MENTAL HEALTH

Antidepressants: Types and Uses

February 7, 2020

Symptom Guides > Mental Health > Antidepressants: Types and Uses

by

Dr. Chris Bodle

Dr. Bodle is a board certified emergency medicine physician. He received his medical degree from Indiana University School of Medicine, and completed his residency in emergency medicine at Emory University. In addition to K Health, he currently works as an Emergency Medicine physician in an Urban, Level 1 Trauma Center in the south east.

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Depression is a common medical condition, impacting 322 million people worldwide. While depression is most commonly known for feelings of sadness, it can come with plenty of other symptoms that can interfere with your moods, physical well-being, and relationships. It is so important that people with depression seek support.

 

There are several ways to treat depression, and how your doctor treats yours depends on the severity of your symptoms. Both lifestyle changes and psychotherapy are effective ways to treat depression. Another way to treat depression is with medication. Antidepressants can balance your brain chemistry to improve depression symptoms. According to one study, about 40-60 people out of 100 people who took an antidepressant reported improved symptoms within 6-8 weeks. Your doctor can help you determine if antidepressants are right for you.

 

In this article, I’ll explore:

• What Is Depression?
• Types of Antidepressants
• Antidepressant Uses
• Common Depression Medications
• What to Know Before You Take Antidepressants
• Depression Medication Side Effects
• Alternative Treatment Options
• When to See a Doctor
• How K Health Can Help

What Is Depression?

Affecting one in 15 adults in any given year, depression is a mood disorder that can interfere with your daily life. Depression can occur in anyone, but it’s more common in women. Usually, people associate depression with persistent feelings of sadness, but depression can manifest differently in different people.

 

Common symptoms of depression include:

 

  • Sadness or a depressed mood
  • Loss of interest in activities you once enjoyed
  • Changes in appetite
  • Sleep disruption—sleeping too much or trouble sleeping
  • Lack of energy or increased fatigue
  • Feelings of hopelessness or guilt
  • Difficulty thinking and making decisions
  • Irritability or restlessness
  • Thoughts of suicide or self-harm

 

 

Types of depression

 

Under the umbrella of depression, there are also several subtypes that can cause different symptoms. It’s important to talk to a doctor or behavioral health professional to understand what kind of depression you have so you can get the right treatment.

 

  • Major depressive disorder (MDD): MDD is a type of clinical depression that causes people to feel depressed most days of the week.

 

  • Bipolar disorder: Previously known as "manic depression," bipolar disorder causes mood episodes that range from extremes of high energy with an "up" mood to low "depressive" periods. Symptoms of major depression arise during the low phase.

 

  • Seasonal affective disorder (SAD): SAD is a period of major depression more likely to occur during the winter months, when the days are shorter and there is less sunlight.

 

  • Postpartum depression (PPD): PPD is a type of depression that sometimes occurs in women after they give birth. Some women also experience depression symptoms during pregnancy.

 

  • Premenstrual dysmorphic disorder (PMDD): Often accompanied by other premenstrual symptoms like anxiety, irritability, and fatigue, PMDD is a type of depression some women experience before or at the start of their periods.

 

Types of Antidepressants

Since depression can be the result of a chemical imbalance in the brain, your doctor may treat your symptoms with an antidepressant medication. Antidepressants generally work by adjusting levels of neurotransmitters (signaling chemicals in the brain), but each drug works differently. There are five classes of depression medications your doctor may prescribe you:

 

 

Selective serotonin reuptake inhibitors (SSRIs)

 

The most commonly prescribed antidepressants, SSRIs, usually have fewer undesirable side effects than other antidepressant medications. SSRIs work by blocking the removal of serotonin from the brain and thereby increasing serotonin levels. The increase in serotonin can help the brain cells send and receive messages more efficiently, and this can result in a better mood.

 

 

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

 

Similar to SSRIs, SNRIs help balance brain chemistry by blocking the removal of neurotransmitters. Rather than just increasing serotonin levels, SNRIs also increase norepinephrine, which impacts how brain cells communicate.

 

 

Monoamine oxidase inhibitors (MAOIs)

 

Though they are less commonly prescribed now, doctors frequently prescribed MAOIs before the advent of SSRIs and SNRIs. MAOIs inhibit a brain enzyme called monoamine oxidase, which breaks down serotonin and other neurotransmitters. The end result is similar to SSRI and SNRI medications; an increase in serotonin, norepinephrine, and other neurotransmitters. However, MAOIs interact with many other medications and foods, so they are usually used as a second line medication when people are not responding to other treatments.

 

 

Tricyclic antidepressants (TCAs)

 

Tricyclic antidepressants are another, older type of antidepressant. While they are known to cause more severe side effects in some people, TCAs can help manage depression by blocking the removal of neurotransmitters, serotonin and norepinephrine, ultimately increasing their levels in the brain. They are called “tricyclic” antidepressants because there are three rings in their chemical structure.

 

 

Atypical antidepressants

 

In some cases, a doctor might prescribe an atypical antidepressant like Wellbutrin (bupropion). They are so named because they don’t fit into any other antidepressant class—each atypical antidepressant is unique and works differently. As with other antidepressants, atypical medications ease depression symptoms by altering brain chemistry.

 

Antidepressant Uses

Along with treating depression, antidepressants are also approved to help people with a number of other conditions, including:

 

  • Generalized anxiety disorder (GAD)
  • Obsessive compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Bipolar disorder
  • Social anxiety disorder

 

Studies show that 29% of antidepressant use is for “off-label use,” which means a doctor may prescribe them to treat conditions like insomnia, pain, or migraines.

 

Common Depression Medications

Depending on factors like your symptoms, current medications, and health history, along with potential side effects, your doctor may prescribe any of the below antidepressants for your depression. The medications are listed with a brand name and followed by the generic name.

 

 

SSRIs

 

  • Celexa (citalopram)
  • Lexapro (escitalopram oxalate)
  • Prozac (fluoxetine)
  • Paxil (paroxetine)
  • Zoloft (sertraline)

 

 

SNRIs

 

  • Cymbalta (duloxetine)
  • Effexor (venlafaxine)
  • Pristiq (desvenlafaxine)

 

 

MAOIs

 

  • Parnate (tranylcypromine)
  • Nardil (phenelzine)
  • Marplan (isocarboxazid)

 

 

Tricyclic antidepressants

 

  • Tofranil (imipramine)
  • Pamelor (nortriptyline)
  • Elavil (amitriptyline)
  • Norpramin (desipramine)

 

 

Atypical antidepressants

 

  • Wellbutrin (bupropion)
  • Remeron (mirtazapine)
  • Trintellix (vortioxetine)

 

What to Know Before You Take Antidepressants

If you’re thinking of trying an antidepressant, there are a few things to keep in mind. You’ll likely experience relief from depression medication, but it will usually take a few weeks before you notice any positive effects.

 

You may also need to work with your doctor to find the medication that works best for you. If you notice undesirable side effects, your doctor can help.

 

Keep in mind that some depression medications have withdrawal symptoms. If you plan to stop an antidepressant, or if you’re experiencing symptoms of antidepressant withdrawal, talk to a doctor.

 

Depression Medication Side Effects

Antidepressant side effects can vary based on the medication’s class. Some side effects are temporary and will go away a few weeks after you start, including:

 

  • Insomnia or other sleep problems
  • Nausea or stomach upset
  • Dizziness

 

Other symptoms are more likely to persist while a person takes antidepressants. Commonly reported antidepressant side effects include:

 

  • Nausea
  • Increased appetite, which can cause weight gain
  • Insomnia
  • Fatigue or tiredness
  • Dry mouth
  • Blurred vision
  • Dizziness
  • Irritability
  • Anxiety
  • Loss of sexual desire or inability to orgasm

 

Your doctor will work with you to determine whether these side effects outweigh the potential benefit of an antidepressant. If you are having trouble with any side effects from a medicine you’re on, talk to your health care provider or chat with a doctor on K about different medication options.

 

Alternative Treatment Options

Medication can be a helpful tool for your mental health, but it’s not the only line of treatment for depression. Other evidence-based practices can also help manage your depressive symptoms:

 

  • Psychotherapy

 

 

  • Certain natural antidepressants or over-the-counter supplements and herbs, such as St. John’s Wort.

 

When to See a Doctor

It’s normal for people to experience a low mood every now and then. If you find your depression symptoms are interfering with your daily life, or if they persist for more than a week or two, it’s important to talk to a doctor about your symptoms. It can be hard to admit you’re struggling, however it is important to realize you are not alone. Depression is a common condition, and the medical community is well equipped to help. Seeking support will ensure you get the care and treatment you need to feel better.

 

It’s also important to reach out to your doctor if you want to stop or change a medication for anxiety or depression, or manage side effects.

 

Contact a medical professional immediately if you have any thoughts of suicide or self-harm. The National Suicide Prevention Hotline is available 24 hours a day and can be reached at 1-800-273-8255.

 

How K Health Can Help

Anxiety and depression are among the most under-reported and under-treated diseases in America. Nearly 20% of adults in the US suffer from mental health illness and fewer than half receive treatment. Our mission is to increase access to treatment for those suffering in silence.

 

You can start controlling your anxiety and depression and get access to the treatment you need with K Health. Starting at $19/month get prescriptions for mental health medications plus unlimited doctor visits through the K Health app. Start your free assessment to see if you’re eligible.

 

Do you think you have depression?

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“Affecting one in 15 adults in any given year, depression is a mood disorder that can interfere with people’s daily lives.”

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Depression treatment starting at $19/month. Start free assessment to see if you’re eligible.

by

Dr. Chris Bodle

Dr. Bodle is a board certified emergency medicine physician. He received his medical degree from Indiana University School of Medicine, and completed his residency in emergency medicine at Emory University. In addition to K Health, he currently works as an Emergency Medicine physician in an Urban, Level 1 Trauma Center in the south east.

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