Depression patients should realize that depression is a chronic illness
just like diabetes or asthma.
People experiencing depression feel hopeless. They may have feelings
of worthlessness and experience a loss of interest in every-day
activities such as work, hobbies or physical intimacy.
Many factors can trigger depression such as: being out of work,
serious illness, divorce, flunking out of school, loss of a loved one.
Sometimes there is no apparent factor that triggers a depression.
Fortunately, depression is a highly treatable condition. If you are
diagnosed with depression and you take the medications that your
doctor prescribes, there is an excellent chance that your depression
will fade away, like a bad dream.
Scientific studies have determined that antidepressants work best
when they are combined with counseling, such as seeing a
psychiatrist, psychologist, social worker or other health professional
on a regular basis.
It is essential that depressed people who are on medication do not
discontinue taking their medication even when they feel great. You
need to take your medications religiously every day regardless of
how you feel.
If you discontinue taking your medications without the advice and
approval of your doctor, there is a good chance that you will fall into
a tailspin and become depressed again, possibly severely, and the
medicines may take longer to work.
Antidepressants are powerful drugs and should never be taken without
a doctor's prescription. You don't want to self treat depression (even
if you are a doctor) because the consequences could be disastrous.
Use in children
Antidepressants carry a strong warning regarding their use in children
and adolescents. This warning admonishes doctors and parents that
" Patients who are started on therapy should be observed closely for
clinical worsening, suicidality, or unusual changes in behavior".
If your child is taking an antidepressant you must notify the prescriber
at once if you notice any change in his behavior.
How can drugs help depression?
The brain communicates with itself through the use of special chemicals
called neurotransmitters such as "serotonin" and "norepinephrine".
There is correlation between the amount of these chemicals in the
brain and a person's mood. Low levels of serotonin and norepinephrine have not been proven to cause depression but it widely believed that
elevation of these chemicals is associated with improvement in mood
in depressed people, particularly when their use is combined with
psychological counseling.
Doctors elevate these brain chemicals with the use of drugs.
There are many different families of antidepressants available today. The two most common groups are:
- SSRI's (Selective Serotonin Reuptake Inhibitors) These drugs
ncrease the brain's level of serotonin, and are associated with an
improvement in mood. SSRI's have also been shown to be useful in
the treatment of obsessive-compulsive disorder and some forms of
severe shyness.
These drugs come with strong warnings regarding their use in
children. There is data to suggest that occasionally when kids take
SSRI's some of them engage in self destructive thoughts.
However, many times the benefits of giving your child a SSRI far
outweigh the possible side effects. That is a decision for you and
your doctor.
They are generally well tolerated and effective. Some common SSRI
side effects include: heartburn and drowsiness. They can sometimes
produce a transient loss of appetite. SSRI medications can have drug
interactions. You should consult with your doctor or pharmacist prior
to mixing them with other medications.
Tricyclic antidepressants get their name from their chemical structure. Tricyclics were first discovered in the 1950's. Prior to
that, depression was commonly treated with barbiturates or shock treatment.
This class of drugs is effective in combating depression but is associated
with troublesome side effects such as drowsiness, dry mouth and
constipation. They are also associated with weight gain and sleepiness.
Another drawback to tricyclic antidepressants is that these drugs
are dangerous when taken in an overdose.
For this reason, doctors usually prescribe the smallest number of pills
possible -- they do not want a patient to commit suicide by taking
an overdose of tricyclics.
Tricyclic antidepressant medications can have drug interactions. You
should consult with your doctor or pharmacist prior to mixing them
with other medications.
- MAOI's (monoamine oxidase Inhibitors). MAOI's are very effective
but have potentially life-threatening drug interactions and food
interactions. If you are taking a MAOI drug, it is important that you consult with your doctor before you take any other
medicines. Your doctor will also tell you which foods to avoid
mixing with your medicine.
SSRI's: General
Citalopram; Drug Family: SSRI; sometimes referred to as "Celexa".
These days, nobody buys brand Name Celexa. However, generic
citalopram is widely available at low prices.
SSRI's: General
Lexapro (escitalopram HBr: Drug Family SSRI - Forest Laboratories)
Lexapro is a cleaner, improved version of Celexa. Lexapro is
moderately expensive. It is indicated to treat depression and
Generalized Anxiety Disorder (GAD). Lexapro compares favorably
to other antidepressants such as Zoloft or Effexor.
Most people start with 10mg per day, and the doctor can go up to
20mg per day as needed. It's also available as a 5mg tablet or a
tasty peppermint flavored liquid for people who have a hard time
swallowing a pill.
Luvox (fluvoxamine; Drug Family: SSRI - Solvay)
Luvox was the old brand name for fluvoxamine. When Luvox went
generic, people stopped buying brand name Luvox and switched over
to generic fluvoxamine.
Fluvoxamine is useful in treating patients with obsessive symptoms. Somehow, the fluvoxamine short circuits obsessive thought patterns,
so a person can get these ideas out of their minds.
Paxil (paroxetine)
There are two forms of Paxil these days. Glaxo has introduced a timed
release formulation of Paxil called Paxil CR. It costs about three times
as much as generic paroxetine.
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