Antidepressant Information

What are anti-depressants?

The term antidepressant is sometimes applied to any therapy or process found to improve a clinically depressed mood.

In the 1950s Opioids were used to treat major depression, in the 1960s Amphetamines were used,  today SSRIs are used.

Antidepressants are in a group of drugs/medications called SSRI’s or Selective Serotonin Re-uptake Inhibitors.  SSRI’s are typically used to alleviate mood disorders, such as depression, anxiety, insomnia, obsessive-compulsive disorder, eating disorders, chronic pain, post traumatic stress disorder, and premenstrual dysphoric disorder.

SSRI’s work by increasing the extracellular level of the neurotransmitter  (chemical messenger) serotonin in the brain by inhibiting its re-uptake (re-absorption) into the presynaptic cell.  This process is believed to increase the level of serotonin in the synaptic cleft of the brain.

It is believed that changing the balance of serotonin helps brain cells send and receive chemical messages, which then boost mood.

SSRI Efficacy:

It is estimated that between 30% and 50% of individuals treated with a given antidepressant do not show a response.  Where there has been a strong response, it is common to still note significant continuing depression and dysfunction with relapse rates of 3 to 6 times higher in some cases.  Also, antidepressant drugs tend to lose efficacy over the course of treatment.  There are a number of strategies your physician may use to overcome these limits and variations.

A Meta-Analysis from 2010 disputes the efficiency of SSRI’s, indicating that:

“The magnitude of benefit of antidepressant medication compared with placebo, may be minimal or nonexistent, on average, in patients with mild or moderate symptoms.  For patients with very severe depression, the benefit of medications over placebo is substantial.”

 

FDA (Food & Drug Administration) Approved some SSRI’s for the treatment of depression Including:

  • Celexa (Citalopram
  • Lexapro (Escitalopram)
  • Prozac (Fluoxetine)
  • Paxil (Paroxetine)
  • Zoloft (Sertraline)
  • Symbyax (Fluoxetine combined with the atypical antipsychotic olanzapine)

Side effects of SSRI’s include, but are not limited to:

  • Nausea
  • Dry Mouth
  • Headache
  • Diarrhea
  • Nervousness
  • Reduced Sexual Desire
  • Inability to Maintain an Erection
  • Rash
  • Increased Sweating
  • Weight Gain
  • Drowsiness
  • Insomnia
  • Increased Blood Pressure
  • Tremor
  • Agitation
  • Muscle Weakness
The FDA (Food and Drug Administration) requires Black Box warnings on all SSRI’s which state that they double suicidal rates in children and adolescents.  The increased risk of suicidal behavior among adults under 25 is comparable to that seen in children and adolescents.

Long-Term Use Of SSRI’s:

Once the course of your antidepressant ends, the therapeutic effects do not continue, which can result in a high rate of relapse.  A recent study found that 18% of patients who had responded to an antidepressant relapsed while still taking it, compared to 41% whose antidepressant was switched for a placebo.

The American Psychiatric Association guidelines advise 4 to 5 months of continuation treatment on an antidepressant following the resolution of symptoms.

The British Association for Psychopharmacology’s 200 Guidelines for Treating Depressive Disorders with Antidepressants advise remaining on the antidepressant for at least 6 months and as long as 5 years or even indefinitely.

Comments are closed.