Millions of people suffer from varying degrees of depression, which affects their happiness, ability to work, and ability to live life the way they want. Antidepressants and therapy are the most common treatments. No one knows exactly what causes depression, or even what part of the brain is affected. This makes treatment with drugs very difficult, but that doesn’t mean antidepressants are ineffective.
There are several “classes” of antidepressants that treat the brain in different ways, including:
SSRIs (selective serotonin reuptake inhibitors) – This class is probably the most commonly-prescribed these days. It includes medications like Prozac, Zoloft, and Celexa. Since depression may be caused by a lack of serotonin, SSRIs work to block the reabsorption of the neurotransmitter by the brain, so there’s more available.
SNRIs (serotonin and norepinephrine reuptake inhibitors) – This is a newer class and blocks reabsorption of both serotonin and norepinephrine. Medication includes Cymbalta, Pristiq, and Effexor, which is the medication I have been on for five years.
NDRIs (norepinephrine and dopamine reuptake inhibitors) – Wellbutrin is the only drug in this class.
All antidepressants work to balance the brain with neurotransmitters like serotonin and dopamine. We know these play a role in depression; we just aren’t sure how, which is why there are so many different classes of meds.
Everyone reacts to antidepressants differently. Side effects can vary from mild to severe. One medication I was on made me sick every morning for two weeks until I finally told my psychiatrist, and she immediately had me stop taking it. Mild side effects like headaches, dizziness, and so on often disappear once the body adjusts to the antidepressants, but if they’re more debilitating, the patient should talk to their psychiatrist about switching.
Some people get relief from their depression symptoms right away with their first medication, while it can take others a while. I went through five medications before finding one that worked. Around 60% of people find success with their first medication. Even then, antidepressants can stop working after a while. I was on Celexa for a few years before switching to Effexor, because the Celexa stopped being effective. There are a host of reasons why this happens:
Stress – Increased times of stress can weaken the effects of an antidepressant, requiring either a higher dose or switch.
Getting older – Simple aging can affect an antidepressant, as the body’s chemistry changes.
Getting complacent– When a medication is working, people often start to get a bit lazy, and start missing doses or taking them at drastically different times of day. That can reduce the drug’s potency.
Substance abuse – Other drugs and alcohol can make it difficult for the brain to absorb antidepressants.
If you feel like an antidepressant can help your depression, there are some questions you should ask your psychiatrist that can help you understand medication better:
What class is it the drug in?
How much has the drug been studied?
What are the side effects like?
How high will the dose be, and will that affect long-term life?
What is the withdrawal like?
Note: Effexor is known for having terrible withdrawal symptoms, which means I have to take the medication at the same time every day or within the hour, or else the withdrawal hits right away. It’s been compared to heroin withdrawal. Knowing what the withdrawal on your medication is like can help you plan on when to take the dose and how much it will interfere with your routines.