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Depression is often treated with a series of medications and aggressive therapies to resolve the biochemical imbalances that accompany this health challenge. Antidepressants typically help to normalize brain chemicals called neurotransmitters (such as sertonin, norepinephrine and dopamine) to regulate mood though this claim is often disputed.1
There are a large number of antidepressants available including the following: Monoamine Oxidase Inhibitors (MAOIs), Tricyclics (TCAs), and Selective serotonin reuptake inhibitors (SSRIs). Many of the drug therapies have interactions and strong side effects so it is important to take them under the strict supervision of a medical professional. In 2004, the Food and Drug Administration (FDA) conducted a review which revealed that 4% of those taking a specific antidepressant contemplated or attempted suicide versus 2% of those receiving placebos.2 Therefore, it is obvious that the effects of these medications can be severe and should be taken under the strict supervision of a medical professional.
All classes of antidepressants must be taken for three to four weeks before a full therapeutic effect is established. In most states, medical doctors are the ones solely responsible for prescribing antidepressants. Typically, psychiatrists and general practitioners will prescribe and monitor the patient's drug regime. Usually, the doctor will decide if and when a patient should transition off of an antidepressant. In some cases, a patient may have to stay on the medication indefinitely to stay symptom-free.
Antidepressants are the initial and most frequently prescribed form of treatment for unipolar depression in the United States.5 Although psychotropic medications clearly provide enormous benefit and relief to a substantial portion of depressed patients, research does not support this unilateral bias toward medication. Research has shown that a sizable group of patients either chooses not to continue long-term pharmacological therapy in the absence of any depressive symptoms, cannot take medication due to a medical condition that precludes the use of antidepressants, or suffer from the side effects that are intolerable to them.6
Read more about different depression medications below.
Click here to read more on Depression: Opposition to Medical Treatment.
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Effect of Tricyclics on Depression
The majority of the TCAs are thought to act primarily as serotonin-norepinephrine reuptake inhibitors (SNRIs) by blocking the serotonin transporter (SERT) and the norepinephrine transporter (NET)...
Read more about Depression and Tricyclics.
Effect of MAOIs on Depression
Monoamine oxidase (MAO) is an enzyme used to break down catecholamines (dopamine, norepinephrine, and serotonin) in neurons. MAOIs work by inhibiting the breakdown of these neurotransmitters, and the...
Read more about Depression and MAOIs.
Effect of SSRIs on Depression
SSRIs work by selectively blocking serotonin reuptake receptors, increasing the levels of serotonin in the synaptic clefts (spaces between neurons) of the brain. In contrast, tricyclics (TCAs) and...
Read more about Depression and SSRIs.
Effect of Miscellaneous Antidepressants on Depression
The most common miscellaneous antidepressant is bupropion (generic name). Brand name examples of bupropion are:
- Zyban (prescribed to help people quit...
Read more about Depression and Miscellaneous Antidepressants.
Depression: Opposition to Medical Treatment
Though there is a long standing practice of prescribing medication to those with depression, many argue that in addition to a long list of possible side effects and withdrawal symptoms when using antidepressants, there are actually studies showing that they are only as effective as placebos.7
Read more on Depression: Opposition to Medical Treatment
Treatment Resistant Depression
Antidepressants will not work for everyone. Many people begin treatment to alter their neurotransmitter levels with antidepressant medication, but without addressing all possible contributors to their depression, this treatment often does not work. This is known as treatment resistant depression; when treatments, often antidepressants, do not seem to work.
If your symptoms have continued despite your attempt to cure depression with many treatments, you may have this condition. Be sure to find a practitioner who will help you identify as many underlying causes and possible contributors to your depression, and one who will help you find different modalities that will help you treat it!
- Caruso, D. (2008) A Drug-Free Cure for Depression. Life Extension Magazine. Retrieved from http://www.lef.org/
- Depression Handbook, National Institute of Mental Health, 2008
- Preston, J. D., O'Neal, J. H., & Talaga, M. C. (2005). Handbook of clinical psychopharmacology for therapists. Oakland, CA: New Harbinger Publications, Inc.
- Preston, J. & Johnson, J. (1994). Clinical psychopharmacology made ridiculously simple. Miami, FL: MedMaster, Inc.
- Antonuccio, D. O., Danton, W. G., & DeNelsky, G. Y. (1995). Psychotherapy versus medication for depression: Challenging the conventional wisdom with data. Professional Psychology: Research and Practice, 26, 574–585. Retrieved from World Wide Web: http://www.apa.org/journals/anton.html
- Spanier, C. F. E., McEachran, A. B., Grochocinski, V. J., & Kupfer. D. J. (1996). The prophylaxis of depressive episodes in recurrent depression following discontinuation of drug therapy: Integrating psychological and biological factors. Psychological medicine, 26(3), 461-75.
- Gordon, J.S. (2008). A Drug-Free Cure for Depression. Life Extension Foundation.
- National Institute of Mental Health (2008). Depression Handbook.
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