Introduction
Antidepressant drugs are taken to relieve a cluster of symptoms such as insomnia, extreme mood swings or decreased interest in everyday activities that result from depression disorders (Gilbert, 2010). Antidepressants are prescribed by a doctor if the patient condition is severe enough leading to impairment of their social life or has caused major distress and further affected important areas of functioning. The drugs are expected to restore the mental status of the patient and enable them to recover considerably from the depression. Antidepressants drugs should only be taken upon prescription by a doctor since they produce some serious side effects that need doctor’s supervision (Hanson, Venturelli and Fleckenstein, 2008).
How They Work
Depression is mostly caused by a decrease in neurotransmitters chemicals such as dopamine, noradrenalin and serotonin. Neurotransmitters help in the normal functioning of the brain and controlling moods as well as responses such as thinking, sleep and eating. Removal of neurotransmitters from the brain causes depression thus antidepressants slow down the elimination of these chemicals from the brain. They make these chemicals more accessible to the brain, restoring the chemical balance of the brain, thus relieving the depression symptoms (Waterlow, 2001).
Antidepressant drugs also help in reducing depressive symptoms such as hopelessness, severe sadness and reduced interest in life (Waterlow, 2001). For effective treatment, the drugs are taken for about four to six months, but some patients take them for longer periods of time. A Doctor assesses the progress of the patient between the second and the fourth week and if no improvement is noted, another antidepressant is prescribed.
When Not Use Antidepressant
Most antidepressants have serious side effects on anyone taking them but they should not be used on pregnant women since they put the unborn baby at a higher risk of getting autism or temporary withdrawal symptoms such as restlessness, tremors in a newborn after birth. Antidepressants should not be prescribed to people suffering from bipolar disorder as they make the condition worse or triggers manic episodes. Antidepressants also raise the risk of suicide in teenagers and children thus all drugs should have a warning label (Gilbert, 2010). Studies have also showed that the use of SSRI by people over the age of 65 increases the risk of bone loss, falls and fractures.
Types of Antidepressants
Antidepressants are classified according to the pharmacological and chemical qualities. There are three different classes of antidepressants as listed below:
Tricyclic
Tricyclic antidepressants enhance the increase of releasing of norepinephrine by the brain. They also inhibit re-uptake of serotonin and norepinephrine at the nerve terminal, thus relieving the symptoms of depression that can be caused by a decrease of this chemical in the brain (Ophardt, 2003).
Monoamine Oxidase Inhibitors (MAOIs)
These drugs have been used in treating depression since 1960 and work by preventing the brain chemicals such as noradrenaline from naturally breaking down. This is an irreversible action, making these antidepressants to produce more side effects compared to tricyclics (Ophardt, 2003).
Serotonin Inhibitors
Selective serotonin reuptake inhibitors commonly known as SSRIs are the most preferred antidepressants as they have milder side effects compared to tricyclics (Ophardt, 2003). They work by blocking re-uptake of serotonin, thus increasing the level of this chemical in the brain.
Side Effects of Antidepressants
All the three types of antidepressant mentioned above cause serious side effects to the user. Therefore it is important for the doctor to consider and discuss the side effects of the antidepressants with the patient before prescribing them. Tricyclics cause discomfort such as fatigue, libido loss, arrhythmia, dry mouth, constipation, tinnitus, weight changes, and an increase of the heart rate, toxicity and confusion. Monoamine oxidase inhibitors can lead to death if mixed with food containing tyramine (Gilbert, 2010). Although SSRIs are considered to be the safest, they also have side effects such as decreased libido, anxiety, fatigue, stomach disturbances and insomnia. Abuse of antidepressants and dependency should be avoided as they have serious side effects that can damage the emotional health of the user when taken for a long time (Waterlow, 2001).
Interactions
Antidepressants have several drug interactions and patients should ask the doctor for the specific references for the drug being prescribed. However, MAOIs should not be given together with the SSRIs. The patient should be given a period of five weeks before switching from one type of antidepressant to another. MAOIs have the most interaction especially with foods that contain the amino acid tyramine that is found in Chianti wine and aged cheese. Patients must adhere to the strict diet restrictions that are provided when taking MAOIs (Gilbert, 2010).
When taking tricyclics, it is advisable that the patient avoids drugs that produce anticholinergic effects. They should also not be used with sprafloxacin and grepafloxacin antibiotics as this causes severe heart arrhythmias. SSRIs should not be combined with anti-epileptic drugs or minor and major tranquilizers (Gilbert, 2010).
Examples of Antidepressant
There are many types of antidepressants drugs but the commonly used ones are Tryptizol, Anafranil, Cipramil, Sinequan, Prothiaden, Prozac, Gamanil, Tofranil, Triptafen, Lentizol Manerix, Nardil, Parnate, Efexor, Molipaxin, Seroxat and Edronax among others (Waterlow, 2001).
References
Gilbert, P. (2010). Antidepressants. Royal College of Psychiatrists, London.
Hanson, G., Venturelli, P., & Fleckenstein, E. (2008). Drugs & society. USA: Jones & Bartlett Publishers.
Ophardt, E. (2003). Antidepressants. USA: Elmhurst College.
Waterlow, M. (2001). Treating Depression. Web.