Types of antidepressants by J.E

All the groups of antidepressants above are effective in treating depression. On average between 50% and 65% of people with depression find their symptoms are much improved if they take one of these medications, compared with

25-30% if given an inactive” dummy ”pill or placebo. There is little difference in effectiveness of the different antidepressants, though some people find their depression responds to one and not another. The main difference between the groups relates to side effects.

The oldest antidepressants are the TCAs and MAOIs. These tend to have more side effects and/or be more dangerous if taken in overdose than the newer antidepressants.

SSRIs - Selective Serotonin Reuptake Inhibitors (e.g. fluoxetine, sertraline, citalopram, escitalopram)

The most commonly used group of antidepressants now. They treat depression and anxiety. Side effects: When first taken you may feel sick and/or more anxious. There symptoms tend to be mild usually wear off as your body gets used to the drug. In the longer term they can cause sexual problems (though can also help these by treating depression).

SNRIs - Serotonin and Noradrenaline Reuptake Inhibitors (e.g. venlafaxine, duloxetine)

The most common antidepressant used if depression does not respond to an SSRI. They treat depression, anxiety and pain. Side effects are similar to SSRIs. Venlafaxine can increase blood pressure so this needs to be monitored if higher doses are used.

NASSAs - Noradrenaline and Specific Serotoninergic Antidepressants (e.g. mirtazapine).

This is another alternative to an SSRI. They can help sleep and anxiety. The main side effects are drowsiness and weight gain. They cause less sexual problems than SSRI and SNRIs.

TCAs - Tricyclic Antidepressants (e.g. amitriptyline, clomipramine, lofepramine).

Still frequently used, but usually not the first one tried to depression. They are often sedative and can help deal with sleep problems as well as depression. They can also help treat chronic pain. The main side effects experienced with them are: Dry mouth, tremor, fast heartbeat, constipation, sleepiness and weight gain. Many of them are very dangerous in overdose.

MAOIs - Monoamine oxidase inhibitors (e.g. phenelzine, tranylcypromine, moclobemide).

These are rarely prescribed (except moclobemide). They can cause a dangerously high blood pressure if you eat certain foods while taking the drug (for examine, red wine, many cheeses, Bovril, Marmite, game and pickled herrings). They can be helpful in treating depression that has not responded to other antidepressants.

ANTIDEPRESSANTS ARE NOT ADDICTIVE; however, up to a third of people who stop SSRIs and SNRIs have withdrawal symptoms which can last between 2 weeks and 2 months eg include sensations in the body that feel like electric shocks. These can be easily dealt with for most people simply by reducing the dose by smaller amounts over a longer period of time.

When you start an antidepressant you should keep in touch with your doctor. Many of the side effects wear off in a week or so. You must take the tablets every day: if you don’t- they won’t work. They may take 1-2 weeks to start working and have their full effect may take 4-6 weeks or more. Persevere-stopping too early is the commonest reason for people not to get better.