Antidepressants

USE

Antidepressants are used in the treatment of major depressive disorders and can also be effective for the treatment of anxiety disorders, specific phobia, panic disorder, Obsessive Compulsive Disorder and eating disorders, amongst other things. Once a therapeutic dose has been established, signs of improvement can sometimes be seen within the first week of treatment and definite changes would be expected within 4 to 6 weeks. Further improvement can occur over several weeks and treatment should be continued for a period of 6 months after recovery. Maintenance therapy is recommended for people with recurrent or treatment resistant illness. Antidepressant medication should be withdrawn gradually to reduce the risk of relapse.

ACTION

There are a number of classes or types of antidepressant medications, which work in different ways. The most commonly used antidepressants are the Selective Serotonin Reuptake Inhibitors (SSRI) such as Prozac. This class of medication is usually quite effective without being too dangerous in overdose. As their name implies, these drugs work by affecting the concentration of a chemical called Serotonin in the brain.  If someone doesn’t respond to these, then drugs that affect a wider range of brain chemical transmitters may be used such as Venlafaxine and Mirtazapine (which affect both serotonin and another chemical called noradrenalin). Other antidepressants include Tricyclic Antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs) which are at least as effective as other antidepressants, however they have a lot of side effects at normal doses and can be very dangerous in overdose. Their use is usually limited to people who have a poor response to the other (safer) antidepressants.

EFFECTIVENESS

No single antidepressant has been shown to be more effective than another. Research shows that antidepressants are effective in approximately two thirds of people and one third of patients do not respond.