Anti-depression meds: finding one that works for you

By

Walter Alejos

|

May 4, 2021

young woman taking anti depression meds in medicine cabinet
If you’re experiencing depression, antidepressant medications may help you find relief from your symptoms.

If you experience depression or anxiety, your mental health provider may recommend an antidepressant. For many people, using a common depression medication can help manage symptoms. They’re not right for everyone, but anti-depression meds can improve your daily life by treating your symptoms—and may even help you get back to feeling like yourself again.

For people with anxiety and depression, purposefully engaging in pleasurable activities can improve mental health.
If you’re experiencing depression, antidepressant medications may help you find relief from your symptoms.

If you experience depression or anxiety, your mental health provider may recommend an antidepressant. For many people, using a common depression medication can help manage symptoms. They’re not right for everyone, but anti-depression meds can improve your daily life by treating your symptoms—and may even help you get back to feeling like yourself again.

Medication for depression

Depression is one of the most common mental health issues, affecting more than 264 million people worldwide. It’s also highly treatable, both with prescription medication and other strategies.

If you’re considering meds, it’s important to remember that not all prescription antidepressants treat depression the same way. That’s why you may need to try more than one drug to find a med that helps treat your symptoms without also causing side effects.

With so many depression meds on the market, it’s helpful to understand how each one works, so you’re empowered to work with your medical provider to find one that’s right for you.

Learning more about the most common depression medication available can also help you better communicate with your healthcare provider about a drug’s side effects and benefits. Your prescriber can address any concerns, as well as adjust your dosage and prescription as necessary, so you can start feeling better as soon as possible.

Some of the most prescribed brand-name meds include:

Depression medications work in different ways and are classified based on these differences. The most common types of depression medications are:

Other less commonly prescribed anti-depression medications include:

  • Dopamine reuptake blockers
  • 5-HT1A receptor antagonists
  • 5-HT2 receptor antagonists
  • 5-HT3 receptor antagonists
  • Noradrenergic antagonists

These antidepressants are prescribed to help people with depressive disorders, such as major depressionbipolar disorder, and seasonal affective disorder. They can also be used to treat anxiety disorders, such as phobias and panic disorder.

We’ll look at each med on the complete depression medication list in detail to help you understand its benefits, side effects, and risks.

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) work by increasing the amount of serotonin available in your brain. Serotonin is a neurotransmitter, or a chemical messenger, that carries signals between nerve cells. With more of this chemical available, your brain cells can communicate with greater ease, improving your mood and easing the symptoms of depression.

Taking an SSRI increases the availability of serotonin without impacting dopamine and norepinephrine levels.

Some examples of SSRI medications include:

SSRIs are sometimes preferable since they reduce the depression medication side effects caused by some other drugs. Plus, SSRIs are generally safe for long-term use.

Potential side effects of SSRI medications include:

  • Nausea and upset stomach
  • Insomnia
  • Headache
  • Drowsiness
  • Dry mouth
  • Restlessness
  • Dizziness
  • Sexual issues, including low libido and erectile dysfunction
  • Appetite changes, weight loss, and weight gain

SSRIs may take more time to begin working than some other medications for depression. Talk to your doctor about how long it might take before you feel the impact, and what you can do while you wait.

If you’re thinking of getting pregnant or may be pregnant, it’s essential to talk to your provider. Some SSRIs have been linked to congenital disabilities, and your provider can help you find a medication that’s safe to take while pregnant.

Finally, SSRI medications may interact with other over-the-counter drugs, such as blood thinners and the supplement St. John’s wort.

SNRIs

SNRIs impact two neurotransmitters, serotonin and norepinephrine. As with SSRIs, SNRIs work by blocking the absorption of certain chemicals in your brain, increasing the levels available to transmit messages.

In addition to helping with the symptoms of depression, SNRIs are also effective in treating anxiety disorders and chronic pain.

Some examples of SNRI medications include:

  • Desvenlafaxine (Pristiq)
  • Duloxetine (Cymbalta)
  • Levomilnacipran (Fetzima)
  • Venlafaxine (Effexor XR)

Potential side effects of SNRI medications include:

  • Nausea and constipation
  • Dry mouth
  • Dizziness
  • Headache
  • Sweating
  • Tiredness
  • Insomnia
  • Sexual issues, including low libido and erectile dysfunction
  • Appetite loss

Like SSRI medications, SNRIs may interact with over-the-counter medications and supplements that affect your serotonin levels and increase your risk of bleeding.

Certain SNRI medications may increase your blood pressure or worsen liver problems. If you plan to become pregnant while taking SNRI medication, talk to your healthcare professional about meds you can take safely while pregnant.

MAOIs

Like other antidepressants, MAOIs, or monoamine oxidase inhibitors, can help relieve the symptoms of depression by influencing the levels of chemicals in your brain.

MAOIs target a different neurotransmitter than SNRIs and SSRIs and use a different mechanism to do it.

While MAOI medications were one of the first anti-depressants on the market, they can lead to serious interactions. That’s why modern medical professionals prescribe this antidepressant more conservatively than others.

Some examples of monoamine oxidase inhibitors are:

  • Selegiline (Emsam)
  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)

Potential side effects of MAOI medications include:

  • Weight gain
  • Fatigue
  • Low blood pressure
  • Dry mouth
  • Nausea and upset stomach
  • Headache
  • Drowsiness
  • Insomnia
  • Dizziness
  • Skin reactions
  • Involuntary muscle jerks
  • Sexual issues, including low libido
  • Urinary retention
  • Muscle cramps
  • Prickling or tingling sensations

MAOI medications may also interact with over-the-counter medications, such as other antidepressant drugs, some pain and headache medicines, certain cold and allergy meds, and the herbal supplement St. John’s wort.

MAOIs can cause dangerous interactions with certain foods, including those rich in tyramine. Foods that contain tyramine in large amounts include fermented foods like sauerkraut, aged cheeses, cured meats, and fermented soy products like soy sauce.

TCAs

Tricyclic antidepressants work by increasing the amount of serotonin and norepinephrine in your brain. But TCAs also block 3 additional neurotransmitter pathways. It’s by impacting your brain chemistry that this class of medication can improve your mood and treat the symptoms of depression.

Because TCAs influence the levels of several different neurotransmitters, they lead to more side effects and adverse reactions than SSRIs and SNRIs. For this reason, TCAs are no longer considered a first-line treatment option for most depressive disorders.

Mental health professionals typically recommend TCAs for patients with depressive symptoms that haven’t responded to other treatments. They’re also sometimes used to treat the symptoms of particular mental health conditions, such as obsessive-compulsive disorder, bipolar disorder, or chronic nerve pain.

Some examples of tricyclic antidepressants include:

  • Amitriptyline (Tryptizol)
  • Amoxapine (Asendin)
  • Desipramine (Norpramin)
  • Doxepin
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Protriptyline
  • Trimipramine

Potential side effects of TCA medications include:

  • Constipation
  • Dizziness
  • Dry mouth
  • Blurred vision
  • Confusion
  • Urinary retention
  • Rapid heartbeat
  • Low blood pressure
  • Sedation
  • Increased appetite and weight gain
  • Cardiovascular complications
  • Liver problems
  • Suicidal thoughts

TCAs aren’t generally considered safe to take while pregnant. Also, if you have a heart condition, glaucoma, or a history of seizures, your provider will likely suggest another type of medication.

Tetracyclic antidepressants

Like tricyclic antidepressants, tetracyclic antidepressants increase serotonin and norepinephrine levels and also influence other neurotransmitter pathways. By changing the way the chemicals in your brain communicate, these meds can help improve the symptoms of depression.

Examples of tetracyclic antidepressants include:

  • Mirtazapine (Remeron)
  • Maprotiline (Ludiomil)
  • Amoxapine (Asendin)
  • Mianserin

Due to the side effects caused by tetracyclic antidepressants, most mental health professionals don’t consider them a first-line treatment for the symptoms of depression.

Potential side effects of tetracyclic antidepressant medications include:

  • Constipation
  • Dizziness
  • Dry mouth
  • Blurred vision
  • Confusion
  • Urinary retention
  • Rapid heartbeat
  • Low blood pressure
  • Sedation
  • Increased appetite and weight gain
  • Cardiovascular complications
  • Liver problems
  • Suicidal thoughts

Tetracyclic antidepressants can also cause severe withdrawal symptoms if you discontinue them suddenly. Some of the withdrawal symptoms include anxiety, irritability, nausea, sweating, insomnia, and headache.

Atypical antidepressants

The term atypical antidepressants refers to a group of medications that don’t fit into any of the other categories we’ve described. Like other meds, this group of antidepressants changes your brain chemistry to make it easier for brain cells to communicate, helping to improve your mood and relieve the symptoms of depression.

For the most part, these meds have been developed within the last 40 years, which is why people call them second-generation antidepressants.

Atypical depression medication names include:

Because there are so many different types of atypical antidepressants, the side effects can vary significantly. Unlike most other antidepressants, atypical antidepressants are unlikely to cause sexual dysfunction or weight gain.

Potential side effects of tetracyclic antidepressant medications include:

  • Headache
  • Agitation
  • Insomnia
  • Loss of appetite
  • Weight loss
  • Sweating
  • Sedation
  • Nausea
  • Prolonged erection
  • Diarrhea
  • Dizziness

Medication for anxiety and depression

The Food and Drug Administration (FDA) has approved medications to treat anxiety and depressive disorders. The following SSRI medications are commonly used for the treatment of both depression and anxiety.

Sertraline (Zoloft)

This medication has been approved to treat major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

Escitalopram (Lexapro)

In addition to major depressive disorder, Lexapro can treat generalized anxiety disorder (GAD).

Fluoxetine (Prozac)

This med can treat major depressive disorder, bulimia nervosa, OCD, and panic disorder. It can also be combined with other medications to treat bipolar I disorder and treatment-resistant depression.

Paroxetine (Paxil, Pexeva)

Pexeva is prescribed for major depressive disorder, OCD, panic disorder, and GAD.  Paxil CR is approved to treat major depressive disorder, panic disorder, social anxiety disorder, and PMDD.

Citalopram (Celexa)

Celexa has been approved to treat major depressive disorder and GAD.

Getting the most out of your meds

In order to give your meds the best chance of working, it’s important to follow medical advice and take your medication exactly as prescribed. Research has shown that people with depression are 3 times more likely not to follow their medical plan.

This is understandable, but the issue is that this can reduce the effectiveness of the medication significantly. When taken as prescribed, it can still take time for some of these antidepressant medications to positively impact your mood. That’s why being consistent and patient is essential, even when challenging.

Talk with your healthcare professional about any uncomfortable side effects, especially if they’re severe enough to affect your daily life.

Because some antidepressants cause withdrawal symptoms, it’s important to continue taking your medication even if you don’t notice a difference in your mood. When you talk with your healthcare provider, ask how long it usually takes to see an improvement in symptoms.

If your anti-depression meds still haven’t helped after the typical amount of time, please let your healthcare provider know. A mental health or healthcare professional can help you manage your dosage and change medications safely.

If the medication isn’t working for you because of side effects or for some other reason, it’s essential to contact your prescriber. Mild side effects often occur when starting a new med, but you don’t have to live with extreme side effects that disrupt your ability to function. Never try to discontinue medication on your own, as this can have severe repercussions. Contact your provider immediately if you’re having trouble with your meds.

Finally, it’s essential to be mindful of the over-the-counter medications and supplements you take. Certain illegal drugs, prescription meds, and supplements can influence your serotonin levels.

Too much serotonin can lead to a dangerous condition called serotonin syndrome. If you start to experience extreme physical symptoms like anxiety, blood pressure changes, and rapid heart rate, please seek medical help immediately.

Risks

In addition to the possibility of serotonin syndrome, most antidepressants have one significant risk factor—suicidal thoughts and actions. Though the risk is low, occurring in less than 1% of people, these meds may increase suicidal thinking and behavior. There is an especial risk for children, adolescents, and young adults.

Your healthcare professional has recommended or prescribed antidepressants to help you. If the meds you’re taking or considering taking aren’t helping or are making you feel worse, please reach out to your provider right away.

Withdrawal from antidepressant medication can elevate the risks associated with antidepressants, as well as causing other unpleasant symptoms.

That’s why it’s so important to stick to your treatment plan and make decisions with the guidance of a mental health professional. Don’t increase or decrease your dosage without seeking medical advice first.

If you’re experiencing suicidal thoughts, help is available right now. In the event of a psychiatric emergency, call 911 or go to the nearest emergency room. The National Suicide Prevention Hotline— available at 1-800-273-8255 or by texting “home” to 741-741— can provide you with immediate help and guidance.

Takeaway

  • Antidepressant medications can treat a range of depressive disorders, plus some anxiety disorders.
  • The most common types of meds are SSRIs, SNRIs, cyclic antidepressants, MAOIs, and atypical antidepressants.
  • Antidepressants take time to start working and may cause side effects.
  • If you’re having a hard time with side effects or if your meds aren’t working, talk to your prescriber.
  • Don’t stop taking your meds without consulting your medical provider because you might experience withdrawal.
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By

Walter Alejos

|

May 4, 2021