Antidepressants

Common classes of modern antidepressants are selective serotonin reuptake inhibitors (SSRIs), tricyclics (TCAs) and monoamine oxidase inhibitors (MAOIs).

Antidepressants are the most common treatment for clinical depression, relieving symptoms in 70 to 80 percent of people who use them as prescribed.

Effectiveness of drug treatments may vary among classes of antidepressants, especially for cases of severe depression.

Initial treatment with antidepressant medication fails to achieve response in 20 to 30 percent of patients with clinical depression.

Only 41 percent of patients who are prescribed an antidepressant treatment receive an adequate dosage.

Physicians may utilize several options to maximize treatment: increase the dose of the current antidepressant; combine an antidepressant with adjunctive therapy; or switch to another antidepressant.

Antidepressants can be distinguished most commonly by their side effect profile or tolerability. The average discontinuance rate for SSRIs due to side effects is as high as 20 percent.

The most common side effects caused by SSRIs are anxiety, agitation, insomnia, sexual dysfunction, nausea and diarrhea.

TCA side effects include urinary retention, dry mouth, constipation, and blurred vision.

MAOI side effects include sedation, palpitations, dizziness, insomnia, and sexual dysfunction.

Antidepressant Medication Treatment

There are a few critical issues that relate to successful antidepressant treatment. If you are taking antidepressants, make sure your treatment is on the right track.

The Most Common Reasons for Failure of Antidepressant Treatment

• Doses prescribed are too low (doses must be in the "therapeutic range" to be effective, but are often prescribed, especially in primary care settings, at doses too low to be effective).
• Antidepressants almost always must be taken for two to four weeks before the first signs of symptom improvement. Almost 70 percent of people prescribed antidepressants stop taking the medications prior to the onset of positive effects (generally, people feel so pessimistic and hopeless that they simply stop taking the medicine prior to the first signs of improvement).
• Moderate-to-heavy daily alcohol use can interfere with the metabolism of antidepressants, causing them to be ineffective.
• Taking medications on a regular basis is essential. Of those taking antidepressants, about one third take them on a sporadic basis, and the treatment fails.
• Many people take antidepressants and do get a good response, but then stop the medication prematurely and relapse. Almost always, once the medications work to eliminate depressive symptoms, an additional six months of treatment is recommended to prevent acute relapse.

Additional Facts About Antidepressants

• Antidepressants are not addictive or habit forming.
• Antidepressants are not tranquilizers.
• Antidepressants are not "happy pills." They primarily reduce the biological symptoms of depression such as fatigue, reduced sexual drive, and sleep disturbances.
• Antidepressant medications work best if they are combined with psychotherapy and self-help strategies.

Antidepressant Names and Dosages

- Ages 16-60. Over 60, doses are typically lower