Antidepressants – How Do They Work? Types, Choice & List of Antidepressants

Antidepressants – How Do They Work, Types, Choice, List of Antidepressants
Antidepressants – How Do They Work, Types, Choice, List of Antidepressants

This article is about the most common antidepressants. You will learn the work principles of several types of them. Besides, a list of antidepressants is presented below.

Medications for depression are used in modern medicine, they reflect the understanding of role and place so-called neurotransmitters (chemicals that provide communication between our body and brain). Since the “work” of the nervous system involves several neurotransmitters, various medications are used for the recovery of their functions.
Antidepressants are a class of drugs that reduce symptoms of depressive disorders by correcting chemical imbalances of neurotransmitters in the brain. Chemical imbalances may be responsible for changes in mood and behavior.

Before the discovery of drugs with stimulant effect were actively used where the “melancholic” state was replaced by euphoria. These stimulants were opium and other opiates, caffeine, ginseng. Along with them in order to reduce anxiety salt bromine, valerian, lemon balm and motherwort were used.

AntidepressantsThe invention of antidepressants in 50-s was a true revolution in psychopharmacology. During more than half a century these drugs have been the most effective medication for depression. The first medication for depression was “discovered” by accident when iproniazid is a drug used in the treatment of tuberculosis, an unusual side effect was discovered. Patients who took iproniazid were in good mood. Soon it became a drug for depressive disorders. Approximately the same time the German doctor discovered imipramine in the course of experiments with various substances, which also improves mood and gets rid of the blues. Unlike iproniazid, imipramine still exists in the official list of antidepressants; it is one of the most popular and best-selling meds.

How do antidepressants work?

In general, they work by inhibiting the reuptake of specific neurotransmitters, hence increasing their levels around the nerves within the brain.

Are they dangerous?

There is an opinion that the pills for depression are harmful and addictive. The answer is simple: drugs used today are not addictive no matter how long you take them. Their purpose is to help the body to restore the broken mechanisms. Drugs for depression are able to “reconstruct” the broken body and return the person to his normal life.

Do they work immediately?

The effect of drugs is not immediate. As a rule, it takes at least two weeks after taking antidepressants, although some patients notice a positive change in mood after one week.

Types of antidepressants

Tricyclic antidepressants (TCA)

Antidepressants 2Tricyclic antidepressants (TCA) are groups of the oldest drugs. Meds of this type affect the brain chemicals serotonin, norepinephrine, and dopamine. The drugs are still effective, but they are used less often because the side effects are more common. Side effects caused by these medicines can include dry mouth, blurred vision, constipation, difficulty urinating, worsening of glaucoma, impaired thinking, and tiredness. These antidepressants can also affect a person’s blood pressure and heart rate. Today psychiatrists try not to use this type of antidepressants.

Monoamine oxidase inhibitors (MAOIs)

As a rule, MAOIs are prescribed for patients who have not reached any improvement after taking tricyclic antidepressants. These drugs are used in atypical depression (a disease where some symptoms are different from the typical symptoms of depression). It is recommended to take them in order to treat mild depression – dysthymia. MAOIs affect an enzyme in the brain called monoamine. This substance destroys norepinephrine and serotonin, which affect mood. MAOIs can have serious side effects, including weakness, dizziness, headaches, and trembling.

Selective serotonin reuptake inhibitors (SSRIs)

Doctors often start by prescribing an SSRI. These medications are safer and generally cause fewer bothersome side effects than other types of antidepressants. SSRIs affect a chemical in the brain called serotonin. SSRIs are used not only to deal with depressive disorders. They are designed to deal with other unpleasant issues, such as overeating. SSRIs should not be prescribed for patients with bipolar depression, as they can cause mania. The drugs are not recommended for patients with liver disease. You also need to remember that this group of antidepressants may affect erectile function.

Other antidepressants

There are also drugs that do not fit any of the three groups mentioned above as they are different in composition and action.

Melatonergic antidepressants

Melatonergic antidepressants are the latest achievement of psychopharmacology. This drug is capable of influencing simultaneously on three types of receptors that are responsible for regulating the body’s biological rhythms. The product after 7 days of therapy normalizes sleep and daily activity and reduces anxiety.

List of antidepressants

The choice of an antidepressant is the most crucial moment of treatment. It is doctor’s responsibility. Before prescribing an antidepressant, it is important to consider: the patient’s age, individual sensitivity to psychopharmacological drugs, the severity of depression, the effects of previous treatment, and other medications.

Tricyclic antidepressants Tricyclic antidepressants:

  • imipramine (Tofranil),
  • nortriptyline (Pamelor),
  • amitriptyline,
  • doxepin,
  • trimipramine (Surmontil),
  • desipramine (Norpramin), and
  • protriptyline (Vivactil)

Monoamine oxidase inhibitors (MAOIs):

  • rasagiline(Azilect),
  • selegiline(Eldepryl, Zelapar),
  • isocarboxazid (Marplan),
  • phenelzine (Nardil), and
  • tranylcypromine (Parnate).

Selective serotonin reuptake inhibitors (SSRIs):

Other antidepressants:

  • Mianserin
  • Trazodone
  • Mirtazapine
  • Bupropion
  • Tianeptine
  • Venlafaxine
  • Milnacipran
  • Nefazodone

Melatonergic antidepressants

  • Agomelatine (Melitor)

However, you can treat depression with the help of tranquilizers, mood stabilizers or other medications. It is preferable to take an antidepressant instead of a tranquilizer. If your anxiety is so severe that you need medication, an antidepressant is usually a better choice than a tranquilizer. Why? Because anxiety is one of the common symptoms of depression.antidepressants mood stabilizers

Although not common, some people have experienced withdrawal symptoms when stopping an antidepressant too abruptly. Therefore, when discontinuing an antidepressant, gradual withdrawal is generally advisable.

It conclusion, questions about any antidepressant prescribed, or problems that may be related to the medication, should be discussed with the doctor and/or the pharmacist.

References

1. http://www.helpguide.org/articles/depression/types-of-antidepressants-and-their-side-effects.htm

2. http://www.healthline.com/health/depression/medication-list

3. http://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273

Additional:

4. http://joannamoncrieff.com/2013/11/27/why-theres-no-such-thing-as-an-antidepressant/

5. https://psychiatrysho.wordpress.com/2014/04/21/antidepressants-are-not-happy-pills/

6. https://farganne.wordpress.com/2013/01/12/antidepressants-make-ecstasy-look-like-caffeine/

7. http://tmsneuro.com/depression/the-truth-behind-anti-depressants/

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