Anti-Depression

Depression is a complex mood disorder that can be treated in a variety of different ways. However, the popular treatment of choice is antidepressants. Antidepressants are prescription medications used to help alleviate symptoms associated with depression. Depression can not only negatively alter how you feel, but also the way you think and interact with the world and people around you. If you are experiencing feelings of sadness, hopelessness, worthlessness or possibly thinking of harming yourself your psychiatric provider may recommend an antidepressant. We have highlighted the Top 3 most commonly prescribed classes of antidepressants.

Selective Serotonin Reuptake Inhibitor (SSRI)

SSRIs are a first-line treatment depression making them the most commonly prescribed antidepressants. SSRI antidepressants work by increasing levels of serotonin within the brain.

Serotonin is a neurotransmitter that is often referred to as the “feel good hormone”. It carries messages between brain cells and contributes to well-being, good mood, appetite, as well as helping to regulate the body’s sleep-wake cycle and internal clock.

SSRIs are commonly prescribed because they are effective at improving mood, relatively safe and cause fewer or less severe side effects compared to some other antidepressants. Additionally, SSRIs can be used to treat a range of other conditions including:

• Anxiety

• Obsessive Compulsive Disorder

• Panic Disorder

Commonly Prescribed SSRIs:

• Citalopram (Celexa)

• Escitalopram (Lexapro)

• Fluoxetine (Prozac)

• Paroxetine (Paxil, Pexeva)

• Sertraline (Zoloft)

Common Side Effects of SSRIs:

All SSRIs work in a similar fashion thus they generally can cause similar side effects, although some people may not experience any. Often times many of the side effects are short lived and may go away after the first few weeks of treatment.

If you find you are unable to tolerate one SSRI, you may be able to tolerate a different one. Although, a member of the same drug class different SSRIs can differ in their potencies at blocking serotonin reuptake and in how quickly the body eliminates (metabolizes) the drug. One may experience any of the following side effects among others:

• Nausea, vomiting or diarrhea

• Headache

• Drowsiness

• Nervousness, agitation or restlessness

• Dizziness

• Sexual problems, such as reduced sexual desire, difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction)

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs are another class of medication used to treat major depression. Frequently used as an alternative treatment for those who have not been successfully treated by SNRIs. SNRI antidepressants work by increasing levels of serotonin and norepinephrine within the brain.

Norepinephrine is a neurotransmitter in the brain commonly known for its contribution to the “fight-or-flight” response. However, norepinephrine also plays an important role in the sleep-wake cycle, attention, mental focus, mood and memory.

SNRIs and SSRIs are similar in their efficacy at treating major depression. Studies have found that response is subjective some individuals respond better to SNRIs while others respond better to SSRIs. Like SSRIs, SNRIs are relatively safe and cause fewer or less severe side effects compared to some older classes of antidepressants. In addition to the treatment of depression SSRIs can be used to treat a range of other conditions including:

• Anxiety

• Obsessive Compulsive Disorder

• Nerve Pain

• Chronic Pain

Commonly Prescribed SNRIs:

• Desvenlafaxine (Pristiq)

• Duloxetine (Cymbalta) — chronic pain

• Venlafaxine (Effexor XR) — panic disorder

Common Side Effects of SNRIs:

All SNRIs work in a similar fashion thus they generally can cause similar side effects, although some people may not experience any. Often times many of the side effects are short lived and may go away after the first few weeks of treatment.

If you find you are unable to tolerate one SNRI, you may be able to tolerate a different one. Although, a member of the same drug class different SNRIs can differ in their potencies at blocking serotonin reuptake and in how quickly the body eliminates (metabolizes) the drug. One may experience any of the following side effects among others:

• Nausea

• Dry mouth

• Dizziness

• Headache

• Excessive sweating
  

Atypical Antidepressants

Atypical antidepressants consists of a variety of antidepressants that do not fit neatly into other classes. These antidepressants work by altering the levels of one or more neurotransmitters, such as dopamine, serotonin or norepinephrine. Atypical antidepressants can be used to treat depression as a single therapy much like other classes. However, this class is commonly used as and adjunctive therapy to assist with additional symptoms of depression that may not be fully covered by a single medication.

Commonly Prescribes Atypical Antidepressants:

• Bupropion (Wellbutrin SR, Wellbutrin XL, others) — treatment for smoking cessation; low energy; stimulant alternative for ADHD

• Mirtazapine (Remeron)— treatment for unintentional weight loss ; insomnia, taken at night to promote sleep

• Nefazodone

• Trazodone — treatment for insomnia, taken at night to promote sleep

• Vortioxetine (Trintellix)

Common Side Effects of Atypical Antidepressants:

Because atypical antidepressants work in a variety of different ways, each has their own unique characteristics and varying possible side effects. However, like with other classes of antidepressants you may not experience any side effects.

• Many atypical antidepressants list dry mouth, dizziness or lightheadedness as possible side effects.

• Some atypical antidepressants may help you sleep and are best taken at night, while others may cause insomnia.

• Some antidepressants may cause constipation, while others may increase the risk of diarrhea.

• Some antidepressants may increase your appetite, resulting in weight gain, while others may cause nausea.

• Some antidepressants are more likely than others to cause sexual side effects.

At Metamorphosis Psychcierge we provide comprehensive psychiatric care which may include utilizing medication to support your journey of mental wellness. For some clients, medication may prove to be an effective tool for symptom management of mental health conditions. Through our concierge care model, Dr. Moore takes the careful consideration needed to select the best-fit medication and dose.

If you are looking for the support of an empathetic mental health professional request a consultation today. Our home-visit and TelePsych concierge model will provide you with the accessibility that you need to make your mental health a priority.

Dr. Moore looks forward to discussing how the psychcierge lifestyle can get you on the road to mental prosperity.