss any doses. Take a missed dose as soon as possible, but do not double up on doses.

Common side effects of paroxetine can include the following:

• Changes in eyesight
• Increasingly weaker, dizzier, or tired
• Increased anxiousness
• Sweatier or shakier than normal
• Trouble sleeping (having insomnia)
• Sudden infections
• Stomach problems (decreased appetite, increased nausea, vomiting, diarrhea, or constipation)
• Dry mouth
• Unexplained infection
• Unusual headaches
• Sexual dysfunctions (including lowered sex drive)

These are just some of the side effects that can happen. Contact your doctor or medical professional for additional information. Be aware of symptoms to watch for when taking this medicine.

Suicidal Thoughts: What to Do

Depression can often lead people to consider hurting themselves. It can even lead them to believe suicide is their only escape from the pain they feel.

Some of the signs to watch for (in yourself and others) include:

• Discussing a desire to die or kill themselves
• Actively looking for ways to act on their thoughts (like purchasing a weapon)
• Saying they feel hopeless and don’t see a reason to stay alive
• Talk a lot about the pain they are in, that they feel like they can’t escape
• State they feel like a burden to other people
• Use drugs or alcohol more than ever
• Behave out of character (more anxious and agitated)
• Excessive sleeping habits (sleep more or less than usual)
• Become isolated and withdrawn from society
• Obsess over wanting revenge or having extreme anger
• Wide mood swings that seem uncontrollable

If you or someone you know is experiencing these feelings, help is available. The 988 Suicide & Crisis Lifeline is a nationwide support system. It is free and available 24 hours a day throughout the United States.

Don’t hesitate to seek help for yourself and for those you care about.

We Can Help With Your Treatment Plan

Overcoming depression may seem overwhelming to those with the condition. However, there is hope for a fulfilled life with a treatment plan made just for you.

Are you experiencing the symptoms of depression and don’t know what to do? Modern Recovery Services is here to help.

We are a behavioral health and accountability treatment program. We provide support in the form of a professional team and a caring environment.

We believe in treating the patient as a unique individual. Our program has a variety of options available to meet your needs. This means the plan we create to manage depression will also be unique.

Contact us today! Let’s work together to see how psychotherapy and medication can help you have the life you deserve.

Sources:

1. Medical News Today. What is Depression: Definition. August 4, 2022. Available at: medicalnewstoday.com.
2. eMedicineHealth. What are the Top 10 Antidepressant Drugs? May 24, 2022. Available at: emedicinehealth.com.
3. eMedicineHealth. SSRI Drugs and Depression. October 2022. Available at: emedicinehealth.com.
4. Drugs.com. Citalopram. December 3, 2021. Available at: drugs.com.
5. Drugs.com. Sertraline. May 23, 2022. Available at: drugs.com.
6. Drugs.com. Escitalopram. December 1, 2021. Available at: drugs.com.
7. Drugs.com. Paroxetine. December 1, 2021. Available at: drugs.com.
8. 988 Suicide and Crisis Lifeline. Help Someone Else. 2022. Available at: 988lifeline.org.
9. 988 Suicide and Crisis Lifeline. About. 2022. Available at: 988lifeline.org.

Anxiety and depression: Which medications are best?

Selective serotonin reuptake inhibitors, Serotonin-noradrenaline reuptake inhibitors, and benzodiazepines are the most common medications for anxiety and depression. The best option will depend on a person’s symptoms, overall health, and treatment aims.

According to the World Health Organization (WHO), approximately 5% of adults globally experience depression. Anxiety disorders are the most common type of mental health condition in the United States, affecting 40 million adults yearly.

This article will discuss medications a doctor may prescribe to treat anxiety and depression. It will also explore other treatment options and diagnostic processes for these conditions.

Anxiety and depression are mental health conditions.

They often co-occur, with around 45% of people worldwide with lifetime major depressive disorder also experiencing one or more anxiety disorders.

Anxiety

Anxiety links closely with fear. This results in a future-oriented mood and behavioral response, where the person prepares for an anticipated event or situation that they perceive as threatening.

The fear can become worse over time and may interfere with daily life. Different types of anxiety disorders include generalized anxiety disorder, panic disorder, and phobias.

Depression

Depression is a mood disorder. It may result in symptoms such as:

• persistent sadness
• hopelessness
• irritability
• difficulty sleeping and concentrating
• thoughts of suicide

Like anxiety, depression may interfere with a person’s daily life.

Learn more about common signs and symptoms of depression.

Doctors may recommend medication in combination with other treatment options such as therapy for people experiencing anxiety and depression.

The most suitable treatment will depend on a person’s symptoms, co-occurring conditions, and the severity of their condition. Some medications can treat both conditions, while others are more suited to treating either anxiety or depression.

Antidepressant medications can help improve the symptoms of depression. With adequate treatment, 70–80% of people with depression may experience a significant reduction in their symptoms.

Medication for anxiety does not cure the condition but may help with symptoms, such as panic attacks, extreme fear, and worry.

Selective serotonin reuptake inhibitors

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that doctors consider first-line treatments for depression and anxiety.

SSRIs work by increasing the level of serotonin in the brain. Serotonin is a molecule that has important bodily roles, including regulating mood and behavior.

Researchers believe that decreased serotonin in the brain may result in mental health conditions such as depression and anxiety. By increasing serotonin levels, SSRIs may help improve the symptoms of these conditions.

However, it may take up to 6 weeks before a person feels the beneficial effects of SSRIs.

Examples of SSRIs that doctors prescribe in the U.S. include:

• fluoxetine
• sertraline
• paroxetine
• fluvoxamine
• citalopram
• escitalopram
• vilazodone

Side effects

Side effects of SSRIs include:

• anxiety
• restlessness
• insomnia
• dry mouth
• weight gain
• nausea
• diarrhea
• sweating
• headaches
• dizziness
• decreased sex drive
• anorgasmia, or difficulty orgasming

There is also an increased risk of suicidal ideation with SSRIs in young people up to age 25.

Some SSRIs such as citalopram can affect the heart, potentially leading to abnormal heart rhythms.

Dosage

A person takes SSRIs orally. They are available as tablets, capsules, liquid suspensions, and solutions.

The starting dose varies with each drug. For example, the starting dose for citalopram is 20 milligrams (mg) daily, while it is 5–10 mg per day for escitalopram.

A doctor may increase or decrease a person’s dose depending on the severity of their anxiety and how well they respond to treatment.

Stopping medication

A person may wish to discontinue SSRI treatment for various reasons, including side effects. A doctor will likely recommend that a person gradually lower their dosage over weeks or months.

A person may experience discontinuation symptoms when coming off SSRIs, including low mood and irritability.

Learn more about antidepressant withdrawal.

Serotonin-noradrenaline reuptake inhibitors

Serotonin-noradrenaline reuptake inhibitors (SNRIs) are another class of drugs that doctors consider first-line treatment for anxiety and depression.

SNRIs block the reuptake of serotonin and another chemical known as noradrenaline or norepinephrine, increasing the levels of these chemicals in the brain.

In this way, they can have a beneficial effect on mood and emotion. SNRIs may take between 6–8 weeks to have a noticeable effect.

Examples of SNRIs include:

• venlafaxine
• desvenlafaxine
• duloxetine
• milnacipran
• levomilnacipran

Side effects

Common side effects of SNRIs include:

• nausea
• insomnia
• dry mouth
• increased blood pressure
• sexual dysfunction
• weight gain
• headaches

There is also an association between this kind of medication and an increased risk of reduced bone mineral density and falls. In the elderly, this may result in fractures.

Dosage

The starting dose for SNRIs may also vary depending on the drug. For example, the starting dose for milnacipran is 12.5 mg per day, while the starting dose for venlafaxine is 37. 5 to 75 mg per day.

Learn more about SSRIs and SNRIs.

Benzodiazepines

Benzodiazepines are a type of antianxiety medication that may help reduce anxiety symptoms.

They work by enhancing the activity of gamma-aminobutyric acid, a chemical in the brain that has a repressive effect on nerves and movement.

According to research, the effects of benzodiazepines occur within 30–60 minutes. These fast-acting drugs may help with anxiety symptoms such as panic attacks, insomnia, and muscle tension.

Examples of benzodiazepines include:

• alprazolam (Xanax)
• clonazepam
• diazepam
• lorazepam

Side effects

The drawback of benzodiazepines is that a person may develop tolerance to the medication. This means they require a higher dose to have the same effect. Because of this, a person may become dependent, and doctors usually prescribe benzodiazepines for short-term use only.

Learn more about drug dependence.

A person using benzodiazepines may experience some side effects, such as:

• drowsiness
• dizziness
• sedation
• loss of balance

Learn more about withdrawing from benzodiazepines.

Risks

There is also an association between benzodiazepine use and an increased risk of being unable to learn or remember new information or do certain physical and cognitive tasks. These side effects normally reduce once the drug clears the body.

Other risks associated with long-term benzodiazepine use include:

• dementia or dementia-like illnesses
• impaired motor function
• aggressive behavior
• impaired cognitive function
• addiction

Tricyclic antidepressants

Tricyclic antidepressants (TCAs) are a class of medications doctors use to treat depression. Some may also prescribe them for anxiety.

TCAs work by blocking the reuptake of serotonin and noradrenaline, increasing their levels in the brain.

Examples of TCAs include:

• amitriptyline
• imipramine
• nortriptyline

Side effects

Side effects of TCAs include:

• dry mouth
• urinary retention
• constipation
• seizures
• low blood pressure

As they can cause significant adverse effects, doctors do not often prescribe TCAs for anxiety.

Learn more about TCAs.

Beta-blockers

A doctor may prescribe beta-blockers to help with symptoms of anxiety.

Beta-blockers are a class of drugs doctors usually use to treat heart conditions. They inhibit the actions of adrenaline and noradrenaline, hormones that play a role in the body’s fight or flight response.

Beta-blockers may be able to improve physical symptoms of anxiety, including:

• a fast heart rate
• a trembling voice
• dizziness
• sweating
• shaking hands

Propranolol and atenolol are examples of beta-blockers a doctor may prescribe for anxiety.

Monoamine oxidase inhibitors

Monoamine oxidase inhibitors (MAOIs) are a type of antidepressant that blocks the function of monoamine oxidase.

Monoamine oxidase is an enzyme that breaks down chemicals such as serotonin, noradrenaline, and dopamine. When a person takes MAOIs, the levels of these chemicals in the brain increase, with a therapeutic effect.

MAOIs normally take 2–3 weeks to work. However, doctors do not consider them first-line due to their adverse effects and interactions with other drugs.

Examples of MAOIs include:

• selegiline
• moclobemide
• isocarboxazid
• phenelzine

Side effects

Adverse effects of MAOIs may include:

• dry mouth
• nausea
• diarrhea
• constipation
• drowsiness
• insomnia
• dizziness

Medication may not suit everyone, and a person may prefer other treatment options for depression and anxiety. They may wish to consider:

• Cognitive behavioral therapy (CBT): This focuses on identifying and modifying behaviors that are not constructive in dealing with anxiety and depression. It may provide individuals with skills and tools to react more productively to certain situations.
• Exposure therapy: This type of therapy involves a person moving toward anxiety-causing situations that they normally avoid to learn how to deal with anxiety and reduce their symptoms.
• Arts and creative therapy: This involves using music, painting, or drama to help a person express their feelings and deal with symptoms.
• Talk therapy: This involves a person speaking to a professional about experiences and feelings and may help them find new methods to deal with situations.
• Support groups: These provide a setting for individuals to meet others with anxiety or depression, with whom they can discuss their feelings.
• Stress management techniques: Techniques such as exercise, mindfulness, and meditation may help reduce anxiety and depression symptoms.

A person will need to see a doctor to receive a diagnosis of anxiety, depression, or both.

A doctor will usually take a medical history from the individual. Depending on the symptoms the person is experiencing, the doctor may also conduct a physical exam to rule out other conditions.

The doctor will likely ask about symptoms and the person’s mood and emotions. They may ask the person to complete a questionnaire identifying signs and symptoms of anxiety or depression.

For a person to receive a diagnosis of depression, their symptoms must be present for at least 2 weeks.

A person should speak with a doctor if they have been experiencing symptoms of depression or anxiety, such as low mood or anxious thoughts, for more than 2 weeks.

They may also want to see their doctor if they are on antidepressant or antianxiety medication and have been experiencing adverse effects.

Anxiety and depression are mental health conditions that affect mood and emotion. Anxiety is linked to fear and depression to low mood.

Some medications, such as SSRIs, SNRIs, and TCAs, treat both conditions. Others target one specific condition.

Nonmedicinal treatment options for anxiety and depression include CBT, exposure therapy, counseling, and support groups.

People should speak with their doctor if they are experiencing symptoms of depression and anxiety. A doctor can advise them on suitable treatment options.

Medicine for depression and stress

In the modern world, with its stress, frantic pace of life, instability, you rarely find a person who would not know what depression is. We often complain about depression, although this word can hide a bad mood, anxiety, irritability, grief, or other nervous disorders that have nothing to do with depression.

Depression treatment

Noticing symptoms similar to depressive symptoms, many immediately run to the pharmacy for an antidepressant or some kind of sedative.

You can’t do without consulting a specialist, but many people ignore visiting a doctor, preferring self-medication. Meanwhile, self-treatment with psychotropic drugs can lead to the most serious consequences, including the aggravation of existing neuropsychiatric diseases.

Medicines for depression

All psychotropic drugs are divided into three groups: antipsychotics, antidepressants and tranquilizers.

Antipsychotics

Antipsychotics are strong psychotropic drugs that are used to treat psychoses with hallucinations and delusions. Treatment with such drugs is carried out only in hospitals, but in some cases, small doses of the drug can be prescribed to people suffering from insomnia, experiencing weakness and pain, people with obsessive thoughts.

Antipsychotics complement the treatment regimen for asthenia, shyness, and depression.

Antidepressants

Antidepressants fall into two classes.

The first is drugs with a pronounced sedative effect. These include drugs such as amitriptyline, anafranil, larivon, ludiomil.

The second group includes preparations containing an activating component. These include melipranil and petylil.

Recently, a variety of combination antidepressants, such as Prozac, have appeared.

The risk of developing dependence on antidepressants is only 15%.

tranquilizers

Tranquilizers are the most famous and most dangerous drugs in terms of addiction. They are most often used for insomnia, obsessive thoughts, anxiety.

The most powerful tranquilizers are phenazepam, clonazepam, lorazepam, lexotane. Less strong Relanium, Seduxen, Librium, Valium, Signopam, Tazepam. Weak – grandaxin, mezapam, rudotel. Tranquilizers with a pronounced hypnotic effect – radedorm and reladorm.

Attention! Do not self-medicate. Prescribing and taking drugs for depression is possible only after consultation with a specialist.

Nootropics

In addition, there is a group of drugs with a pronounced stimulating effect used in chronic fatigue syndromes. These are the so-called nootropics – drugs designed to increase cerebral circulation. These include nootropil, encephabol and cogitum.

When taking tranquilizers, you must strictly observe the dosage and schedule for taking the medication, otherwise drug dependence may occur, which is very little different from drug addiction. Only a doctor can prescribe medications and a treatment regimen.

When taking, do not expect an immediate effect, it occurs approximately in the second or third week of treatment. At the first sign of relief from the condition, do not stop taking the drug. Dose reduction and discontinuation, it is better to discuss with your doctor. If the neurotic disorder is not treated, the disease is likely to return in a more severe and difficult to treat form.

All drugs mentioned in the article are released strictly by prescription!

Recommendations for the treatment of depression

We recommend that you consult a neurologist. As a rule, depression is accompanied by lack of sleep, lack of appetite, absent-mindedness and difficulty focusing on something. When diagnosing and treating, it is necessary to take into account the totality of the manifestations of a depressive state.
Domestic injuries, head injuries of many years ago, active weightlifting can also affect the development of depression.

No need to drink several cups of coffee a day, or try to cheer yourself up with energy drinks – these will only aggravate your condition. Nervous breakdowns are possible, after which it is difficult to restore a normal emotional state.
In our clinic, appointments are conducted by neurologists — qualified specialists who have helped many to restore their condition and get rid of depression.

Which antidepressants are best for anxiety and depression – Healthy Youth Center

The best treatment for depression is holistic. A specialist (psychotherapist or psychiatrist) creates an individual treatment plan and, based on the examination, selects only those components that correspond to the indications and contraindications. Typically, these are antidepressants combined with some other medication for depression, stress, and anxiety. The patient takes the prescribed drugs for depression until there is a therapeutic effect or a stable remission. Treatment of depression takes a long time. As a rule, therapy lasts from 1.5 to 7 months.

Prescribing drugs for calming nerves and against depression

Drugs for depression and anxiety have a pronounced effect, they are potent drugs that have a number of contraindications and side effects if the doctor’s prescription and instructions for use are not followed. That is why drugs for depression without prescriptions cannot be bought in our country. It is impossible to both prescribe and stop taking drugs against depression on your own, this can affect mental health, lead to the development of depressive states and even suicidal thoughts.

Therefore, it is very important to follow all the doctor’s recommendations, take drugs for depression and stress in the dosage prescribed by the doctor. Even if a person’s mood improved after a week and the main symptoms disappeared, you should not stop taking the drug.

The drug method is quite effective in anxiety-depressive disorders and neurotic conditions. It is important that the diagnosis of depression be made by a specialist, since taking medications simply to cheer up in the absence of deviations from the psyche can cause only a number of side effects. Antidepressants, neuroleptics and tranquilizers are potent drugs that are prescribed only with a diagnosis confirmed by a doctor. Self-medication is unacceptable. Next, consider the main drugs for stress and depression that are prescribed to patients.

Antidepressants

Should I take antidepressants for severe depression? Many people believe that these drugs are addictive. If earlier drugs that could cause addiction and drug dependence were used in psychotherapy, today new generation drugs are used that affect the human body and psyche more gently and sparingly.

Among the reasons for distrust in the use of antidepressants for depression, one can single out the fact that if the course of treatment is interrupted, a person may feel worse. If abstinence occurs, this indicates an incorrect withdrawal of the prescribed drug. Do not take such a reaction of the body as an addiction to pills.

If the artificial synthesis of brain neurotransmitters is stopped, their quantity in the human body will drop sharply. Patients feel that the depression or anxiety disorder is returning as anxiety increases. Any changes in the condition should be reported to the attending physician. The specialist knows how to smoothly cancel the prescribed medicine. In combination with psychotherapy, pharmacotherapy works excellently, giving a long-term result.

There are several classes of drugs for anxiety and depression.

Tricyclic

The first group includes drugs that have a tricyclic structure, they do not belong to sedatives and prevent the instant breakdown of neurotransmitters (serotonin and norepinephrine). They do not disappear from the nerve endings, their synthesis increases, as does the amount of serotonin. These drugs have a number of contraindications, they are not recommended for people who have kidney and liver diseases, glaucoma, atherosclerosis, and drugs are taken.

Monoamine oxidase inhibitors (MAOIs)

MAOIs are monoamine neurotransmitters that regulate our emotions, as well as a number of processes in the brain: attention, cognitive functions, memory, arousal. Due to the inhibition of leasing, there is an increase in the amount of monoamines and their accumulation in the nerve endings. Some groups of these drugs are contraindicated for pregnant women and people who work that requires concentration, as well as hypertensive patients.

Selective serotonin uptake inhibitors (SSRIs)

The third group of drugs for the treatment of depression are serotonin selective uptake inhibitors. Medications are prescribed in order to replenish the “hormones of happiness.” Do not think that this happens quickly, the process of restoring neurotransmitters is gradual. SSRIs have one important advantage – with the abrupt withdrawal of drugs, there is no withdrawal syndrome. Among the contraindications to their use are diseases of the genitourinary system, as well as alcoholism and drug addiction.

If a person develops alcoholism against the background of a depressive state, he should not take antidepressants, since alcohol increases the side effects of the depression medication. Symptoms of the disorder can increase significantly, and the condition can worsen. Quite often, psychological causes cause the development of alcohol dependence, the risk of depression in alcoholics is many times higher than in healthy people. The first group of drugs against depression is especially dangerous to combine with ethanol, as this leads to a sharp increase in pressure.

Which antidepressant is best for anxiety and depression? The doctor will answer this question for you, the choice of medicines should always take into account the individual characteristics of the patient’s body.

Tranquilizers for depression and neurosis

Species:

• sleeping pills;

• sedatives;

• muscle relaxants.

In the first case, there is a significant reduction in anxiety, improved quality and increased sleep duration. Doctors do not recommend taking sleeping pills for a long time or independently extending the period of admission prescribed by a specialist, since drugs in this group can cause drug dependence. Because of this feature, sleeping pills are popular with drug addicts.

Sedative drugs have a positive effect on the central nervous system, they can be both herbal and synthetic and have a rather mild effect on the central nervous system. They help to restore the balance between the systems of excitation and inhibition, give a person the opportunity to more calmly respond to stressful situations and eliminate sleep problems.

Muscle relaxants – drugs that reduce the tone of the muscles of the skeleton and reduce motor activity. They block H-cholinergic receptors and stop the supply of impulses to the muscles, due to which they stop contracting.

Tranquilizers are used for depression and panic attacks, sleep problems, as well as for:

• behavioral and mental disorders;
• neuroses;
• psychoses;
• personality disorders;
• causeless fears;
• schizophrenia;
• when stopping withdrawal symptoms in alcohol and drug addiction;
• eczema;
• anorexia;
• bulimia;
• arrhythmias;
• hypertension.

In some cases, these psychotropic drugs are given to children. Do not use drugs of this group for people with alcohol or drug intoxication. Doctors do not advise drugs for the treatment of neurosis and depression and during work associated with increased concentration of attention, including drivers.

As with the treatment of depression with antidepressants, in order to reduce the risk of withdrawal symptoms upon discontinuation of the drug, it is necessary to reduce the dosage gradually. Your doctor should tell you about this. In addition, a long course of its use is fraught with the development of drug dependence, so the course is divided into short periods. Pregnant and lactating women should not use tranquilizers.

Preparations help to cope with stress, to endure traumatic situations more easily, eliminate fears, phobias, panic attacks without inhibiting cognitive functions. Quite often, tranquilizers help eliminate sleep problems, frequent awakenings, insomnia at night, and daytime sleepiness. In the treatment of psychosis, these medications are used as part of a complex therapy that helps eliminate the side effect of antipsychotics. But the drugs themselves have various side effects, including muscle weakness, lethargy, decreased concentration of reactions, libido, memory impairment, a drop in blood pressure, and nausea.

Tranquilizers are quite dangerous drugs, some of them are classified as pharmacy drugs, since if the duration of treatment and dosage are violated, psychophysical dependence can occur. Their use is also known for recreational purposes. If you notice that your loved one has been taking the same medication for a long time, you should seek help from the Center for Healthy Youth. After all, it is possible that he became addicted and now needs drug addiction treatment. We work throughout Russia. The appeal is free and anonymous.

Antipsychotics for depression and anxiety

Today, drugs such as neuroleptics are actively used in the treatment of depression and neuroses. They eliminate panic fears, anxiety, normalize sleep patterns.

Doctors classify them according to their chemical structure.

1. Dibenzazepines are needed to combat psychotic manifestations, are excellent in combination with other drugs, but have a minimal sedative effect, have quite few adverse reactions.
2. Aliphatic phenothiazines have a greater sedative and sedative effect and eliminate sleep problems.
3. Phenothiazine derivatives are used in the presence of pain, vascular problems.
4. Butyrophenones are drugs that are used in medicine to combat delusional disorders and hallucinations, they have practically no sedative effect.

There are 2 types of antipsychotics: typical and atypical (as well as those with prolonged and non-prolonged action). In the first case, these are drugs that are already a thing of the past, they really did a good job with their main task – the relief of psychotic symptoms, but they had a rather large number of undesirable side effects.

In the second case, the use of atypical antipsychotics is more modern. These are drugs of the latest generation, antipsychotics, which have practically no side effects. If drugs have a prolonged effect, this means that they have a long-term effect on the body, for example, within a month.

Nootropics for depression and asthenia

Nootropic drugs, they are also cerebroprotectors or neurometabolic stimulants, are an effective tool for a specific effect on the higher functions of the psyche. It increases the resistance of the central nervous system to the effects of negative factors of traumatic episodes. Nootropics have a positive effect on the intellectual and cognitive abilities of a person, help him improve memory, focus on the important, increase learning and stress resistance.

These psychotropic drugs are divided into the following groups:

• true;
• neuroprotective agents;
• primary action;
• secondary action;
• neuroregulatory.

They have various effects: anticonvulsant, muscle relaxant, mnestic, antihypoxic, help with ischemia and intoxication, improve metabolism and metabolic processes in the central nervous system, neurotransmitter metabolism.

Among the contraindications are pregnancy and lactation, stomach ulcers, kidney and liver diseases, allergic reactions to the components of the drug. Before their appointment, the doctor examines the patient, during the course of therapy he will take a urine test to obtain accurate data on the results of treatment.

Effective drugs for depression

Phenazepam

This is perhaps the most common drug in narcology and psychiatry. However, it is popular not only because it is highly effective in the treatment of anxiety disorders, but also because it is a dangerous pharmacy drug that causes addiction.

That is why the doctor controls the duration of the course of treatment and the dosage. It will not be possible to buy Phenazepam in a pharmacy without a doctor’s prescription. This is a benzodiazepine that acts on the central nervous system and is a potent drug. Today, the tranquilizer is used less and less, as it has a rather large list of side effects, including drug dependence. It has a sedative and hypnotic effect.

Afobazole

Innovative modern drug used for depression and neurosis. It eliminates anxiety, anxiety, relieves tension and stress, does not cause drowsiness, and has a minimum of side effects. The drug is a neuroprotector, protects nerve cells, stabilizes GABA receptors.

Mexidol

The purpose of antioxidants is to protect the body from dangerous substances that damage cells and adversely affect human health. The drug is prescribed to patients after TBI, in the presence of deviations from the cerebral circulation, stress. Mexidol is used in the treatment of encephalopathy, coronary artery disease and VVD.

Magnesium

Our bodies cannot function properly without magnesium. This substance is involved not only in metabolic processes, but also affects the work of the central nervous system. That is why it is necessary for depressive disorders to make up for the existing magnesium deficiency.

Quetiapine

The agent acts on serotonin receptors to a greater extent than on dopamine receptors. Therefore, depression is prescribed quite rarely, or in minimal doses. Most often used for more severe diseases, dementia, Alzheimer’s or Parkinson’s disease. Contraindications are oncology, hypotension, heart attack, diseases of the cardiovascular system, liver.

Amitriptyline

The drug increases the concentration of norepinephrine and serotonin and inhibits their reuptake. It is used in the presence of psycho-emotional disorders, psychosis, anxiety, insomnia, depression. It is not recommended to take in the presence of hard drinking and alcoholism, diseases of the gastrointestinal tract, pregnancy.

Atarax

Inhibits the work of the central nervous system, is prescribed for mental disorders, psychomotor agitation, nervousness, anxiety, irritability. It is not used during pregnancy and individual intolerance to the components of the drug.

Over-the-counter depression treatment

Do not think that you can buy drugs for stress and depression without prescriptions. Also, do not be mistaken about self-treatment. Depression is not just a bad mood or spleen, but a real deviation in the psyche, which is treated not only with medication, but also with long-term work with psychologists, psychotherapists or psychiatrists. If you regularly have suicidal thoughts, lack of appetite, disturbed sleep patterns, you should contact a specialist.

However, you can improve your mood and avoid illness if you use as a preventive measure:

• sport;
• travel;
• breathing exercises;
• creative pursuits;
• bathing in hot baths;
• consumption of green tea;
• aromatherapy;
• meditation.

Physical education and exercise help synthesize new neural connections that have a beneficial effect on the functioning of the nervous system and human mood. Just 30 minutes of exercise a day and a bad mood does not threaten you. No less useful for the activity of brain cells is dancing.