Anti Depressants

Occasional feelings of sadness or depression are experienced by most people at some point in life. Feeling sad is a normal human response to difficult situations such as loss of a loved one, financial troubles, or problems at home. These feeling usually last for a few days. However, when these feelings turn into intense sadness, or a person feels helpless, worthless, and hopeless, and last for weeks or longer, it could be due to clinical depression. Depression is a common but serious mental illness that affects millions of Americans. The symptoms of depression interfere with daily life and cause significant pain to the patient and their loved ones. Although with proper treatment even severe symptoms of depression can get better, many people never seek treatment due to the societal stigma associated with mental illnesses.

Common symptoms of depression include the following:

·         Sadness, unhappiness

·         Loss of interest in enjoyable activities

·         Anger, frustration, irritability

·         Sleep changes (too much or too little)

·         Feelings of worthlessness

·         Thoughts of death or suicide; suicidal attempts

·         Weight loss or weight gain

CLASSES OF ANTIDEPRESSANTS

1. Selective serotonin reuptake inhibitors (SSRIs)
2. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
3. Tricyclic antidepressants (TCAs)
4. Monoamine oxidase inhibitors (MAOIs)
5. Atypical agents

Side Effects of SSRI’s

Nausea, insomnia, dizziness, weight gain or loss, tremors, sweating, anxiety and restlessness, decreased sexual drive, drowsiness or fatigue, dry mouth, constipation, Headache etc.

Side Effects of TCA’s

Blurred vision, Constipation, Increased appetite, nausea, weight gain, loss of sex drive, dry mouth, difficulty urinating, sun sensitivity and increased heart rate etc.

Side Effects of SNRI’s

Nausea, anxiety, restless, insomnia, sexual dysfunctioning, gastric upset, sweating, tremor, dizziness, weight loss, decreased sex drive, fatigue, dry mouth etc.

Side Effects of Atypical Anti Depressants

Dry mouth, nervousness, seizure at high dose, nausea, fatigue, weight gain, sleepiness, nervousness, dry mouth and blurred vision etc.

Side Effects of Monoamine Oxidase Inhibitors

Nausea, headache, stiff neck, dry mouth, dizziness, insomnia, weight gain, sleepiness at day time, sexual problems, headache etc.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They are highly effective and generally cause fewer side effects than the other antidepressants. SSRIs help to alleviate symptoms of depression by blocking the reabsorption or reuptake of serotonin in the brain. Serotonin is a naturally occurring neurotransmitter (chemical) that is used by brain cells to communicate. As SSRIs mainly affect the levels of serotonin and not levels of other neurotransmitters, they are referred to as “selective.

SSRI generic and brand names

Fluoxetine (Prozac), Fluvoxamine (Luvox), Sertraline (Zoloft), Paroxetine (Paxil), Escitalopram (Lexapro), Citalopram (Celexa)

Serotonin norepinephrine reuptake inhibitors (SNRIs)

            Serotonin norepinephrine reuptake inhibitors (SNRIs) work by blocking the reabsorption of the neurotransmitters serotonin and norepinephrine in the brain. They may also have an effect on other neurotransmitters.

SNRI’s generic and brain names

Desvenlafaxine (Pristiq), Duloxetine (Cymbalta), Levomilnacipran (Fetzima), Milnacipran (Ixel, Savella), Tofenacin (Elamol, Tofacine), Venlafaxine (Effexor)

Tricyclic antidepressants (TCAs)

Tricyclic and tetracyclic antidepressants, also called cyclic antidepressants, are among the earliest antidepressants developed. They're effective, but they've generally been replaced by antidepressants that cause fewer side effects. However, cyclic antidepressants may be a good option for some people. In certain cases, they relieve depression when other treatments have failed.

Cyclic antidepressants ease depression by impacting chemical messengers (neurotransmitters) used to communicate between brain cells. Like most antidepressants, cyclic antidepressants work by ultimately effecting changes in brain chemistry and communication in brain nerve cell circuitry known to regulate mood, to help relieve depression. Cyclic antidepressants block the absorption (reuptake) of the neurotransmitters serotonin (ser-o-TOE-nin) and nor epinephrine (nor-ep-ih-NEF-rin), increasing the levels of these two neurotransmitters in the brain. Cyclic antidepressants also affect other chemical messengers, which can lead to a number of side effects. The Food and Drug Administration (FDA) approved these cyclic antidepressants to treat depression:

Tricyclic antidepressants:

Amitriptyline, Amoxapine, Desipramine (Norpramin), Doxepin, Imipramine (Tofranil), Nortriptyline (Pamelor), Protriptyline (Vivactil) and Trimipramine (Surmontil)

A Typical Antidepressants

Atypical antidepressants ease depression by affecting chemical messengers (neurotransmitters) used to communicate between brain cells. Like most antidepressants, atypical antidepressants work by ultimately effecting changes in brain chemistry and communication in brain nerve cell circuitry known to regulate mood, to help relieve depression. Atypical antidepressants change the levels of one or more neurotransmitters, such as dopamine, serotonin or norepinephrine.

Bupropion (Wellbutrin, Forfivo XL, Aplenzin), which under the name Zyban is used to aid in smoking cessation, Mirtazapine (Remeron), Nefazodone, Trazodone, which is also used to treat insomnia and Vortioxetine (Trintellix).

Monoamine Oxidase Inhibitors

Monoamine oxidase inhibitors (MAOIs) were the first type of antidepressant developed. They're effective, but they've generally been replaced by antidepressants that are safer and cause fewer side effects. Use of MAOIs typically requires diet restrictions because they can cause dangerously high blood pressure when taken with certain foods or medications. In spite of side effects, these medications are still a good option for some people. In certain cases, they relieve depression when other treatments have failed. Antidepressants such as MAOIs ease depression by affecting chemical messengers (neurotransmitters) used to communicate between brain cells. Like most antidepressants, MAOIs work by ultimately effecting changes in the brain chemistry that are operational in depression. An enzyme called monoamine oxidase is involved in removing the neurotransmitters norepinephrine, serotonin and dopamine from the brain. MAOIs prevent this from happening, which makes more of these brain chemicals available to effect changes in both cells and circuits that have been impacted by depression. MAOIs also affect other neurotransmitters in the brain and digestive system, causing side effects. MAOIs are sometimes used to treat conditions other than depression, such as Parkinson's disease.

The Food and Drug Administration (FDA) has approved these MAOIs to treat depression:

Isocarboxazid (Marplan), Phenelzine (Nardil), Selegiline (Emsam) and Tranylcypromine (Parnate)

Selegiline is available as a skin (transdermal) patch. Using a patch may cause fewer side effects than MAOIs taken by mouth. If you're using the lowest dose patch, you may not need diet restrictions, but ask your doctor.