10 Common Questions About Antidepressants

1. How do antidepressants work?

antidepressantsMost antidepressants alter the balance of chemicals in the brain, called neurotransmitters. Lack of neurotransmitters can cause a variety of disorders, such as depression. Antidepressants make neurotransmitters more available to brain cells. Antidepressants do not work right away – usually must go through from two to four weeks before they start working.

Before you take any medications, make sure to learn more about how they work and how are medications used to treat mental disorders. The following link “Mental Health Medications“, is a perfect resource to star from.

2. What to expect from antidepressants?

Antidepressant – is a very effective medicine, if it is used along with therapy. This combination has been recognized as the best treatment for depression. Most people who take antidepressants have reported significant improvement of symptoms such as sadness, loss of interest in life and a sense of hopelessness. Remember that the antidepressant will work no earlier than 3 weeks after the start of administration.

In the study Combining psychotherapy and antidepressants in the treatment of depression, published by the Journal of Affective Disorders, it was concluded that — “Patients found combined treatment significantly more acceptable, they were significantly less likely to drop out of combined therapy and, ultimately, significantly more likely to recover.”

3. What if the antidepressants do not work for me?

If the symptoms of depression do not decrease after 3 weeks, you should consult your doctor. Perhaps you should change the dosage or the medication at all. It is a normal practice: usually the first administrated antidepressant does not work. Wait at least 3 months in order to assess the effectiveness of the drug.

If your depression symptoms did not get better while taking SSRI (Selective Serotonin Reuptake Inhibitors, please note that not all antidepressants are SSRIs ), you are not alone. There are other options to treat your depression. This summary report can help you.

4. Expensive VS. cheap antidepressants?

According to U.S. Food and Drug Administration, expensive counterparts do not differ from cheap (generic) in strength, safety or quality. However, some studies indicate the opposite. If you have concerns about your medication, consult your doctor.

I suggest you to take a look to this research also “Effectiveness and Cost-Effectiveness of Antidepressants in Primary Care: A Multiple Treatment Comparison Meta-Analysis and Cost-Effectiveness Model” (Authors:Joakim Ramsberg, Christian Asseburg, and Martin Henriksson)

5. How long will I have to take the antidepressant?

Usually the treatment with antidepressants lasts no longer than a year. You should not suddenly stop taking antidepressants that have been prescribed for you, even if you feel better. If it became difficult for you to fall asleep, ask your doctor to develop a suitable drug administration. For example, you can drink a pill every day for breakfast.

Approximately 60 to 70 percent of patients respond to the first antidepressant that is prescribed or to an increased dosage of that drug, according to Mathis. But patients must take regular doses of a prescribed antidepressant for at least 3 to 4 weeks before they are likely to experience the full therapeutic effect. And if patients start to feel better, they should not stop taking the antidepressant.

“Even if you start to feel better, you may be in between episodes,” says Mitchell Mathis (M.D., deputy director of the Division of Psychiatry Products at FDA.) “Depression tends to be chronic and requires everyday treatment just like high blood pressure.” — Source:  Understanding Antidepressant Medications – FDA.GOV

6. Are there any dangerous side effects?

Do not hesitate to inform your doctor about the side effects of the antidepressant. For example, if you take the medicine with food, then you may experience nausea. Sometimes antidepressants cause sexual problems. If you have trouble falling asleep, take medication 2 hours before sleep or in the morning. Usually, the side effects disappear after a few weeks of administration.

The Mayo Foundation for Medical Education and Research published an excellent article on this particular question called “Antidepressants: Get tips to cope with side effects“, take a look here.

7. Is it safe to take antidepressants with other medications?

The new generations of antidepressants have far fewer side effects and hardly react with other medications. However, you should still put your doctor on notice if you drink some pills or dietary supplements along with an antidepressant.

A more detailed information about the Use of Antidepressants With Other Medications can be found in the book called Outpatient Management of Depression, by Sheldon H. Preskorn, M.D., the President and Chief Executive Officer for the Clinical Research Institute and Professor in the Department of Psychiatry at the University of Kansas School of Medicine-Wichita.

8. Are antidepressants addictive?

Some patients worry that antidepressants will turn them into robots. These drugs only reduce feelings of sadness, while other emotions do not disappear. Others are afraid that they will become addicted to them. The usual course of antidepressants is from 6 to 12 months. Antidepressants do not cause physical addiction.

Even so, some studies including a Danish meta-analysis conducted by Margrethe Nielsen, claims that antidepressants lead to addiction. While I cannot agree with it besides the fact  that some antidepressants are more likely to cause withdrawal symptoms than others, but this in no ways means it can cause addiction. (Remember : “Addiction represents harmful, long-term chemical changes in the brain. It’s characterized by intense cravings, the inability to control your use of a substance and negative consequences from that substance use. Antidepressants don’t cause these issues.”)

9. Can I drink alcohol while on antidepressants?

Ask your doctor first. Alcohol can cause a bad reaction or make you feel worse. The use of alcohol is discouraged by all manufacturers of antidepressants. Furthermore, alcohol is known to cause or worsen depression and should be avoided in general while on antidepressants.

It is known that alcohol does have a sedative effect on the brain, and as said in the earlier published article, a new study even claims that A Glass of Wine Helps With Depression. So a single drink for the day should help stop depression from getting the better of you. While drinking heavily not only could be a sign of alcohol abuse, but also could increase your level of depression. Even  it’s not clear yet whether depression triggers alcohol abuse or vice versa, but it’s very likely that they share common triggers. So the best you can do now is to ask your doctor or chemist if it is safe to drink alcohol with any medicine that you have been prescribed.

10. When to stop taking antidepressants?

Your doctor will determine the best time to stop taking the medication. If you give up sharply from the course, it can cause unwanted side effects or even relapse. It is best to gradually reduce the dose in accordance with the guidance of a doctor.

One last article I would recommend here for additional reading is Recognising and managing antidepressant discontinuation symptoms, by Peter M. Haddad and Ian M. Anderson.