What types of antidepressant are there?
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Read on to find out more about antidepressants:
Antidepressants
Dosage
Side-effects
Treatment
Main types of antidepressants
Here is a list of the main types of antidepressants
- Tricyclic antidepressants (TCAs) - e.g. nortriptyline, clomipramine, imipramine
- Selective serotonin reuptake inhibitors (SSRIs) e.g. Citalopram, Sertraline, Paroxetine, Fluoxetine and Fluvoxamine
- Monoamine oxidase inhibitors (MAOIs) - e.g. Moclobemide
- Serotonin Norepinephrine reuptake inhibitors- e.g. Venlafaxine, Mirtazapine
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Antidepressants for mild and moderate depression
The most widely used type of antidepressant is the SSRIs, which are effective in the treatment of mild and moderate depression. Your doctor will be able to make the appropriate choice of antidepressant for you.
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How much to take
It is extremely important that you take the correct dose of your medication. Otherwise it will be less effective and this may jeopardize your treatment.
For further information regarding the dose of your medication, please talk to your doctor or pharmacist.
NB! Elderly people may need lower doses. Talk to your family physician about this.
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Side effects from treatment with TCAs
The side effects that may result from treatment with tricyclic antidepressants include:
- Dry mouth
- Constipation
- Sweating
- Difficulty focusing on close objects
- Difficulty urinating (especially among older men with enlarged prostate)
- Dizziness (especially when rising from a sitting or lying position)
- Weight gain
- Slight trembling of the hands, heart palpitations (especially following overdose)
People who suffer from severe arrhythmia (irregular heartbeat), glaucoma (condition affecting the eye) or prostatism should avoid treatment with TCAs.
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Side effects from treatment with SSRIs?
Here are the side effects that may result from treatment with SSRIs and dual-action antidepressants. Note that the side effects vary from drug to drug - ask your doctor!
Remember that you are likely to experience side effects in the first couple of weeks of treatment. In most cases the side effects are mild and transient. If they are severe or do not go away in the first few weeks, you should talk to you doctor about it.
- Restlessness
- Sleep problems
- Dry mouth
- Nausea and vomiting
- Headache
- Sexual problems (loss of libido, delayed ejaculation, inability to ejaculate)
- Weight gain
- Blood pressure changes
- Changes in the body's salt balance
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Do I have to take my medication every day?
Yes. The most important thing for antidepressant treatment to work properly is that you take your medication as prescribed by your doctor.
It's a bad idea to take less than the prescribed dose or not to take your medication every single day. Unfortunately many people take less than they should. To avoid this please read on about:
- The purpose of treatment.
- The effects of treatment.
- The side effects of treatment.
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Does my treatment need to be monitored?
Everyone undergoing antidepressant treatment must go to his or her doctor for check-ups. It's important to keep a close eye on the effects and side effects of the treatment.
In many cases the treatment will proceed without any problems - you simply get better on the medicine prescribed by your doctor. However, other times the treatment may need to be adjusted along the way:
- Sometimes the dose needs to be increased to obtain a better effect
- Sometimes the dose needs to be reduced to prevent side-effects
- Sometimes people need to switch to another antidepressant to obtain a better effect or prevent side-effects
If you are prescribed any of the newer antidepressants, there is no need to monitor your treatment using blood tests.
If you are treated with TCAs, the amount of TCA in your blood may need to be monitored.
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How long do I need to continue treatment?
This depends on whether or not this is your first depressive episode.
Here you can read about:
- Treatment for your first depressive episode
- Treatment for subsequent depressive episodes
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Treatment for your first depressive episode
If you haven't suffered from depression before, your treatment may be phased out slowly after about a year. Your doctor will advise you about this.
Unfortunately there is a 50% risk of a second depressive episode.
But don't worry - there's a lot you can do to reduce this risk and get on top of depression. Read more...
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Treatment for subsequent depressive episodes
If you've already had three or four bouts of depression, sadly the risk of another is as high as 90%.
It may seem frightening that the risk of another depressive episode is so high, but antidepressants can be used to treat your depression and long-term treatment can effectively reduce the risk of further episodes.
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What if the treatment doesn't work?
Many of the cases are treatable in the expected time with few problems.
However, sometimes depression can be difficult to treat satisfactorily. The most common reasons for this are as follows:
- Not taking the correct dose
- Forgetting to take the medication
- Not being treated for long enough
- The drug is not suitable for you
It may be two or three weeks before you begin to notice the effects of your medication. It is common for it to be four to six weeks before you begin to feel well again.
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No grounds for pessimism
In a very few cases the medication and dose prescribed by your doctor may not be enough. Fortunately your family physician or psychiatrist has many options for improving your treatment. He or she can choose to:
- Continue your treatment unchanged for a while longer
- Increase the dose
- Switch to another antidepressant
- Give you two types of antidepressant with different effects at the same time
- Combine antidepressants with other forms of medication
- Combine antidepressants with psychotherapy or cognitive behavioural therapy
- Combine antidepressants with ECT
There is plenty of good news about depression. Although depression is a serious illness that needs to be taken seriously, you should remember that:
- Never before have we been so aware of depression
- Never before have we had so many different forms of effective treatment
- Never before have we been so good at treating depression
- Doctors, psychiatrists, psychologists, nurses and other medical staff are better equipped than ever before to help you and treat you if you are suffering from depression.
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