Medical Treatments for Depression

Treatments for Depression

Clinical depression is a collection of symptoms characterized by low mood, low self-esteem and the loss of pleasure in activities that are normally enjoyable. It is a disabling condition that can adversely affect all aspects of a person’s life and 3.4 percent of people with clinical depression commit suicide. Fortunately, a variety of medications are able to manage clinical depression. These medications can be classified into the following categories:

  • Selective serotonin reuptake inhibitors
  • Serotonin-norepinephrine reuptake inhibitors
  • Tricyclic antidepressants
  • Monoamine oxidase inhibitors

Selective Serotonin Reuptake Inhibitors

SSRIs work by increasing the level of serotonin in the brain, which is a mood elevator. They are currently the preferred medication for severe depression due their broad effect on depression and relatively mild side effects. Common SSRIs include escitalopram (Cipralex, Lexapro), fluoxetine (Prozac) and sertraline (Lustral, Zoloft). Patients who don’t respond to the first SSRI are typically switched to another SSI, which improves the patient’s condition in nearly half of all cases. SSRIs typically have limited effectiveness against mild and moderate depression.

Serotonin Norepinephrine Reuptake Inhibitors

SNRIs elevate the levels of the mood elevators serotonin and norepniphrine. They include desvenlafaxine (Pristiq), duloxetine (Cymbalta), milnacipran (Ixel) and venlafaxine (Effexor). SNRIs are the newest type of anti-depressants and have side effects that are generally similar to those of SSRIs, although they are slightly less severe. SNRIs are typically administered in low doses at first and then gradually increased until the therapeutic level is reached. Similarly, a patient must taper off SNRIs gradually to minimize the risk of side effects.

Tricyclics

Tricyclics are so-named because their chemical structure is characterized by three carbon rings. This is an older class of anti-depressants that have more side effects than SSRIs. Tricyclics are typically used only when patients do not respond to the newer anti-depressants, especially inpatients. Many tricyclics are available, although amitriptyline is the most common tricyclic still in use.

MAOIs

A monoamine oxidase inhibitor reduces the ability of monoamine oxidase, which breaks down monoamine neurotransmitters. MAOIs are typically used only when all other types of anti-depressants have failed due to their interactions with other drugs which can be lethal. They are most effective in treating atypical depression, in which the patient can experience an improvement in mood when a positive event occurs. The most recent form of MAOI is Emsam, which is a transdermal patch of selegiline that was approved by the FDA in 2006.

One Comment

  1. While the specific cause of depression is not well understood , most researchers think that brain chemistry has something to do with it. Antidepressants work by altering the balance of certain chemicals in the brain, but with that come some risks and side effects that you should know about.

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