Antidepressants have been around since the 1950s, with usage increasing drastically over the last few decades. According to recent studies, more than 37 million Americans take some form of antidepressant medication. Read below to learn more about the benefits and side effects of antidepressants.
What are antidepressants?
Antidepressants are a type of medication that helps combat the symptoms of depression, anxiety disorders, seasonal affective disorder, dysthymia, and other mild or chronic conditions. While antidepressants cannot fully cure conditions like depression and anxiety, they are effective at diminishing symptoms.
How do antidepressants work?
Antidepressants work by leveling out chemical imbalances in the brain’s neurotransmitters, leading to improved changes in mood and behavior. Increasing neurotransmitters like serotonin, norepinephrine, and dopamine can help offset the effects of depression and anxiety.
While antidepressants aren’t for everyone, as much as 70 percent of people who try them find they offer some relief from their symptoms.
How many types of antidepressants are there?
There are five main types of antidepressants:
SNRIs and SSRIs
Serotonin and noradrenaline reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs) are the two most commonly used types of antidepressants.
SNRIs can help treat major depression and mood disorders and are sometimes used to treat other conditions like attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and anxiety disorders.
SNRIs work by boosting serotonin and norepinephrine production in the brain. These neurotransmitters are responsible for stabilizing our moods.
Common SNRI antidepressants include duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq).
SSRIs, the most commonly prescribed antidepressant, are predominantly used to treat depression and may have fewer and less severe side effects than other antidepressant medications. SSRIs are termed “selective,” as they mainly focus on serotonin rather than other neurotransmitters.
Rather than producing more serotonin in the brain, SSRIs work by blocking the brain’s ability to absorb serotonin. This method allows the brain to send and receive messages more easily, aiding in mood stabilization.
Examples of popular SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).
Potential side effects of SNRIs and SSRIs include:
- hypoglycemia
- low sodium
- dry mouth
- constipation or diarrhea
- nausea
- sweating and tremors
- weight loss
- insomnia
- headaches and dizziness
- anxiety
- sexual dysfunction
In some cases, SNRI and SSRI antidepressants can cause suicidal thoughts, especially in people under 18 years old.
Tricyclic antidepressants (TCAs)
Tricyclic antidepressants get their name from the medication’s three-ringed chemical structure. They are the oldest type of antidepressant and are not typically the first course of action for treating conditions like depression.
Tricyclic antidepressants work by increasing noradrenaline and serotonin production in the brain. They can be used to treat depression, fibromyalgia, OCD, panic disorders, and PTSD, and can also be used to ease chronic pain.
Common tricyclic medications include amitriptyline (Elavil), amoxapine-clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil).
Potential side effects of tricyclic antidepressants include:
- seizures
- arrhythmia, or irregular heart rhythm
- hypertension
- rash
- anxiety
- weight loss
- abdominal pain and cramping
- nausea and vomiting
- pain and pressure in the eyes
- urinary retention
- constipation
- sexual dysfunction
Monoamine oxidase inhibitors (MAOIs)
Monoamine oxidase inhibitors are used less frequently nowadays, as SNRIs and SSRIs have effectively replaced them.
This type of antidepressant controls monoamine oxidase, a brain enzyme that can break down neurotransmitters like serotonin that help stabilize mood.
Doctors may still prescribe MAOIs if SSRIs have proven ineffective in a patient. Because MAOIs react with other medications, they are typically only used when other antidepressants haven’t worked.
Side effects of MAOIs include:
- blurry vision
- rash
- seizures
- weight loss or gain
- diarrhea, nausea, and constipation
- anxiety
- insomnia
- headache and dizziness
- sexual dysfunction
- arrhythmia
- fainting or light-headedness
- hypertension
Noradrenaline and specific serotoninergic antidepressants (NASSAs)
NASSAs are used to treat depression, anxiety disorders, and some personality disorders. They are often prescribed when someone is unable to take SSRIs.
NASSAs increase the amount of noradrenaline and serotonin in the synaptic cleft and block specific serotonin receptors to aid with depression.
Side effects of NASSAs can include:
- drowsiness
- dizziness
- weight gain
- dry mouth
- constipation.
NASSAs are thought to cause less sexual dysfunction than other antidepressants. However, in rare cases, NASSAs can cause serotonin syndrome.
How long do you have to take antidepressants?
Antidepressant usage varies widely between individuals. While it can be tempting to stop taking medication once your symptoms ease, it is inadvisable, as depression, anxiety, and other conditions can quickly return in the absence of medication.
In general, doctors recommend staying on medication for at least 6 to 9 months, and the period increases the more recurrences of depression you have. If you are considering antidepressants, talk to a licensed professional who can help create a plan that works best for you.
