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What are Antidepressant Medications?

Writer's picture: Munachiso EzeasorMunachiso Ezeasor
Nov 4, 20244 min read

Antidepressants| What are Antidepressant Medications?| Mental Aid blog

Overview on antidepressants

Antidepressants are medications primarily prescribed for managing clinical depression, but they also have applications in treating various other conditions [1]. These include obsessive-compulsive disorder (OCD) [1], generalized anxiety disorder [1], social phobia [2], panic disorder [2] and post-traumatic stress disorder [1](PTSD) [1]. Additionally, antidepressants are sometimes utilized to help individuals cope with chronic pain [1]. Studies indicate that antidepressants can be beneficial for individuals with moderate to severe depression [1]. They are generally not recommended for mild depression unless other approaches, such as talk therapy, have proven ineffective [1].


Antidepressants are typically administered in tablet form, with an initial dose set at the lowest level thought to be effective for symptom relief [1]. It often takes 1 to 2 weeks of consistent use before any benefits are noticed, so it's important not to discontinue use if mild side effects appear early, as these usually subside quickly [1]. If after 4 weeks there is no improvement, consult your GP or mental health specialist, who may suggest adjusting the dosage or trying an alternative medication [1]. Treatment usually continues for at least 6 months after symptoms improve, and for those with recurrent depression, long-term use may be recommended [1].


Consult your doctor before discontinuing antidepressants, as it's essential not to stop taking them abruptly [1]. When you are ready to stop, your doctor will likely advise gradually reducing your dose over several weeks, or longer if you have been on them for an extended period [1]. This approach helps minimize potential withdrawal symptoms associated with stopping the medication [1].


Types of antidepressants

  1. Selective serotonin reuptake inhibitors (SSRIs)[1]

SSRIs are the most commonly prescribed antidepressants and are generally favored over other types due to their lower likelihood of causing side effects [1]. Additionally, they present a reduced risk of serious consequences in the event of an overdose [1]. Examples are fluoxetine (Prozac) [1], citalopram (Cipramil) [1], escitalopram (Cipralex) [1], paroxetine (Seroxat) [1], fluvoxamine [2] and sertraline (Lustral) [1].

  1. Serotonin-noradrenaline reuptake inhibitors (SNRIs)[1]

SNRIs are similar to SSRIs and were developed with the intention of providing a more effective treatment for depression [1]. However, evidence on whether SNRIs are indeed more effective remains inconclusive [1]. Some individuals seem to respond better to SSRIs, while others may find SNRIs more beneficial. Examples are duloxetine (Cymbalta and Yentreve) [1], desvenlafaxine [2], milnacipran [2], levomilnacipran [2], and venlafaxine (Effexor) [1].

  1. Noradrenaline and specific serotonergic antidepressants (NASSAs)[1]

NASSAs can be an effective alternative for individuals who cannot take SSRIs [1]. While their side effects are similar to those of SSRIs, NASSAs are believed to cause fewer sexual side effects [1]. However, they may initially lead to increased drowsiness [1]. Examples are mirtazapine (Zispin) [1], venlafaxine [2], desvenlafaxien [2], duloxetine [2], and levomilnacipan [2].

  1. Tricyclic antidepressants (TCAs)[1]

    TCAs are an older class of antidepressants and are generally not the first choice for treating depression due to their higher risk in overdose situations and a greater likelihood of unpleasant side effects compared to SSRIs and SNRIs [1]. However, they may still be prescribed for individuals with severe depression who do not respond to other treatments [1]. Additionally, TCAs can sometimes be recommended for managing other mental health conditions, including OCD and bipolar disorder [1]. Examples are amitriptyline, clomipramine [1], dosulepin [1], imipramine [1], lofepramine [1], doxepin [2], trimipramine [2], desipramine [2], protriptyline [2], maprotiline [2], amoxapine [2], and nortriptyline [1]. TCAs, such as amitriptyline, are used to treat chronic nerve pain [1].

  2. Serotonin antagonists and reuptake inhibitors (SARIs)[1]

    SARIs are typically not the first-line option for antidepressants but may be prescribed when other antidepressants prove ineffective or cause adverse side effects [1]. Examples are trazodone (Molipaxin) [1], nefazodone [2], vilazodone [2], and vortioxetine [2]

  3. Monoamine oxidase inhibitors (MAOIs)[1]

    MAOIs are an older class of antidepressants that are seldom used today due to the potential for serious side effects [1]. They should only be prescribed by a specialist [1]. Examples of MAOIs include tranylcypromine [1], phenelzine [1], selegiline [2], moclobemide [2], and isocarboxazid [1].

  4. Atypical antidepressants[2]

    These antidepressants are labeled as atypical because they do not clearly align with any of the other established categories of antidepressants [3]. Examples are bupropion [2], mirtazapine [2], and agomelatine [2].


How antidepressants work

Antidepressants work by increasing levels of neurotransmitters in the brain, such as serotonin and noradrenaline, which play a role in regulating mood and emotions [1]. These neurotransmitters may also influence nerve-related pain signals, which could explain why some antidepressants are effective for chronic pain relief [1]. Although antidepressants can alleviate depression symptoms, they do not necessarily target the underlying causes [1]. Therefore, they are often combined with therapy, especially for treating severe depression or other mental health conditions [1].


Side effects of antidepressants

Side effects of selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) include:

  1. Feeling agitated [4]

  2. Indigestion and stomach ache [4]

  3. Diarrhea or constipation [4]

  4. Loss of appitiete [4]

  5. Dizziness [4]

  6. Insomnia [4]

  7. Headaches [4]

  8. Loss of libido [4]

  9. Difficulty achieving orgasm during sex or masturbation [4]

  10. Difficulty obtaining or maintaining erection [4]

Side effects of tricyclic antidepressants include:

  1. Dry mouth [4]

  2. Blurring vision [4]

  3. Constipation [4]

  4. Problem passing urine [4]

  5. Drowsiness [4]

  6. Dizziness [4]

  7. Weight gain [4]

  8. Excessive sweating [4]

  9. Hearth rhythm problems (arrhythmia) [4]


References

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