Healthy Living and Fitness

Illness Care: Depression

Medications

Tricyclics. These are some of the most widely used and oldest antidepressants available, with at least a dozen different drugs in this group. Common examples are amitriptyline, dothiepin and mianserin. These are often used if sedation would be beneficial, can be extremely effective in some cases of panic attacks and work by improving the transmission of messages between different parts of the brain although the exact pathways involved are still unclear. Tricyclics tend to last for some time in the body, so are usually able to be given once a day only.

Selective serotonin re-uptake inhibitors (SSRIs) are a relatively more recent group of antidepressants, and act by inhibiting the uptake and consumption of the chemical serotonin in the brain as a lack of serotonin may trigger depression in some susceptible individuals. Examples of SSRIs include Prozac and Seroxat and these tend to be less sedating than the tricyclics as well as being slightly safer in overdose. Their side effects include less drowsiness and dry mouth, but are more likely to have gastroenterological side effects such as nausea and vomiting.

Monoamine oxidase inhibitors (MAOIs) are used less commonly now because of their side effects and the fact that patients have to be careful about what they eat while they are taking them. Foods such as cheese, yeast extracts, broad beans, yoghurt and alcohol can cause the blood pressure to rise considerably with MAOIs or trigger rashes, fainting and headaches. Patients with severe phobias or depressed patients with unusual, hysterical or hypochondrial features are said to respond best to these group of drugs, as well as patients who have failed to respond to other antidepressants. Examples include phenelzine and tranylcypromine.

With all these treatments, at least 2 weeks is needed to begin to suppress the symptoms of depression, and then a period of treatment lasting between 3 and 6 months is usual before antidepressants are stopped. If treatment is stopped too quickly, symptoms are likely to return and in people who are prone to recurring attacks of depression longer-term treatment may be needed for a period of some years.

 

Return to our main Healthy Living and Fitness page