Drugs and medicines used in the treatment of depressive orders are called antidepressants. They are prescribed in moderate to severe cases of depression, post-traumatic stress and anxiety and panic attacks. They may also be used in pain management and in certain psychological ailments like eating and obsessive-compulsive disorders. Some patients, however, may be resistant to the medications.
Types of Antidepressants
The benefits and risks of antidepressants differ according to their chemical composition. In some cases, they may serve the same purpose as a placebo pill. Patients taking antidepressants may feel anxious and nervous, nauseous and may experience headache, weight loss/gain, dry mouth and insomnia. Some avoid SSRIs and Tricyclics and tetracyclic antidepressants as they can cause sexual problems.
Below are the main types of antidepressants:
1. Selective serotonin reuptake inhibitors (SSRIs)
Patients with no drug history of antidepressants are usually given this type. They have relatively few side effects and pose lesser risks from overdose, hence, their popularity. SSRIs include well-known antidepressants such as Paxil, Prozac, Luvox, Zoloft and Celexa.
2. Serotonin and norepinephrine reuptake inhibitors (SNRIs)
These drugs are at times preferred by doctors and psychiatrists because they do not adversely affect certain other drugs. Moreover, nausea is less common with the extended-release form of SNRIs.
3. Norepinephrine and dopamine reuptake inhibitors (NDRIs)
These are generally prescribed to those with attention-deficit hyperactivity disorder or who are dependent to such substances as cocaine and nicotine. However, it should not be taken by patients who have a seizure disorder or bulimia.
4. Monamine oxidase inhibitors (MAOIs)
Despite their effectiveness, they are the least used among the types. They can prove lethal when consumed with another antidepressant or over-the-counter colds and flu medicines. They can trigger a dangerously high blood pressure with certain food intake.
5. Tricyclics and tetracyclic antidepressants
These are rarely resorted to as primary choice for treating depression. They cause multiple side effects like constipation, difficulty urinating and sedation. These medications are usually not given to older adults or people who have low blood pressure or certain heart problems.
Prescribing an antidepressant is customized according to the patient’s symptoms, side effects of the drug, its adverse effects when consumed with another medicine, pregnancy cases and other health conditions.
Managing Patients Unresponsive to Antidepressants
National Center for Biotechnology Information (NCBI) states in its website that no alternative treatment can be singled out if patient is not responding to the prescribed medication. Switching to other antidepressants or augmenting with non-antidepressant drugs has the best supporting evidence. Giving additional antidepressants, psychotherapy and electroconvulsive therapy (ECT) are also among other options.
Risks in Medications
In its March 22, 2004 advisory, the U.S. Food and Drug Administration (FDA) required the manufacturers of certain drugs to include a Warning Statement in their labels recommending close observation of adult and pediatric patients treated with these agents for worsening depression or the emergence of suicidality. This is requisite to the following: Prozac (fluoxetine); Zoloft (sertraline); Paxil (paroxetine); Luvox (fluvoxamine); Celexa (citalopram); Lexapro (escitalopram); Wellbutrin (bupropion); Effexor (venlafaxine); Serzone (nefazodone); and Remeron (mirtazapine).
One recent negative publicity involving these medicines is the Paxil lawsuit filed by patients who are purportedly exposed to certain risks as a result of taking the medicine. Antidepressants got embroiled in another risk issue with the filing of Paxil lawsuit by patients who claimed to have been exposed to certain risks as a result of taking the medicine. Recently, Paxil lawsuit was filed by patients who alleged that the drug exposed to them to certain risks. One cannot yet put a conclusive view on the benefits of antidepressants and their potential risks on patients as developments and advances in medical technology continue to evolve.
URL References:
- rcpsych.ac.uk/mentalhealthinfoforall/problems/depression/antidepressants.aspx
- mayoclinic.com/health/antidepressants/HQ01069
- ncbi.nlm.nih.gov/pubmed/17137547
- fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/PublicHealthAdvisories/ucm161696.htm