Health

15 Things You Should Know About Antidepressant Medications Before Taking Them

3. There are Many Types of Antidepressants There are several different types of antidepressants a mental health care professional can prescribe. They base what they prescribe… Simi - June 9, 2018

3. There are Many Types of Antidepressants

There are several different types of antidepressants a mental health care professional can prescribe. They base what they prescribe on your symptoms and medical history. The most common belong to the family that inhibits the reuptake of the neurotransmitter, serotonin. There are two main types of serotonin reuptake inhibitors, as well as tricyclic and atypical antidepressants. Here’s a quick overview:

  • Selective Serotonin Reuptake Inhibitors (SSRIs): They include fluoxetine or Prozac, and paroxetine or Paxil. You also get Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). These include venlafaxine or Effexor, and duloxetine or Cymbalta.
  • Tricyclic Antidepressants (TCAs): They increase the levels of serotonin and norepinephrine in the bloodstream. They also block the action of acetylcholine which is another neurotransmitter found in the brain. The theory behind tricyclic antidepressants is that creating a balance between serotonin, norepinephrine, and acetylcholine, alleviates depression symptoms.
  • Monoamine Oxidase Inhibitors (MAOIs): Another type of antidepressant. Phenelzine and tranylcypromine (known as Nardil and Parnate respectively) belong to this group. This is the first class of antidepressants discovered and is not used that much anymore. They inhibit an enzyme called monoamine oxidase which elevates the levels of norepinephrine, serotonin, and dopamine.
  • Atypical Antidepressants: These antidepressants don’t fit into any of the categories above. One of these is mirtazapine or Remeron. They restore the natural balance of neurotransmitters in the brain, thereby impacting the symptoms of depression. Wellbutrin is another antidepressant. Its active ingredient is bupropion. It is a norepinephrine and dopamine reuptake inhibitor that restores the balance of chemicals in the brain.

4. Finding the Right Antidepressant is a Process

There is a big possibility the first antidepressant a mental health care professional prescribes for you may not work. Just like the diagnosis, finding the right antidepressant may be a process of elimination. This can be a frustrating time for the patient. You’ve made a commitment to take medication to make you feel better, but it’s not working. For a depressed person, this can make them feel even more despondent than they did before.

Typically, an antidepressant takes four to eight weeks to show positive effects on the patient. But you must follow the dosage instructions to make sure you give the medication a chance to work. If you take your antidepressant properly without skipping doses and still don’t feel better after three months, there’s a problem. Medication that works immediately may also not be effective, which sounds a contradiction, but is true. It’s possible you’re experiencing the placebo effect.

If you feel yourself going into an even deeper depression, seek help because you may need to change your medication. Even if you feel better, but you still don’t feel quite like yourself, see your doctor. There may be an antidepressant that can have more of an effect on you. Violent mood swings and incidences of rage are also a sign your medication is not working.

So ask your support network to monitor your behavior once you start taking your medication and be on the look-out for these factors. Most doctors will start treatment with SSRIs or SNRIs, but if these are not effective, they will try another class of drugs. You’ll have to start the process all over again. Don’t be disheartened, though. Your mental health care professional will find the right medication for you.

5. Antidepressants Come with Side Effects

Like most medications, antidepressants have a variety of side effects. You may experience some of them, all of them, or none of them. You may experience them in a mild form or a severe form. But the odds are, you will experience them. Most people give up taking their medication when this happens. But that is the worst thing you could do.

So, accept the fact that there will be side effects. You may have to change medications with side effects that you can live with, as well. It is important to ask your doctor and pharmacist about the side effects of the medication you’re going to take. You can also consult the package insert or look up the side effects on the internet. But don’t read the list of side effects and decide not to take the medication at all.

Remember that the drug company must supply a list of all the side effects a patient could experience. That does not mean you will experience them all. Also, bear in mind, the mental health care professional who prescribed them is aware of the side effects. And they are confident the benefits outweigh the potential for side effects.

The possible side effects of SSRIs and SNRIs include, but are not limited to the following:

  • Nausea, constipation, or diarrhea.
  • Anxiety, restlessness and a decreased sex drive.
  • Tremors, dizziness and sweating.
  • A dry mouth and headaches.
  • Fatigue or insomnia is possible as well.

Although atypical antidepressants have similar side effects, blurred vision is an additional one. Older antidepressant classes, tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) tend to cause even more severe side effects. Medical professionals don’t use them as much as in the past. They only try them when all other options have failed.

6. Listen to Your Body When Starting Antidepressants

As soon as you start taking antidepressants, monitor any changes in your body. Don’t limit yourself to thinking about how you feel emotionally. Think about any physical changes that may be happening. Your body will take a while to adjust to the medication you’re taking. Some of the symptoms you may experience during this phase will mimic depression symptoms.

So, keep a detailed journal to write down anything unusual you experience. When you visit your doctor for a follow-up, and they want to see if the medication is working, it helps to have a written record. That way, you can be sure you don’t forget anything.

Common complaints include severe headaches, unexplained aches and pains, and muscle tension. Other patients experience an upset stomach, constipation or diarrhea. Some people report feeling tired and sleeping all the time. Others report feeling “wired” and restless, and unable to sleep. Some people are too nauseous to eat, while others can’t stay out of the fridge.

During the initial stages of antidepressant use, these types of episodes are normal. But if they persist, there’s a chance your doctor needs to re-visit your prescription. If they are so severe that they affect your quality of life to the point that you can’t go on, seek help. As your body becomes accustomed to the medication, these symptoms should lessen in their severity. Some may even go away completely.

In your depressed condition, it may be difficult to talk about the responses you’ve had to your medication. But take the leap of faith and tell your doctor everything. If you don’t, they won’t be able to help you get on the road to recovery.

7. Antidepressants Can Interact with Other Medications

Before accepting your mental healthcare professional’s prescription, make sure to give them a detailed family health history. Inform them of any medications you currently take or conditions you’ve had. That gives them the best chance of prescribing an antidepressant that won’t interact negatively. A negative interaction can cause something as mild as a temporary discomfort, or as severe as serious illness or death.

Conditions that affect antidepressants include high or low blood pressure, heart disease, vascular disease and epilepsy. Also, tell your doctor if you take blood thinners like Warfarin, for example. A family history of any of these conditions will affect what they prescribe. Painkillers and antihistamines can also have a negative interaction with SSRIs. Although some people say it is a natural remedy for depression, avoid St. John’s Wort, too.

Taking any medication affects the liver because it processes the medication and eliminates its by-products. Anyone who takes medication on a regular basis should have their doctor check their liver function annually. If you have liver disease or there is a history of it in your family, make that clear to your doctor. If your liver becomes inflamed or diseased because of your medications, your doctor should review your drug regimen.

It is important to note that most antidepressants don’t interact well with alcohol and drugs, such as marijuana. They can reverse the effects of the antidepressants, leaving you feeling even worse. Alcohol consumption also burdens the liver even more, so avoid excessive alcohol consumption, if you’re taking antidepressants.

8. You May Develop a Resistance to Antidepressants

It can be a struggle to find the right antidepressant. You may go through the initial symptoms when you start taking one and adjust to the side effects. Within a few weeks, you start to feel better. It seems that you’ve got it made. But a few years down the line, you find yourself going back into a depression.

The reason for this may be that your body has become tolerant of your antidepressant. This means it’s time for a change. A resistance can happen because of the altered levels of neurotransmitters your antidepressant creates. Your body eventually starts to oppose or resist the changes to the levels of serotonin, norepinephrine or dopamine your antidepressant causes.

Developing a tolerance toward your antidepressant is called tachyphylaxis, although people tend to refer to it as the “poop out” effect. It’s a gradual process, so you won’t notice it happening overnight. When you detect that your antidepressant is no longer as effective as it used to be, consult your mental health professional immediately. The longer you leave it, the harder it will be to correct.

If you leave it until it reaches the point of a full relapse, you’ll be back where you started. Or this second bout of depression could be even worse. Based on your description of your symptoms, your doctor will determine if it’s time to change your antidepressant. If you’re not at the maximum dose of your current medication, your doctor may increase the dosage.

However, don’t assume that because your symptoms are returning, your antidepressant is no longer effective. It is possible that your depression is worsening, or you could have a condition such as hypothyroidism. Or you may have been put on a new medication for another condition that is not interacting well with your antidepressant.

9. You May Need More Than One Medication

Most mental health care professionals won’t prescribe an antidepressant in isolation unless it is all they feel their patient needs. Sometimes, they may prescribe two different antidepressants from different classes as the best way to treat you. In the case of a recurrent, severe depression, a doctor may prescribe a mood stabilizer to help prevent extreme mood swings.

Mood stabilizers are psychiatric drugs just as antidepressants are, but they are not the same. Doctors use mood stabilizers for the treatment of bipolar disorder, mania and hypomania. And there are different types of mood stabilizers. Lithium is a natural mineral to treat bipolar disorder. Carbamazepine, lamotrigine and valproate are anticonvulsant drugs.

Originally for epilepsy, they are effective mood stabilizers. Also, Asenapine is an antipsychotic mood stabilizer. A mental health care professional may also choose to prescribe medication for anxiety. There are a variety of medications that will get anxiety under control.

Anxiety can perpetuate and exacerbate depression, so it is important to treat it. If a patient is struggling with insomnia as part of their depression, their doctor may choose to prescribe a sleeping medication, too. A healthy sleep pattern is critical for getting the symptoms of depression under control. Doctors will start by prescribing a mild sleep medication and progress to stronger medication if necessary.

Doctors are bound by professional conduct requirements to prescribe medicines responsibly. Also, they must avoid placing patients on dependency-forming medications unless necessary. Medical professionals have to exercise their judgment. Also, they use their knowledge to determine the best course of action for a patient. And that may mean a regimen of more than one drug.

10. See the Right Medical Professional

Your family doctor should help you in the beginning stages of your treatment. Usually, your general physician (GP) can recognize you may have depression and need help. And your doctor has the right to prescribe any medication, including antidepressants. However, you should consult a specialist mental healthcare professional since they are far more conversant with the condition and its treatment.

However, your family doctor can prescribe an antidepressant for the short-term while you wait to see a psychiatrist. But don’t assume your GP knows enough about the condition to treat it with the right medications. Their knowledge of medications is probably limited to the better-known ones, which may not be right for you. The go-to medication most GPs will prescribe is fluoxetine, better known as Prozac.

There is a reason for this. Fluoxetine is an excellent antidepressant and works well unless it’s not for you. So, you may experience side effects or even the worsening of your depression. A psychiatrist knows the latest trends, treatments and medications for depression because it’s their specialty. A GP is a generalist, so they won’t have such detailed knowledge.

The waiting period to see a psychiatrist may be long, and if you have to pay for the consultation, it’s expensive. However, you’ll receive the best treatment possible and have a sustained recovery, so it is vital. After all, you wouldn’t go to a criminal lawyer to represent you in a divorce. So don’t leave your treatment entirely in the hands of your GP.

Of course, if something goes wrong, and you can’t see your psychiatrist, you’ll have to go to your regular doctor. But your doctor can consult with your psychiatrist by telephone before making major decisions about your treatment.

11. Antidepressants Go Hand in Hand with Therapy

An effective treatment plan for depression has multiple approaches. And medication is only one of them. Your mental health care professional may prescribe therapy, too. They will encourage you to go to a support group or therapist. Also, they may teach you techniques for taking a mindful approach to your depression.

Going for therapy, getting support from others, and staying in touch with how you’re feeling, and progressing are helpful tools. All of them teach you the things you need to be in control of your own recovery. Therapy can teach you how to recognize your triggers and what to do when they occur. Support groups help keep you grounded in the knowledge you are not alone in what you’re going through.

Deep breathing, keeping a journal and being mindful of your recovery are techniques that will help you along the way. One of the things you get from a multilayered approach is an understanding of the importance of self-care. They also give you the courage to embrace yourself and who you are. This will boost your self-worth and self-esteem. These are the keys to combatting depression and the negative thoughts it creates.

Also, you’ll learn about the importance of a healthy diet and exercise program as part of your recovery. In a group setting, you’ll make new friends who have similar experiences to yours. This can be liberating because people with depression often feel like they’re alone. In fact, most patients think no one understands how they’re feeling.

Breaking free of the shackles of loneliness and isolation is a powerful experience. It is something to draw on every time the dark clouds of self-doubt start to gather on the horizon, and a bout of depression is quickly approaching.

12. Search for the Right Therapist

Therapy is an important part of recovering from depression. But it needs to be with a therapist you can unburden yourself to comfortably. If you can’t trust your therapist or feel they don’t understand you, you’re not likely to share with them. Therapy doesn’t work if the process isn’t open and honest. It takes time to build up enough trust with a person, especially if you’re the victim of trauma.

That doesn’t mean that your therapist shouldn’t challenge you. They should because that’s part of their job. A therapist must get you to look at things from a different perspective. They want you to see and do things you’ve been afraid to tackle for years. And how you respond to these types of challenges indicates where you are in your recovery process.

Therapists assign “homework” to do between sessions. Their homework teaches new behaviors, coping mechanisms and methods for handling stress, anxiety or depression. But you must be able to relate to the therapist you see. If you are from a conservative culture, you may feel more comfortable with a therapist who shares or understands your culture.

As a transgender person, you may find that it’s harder to find a therapist you can relate to and who can relate to you. You might feel that it’s important to see a therapist who follows the same religion as you. But bear in mind that therapists are trained to be open-minded and non-judgmental. If you are not comfortable with a therapist after a few sessions, it may be time to ask for a referral. You need to find a therapist who will be able to help you best.

13. Stopping Your Meds May Bring Withdrawal Symptoms

You will experience withdrawal symptoms if you stop taking your antidepressants abruptly. Withdrawal symptoms can include anxiety, insomnia, nightmares, aggression, mood swings, dizziness, clumsiness and muscle spasms. There are other symptoms such as nausea, vomiting, stomach cramps and flu-like symptoms. So it’s never advisable to stop taking your antidepressants suddenly without the guidance of a doctor.

It is possible to go off your antidepressants, but it is vital that you do it safely. In addition, one of the most frequent outcomes of stopping is the return of your depression symptoms. So, you must wean off your meds slowly, or you’ll be back to square one. If you and your doctor agree that you should stop taking antidepressants, they will advise you to do so incrementally.

A slow reduction of your daily dose is the safest way to do it. This means you’ll be coming off your medication for a long time. Often, doses are reduced for a period of six weeks. Thereafter, there will be another dose reduction for six weeks, and so on. So don’t rush the process.

If you feel you’re not coping well, see your doctor immediately. They may consider leaving you on the current dose for a longer time. Also, avoid stopping your antidepressants if you are experiencing a stressful situation such as moving, divorce or exams. If you’re experiencing a life-changing event or there is stress in your life, try to wait.

The timing may not be right because going off your medication is not as easy as it sounds. If you do it at the wrong time, it could have disastrous implications. So, it may be worth your while to wait for a time that is better before stopping them.

14. The Risk Factors of Taking Antidepressants

Like all medications, there are risk factors that make certain groups of people more vulnerable to the side effects and interactions of antidepressants. These are the four main groups of people who should be extra cautious before taking antidepressants:

  • People Over 65: Studies have shown that antidepressant medications, especially SSRIs, increase the risk of falls and fractures among senior citizens. They also account for some bone loss.
  • Teens: When teenagers take antidepressants, there is a greater risk they will experience the effects. In fact, there is an increased risk of suicide among teens who take these medications. So they need to be in the care of an experienced professional. Their parents should understand the warning signs, too. Many parents find out too late that their teen was feeling suicidal, which is a great tragedy.
  • Bipolar Patients: Those with bipolar disorder should not take antidepressants. They can make the bipolar disorder worse or trigger a manic episode, which can be dangerous. This is where the care of a psychiatrist is essential. A GP with little experience of mental health treatment may prescribe antidepressants to a bipolar person because they don’t know the difference. So their best intentions may lead to a patient’s worsening condition.
  • Pregnant Women: Prescribing antidepressants to pregnant women also carries some risk. While on the one hand, the patient needs the medication for her daily survival, there is also the baby to consider. Most antidepressants have labels that read, “untested for pregnancy.” And there is no research on their effects on the brain development of a fetus or whether they cause birth defects. Also, when women take SSRIs during pregnancy, their babies may experience withdrawal symptoms after birth.

15. The Stigma of Depression and Antidepressants

Despite the enlightened times we live in, some people are still in the dark when it comes to depression. In certain religions, cultures and countries, they don’t recognize depression as an illness. People marginalize and label depressed people as being crazy. Even some doctors don’t acknowledge the condition and treat it. And some families regard mental illness as a mark of shame on their honor.

How much you decide to share with those around you is up to you. It will depend on you as a person, and the relationships you have with people around you. But regardless of how careful you are, there will always be that one person who will tell you to smile and get over it. The important part is to know that such statements come from a place of ignorance. If the person truly understood what you were going through, they’d never make statements like that.

When you’re strong enough, try to be an advocate for other sufferers. Stand tall and don’t let others judge you. Choose to educate them about your condition and what triggers it. Explain why you take antidepressants and what they do. Persist in the face of their judgment, and don’t take it to heart.

This may not be easy at the beginning of your recovery, but it will seem possible later. When more people can be open about their struggles with depression, it will become less of a stigma. This will lead to less finger-pointing and whispering, leaving you free to focus on your recovery. As a sign of solidarity for those suffering but afraid, stand up and be counted.

These are the things you should know about antidepressant medications before taking them. Perhaps you know some of the already, but hopefully, you learned some new ones. If you are suffering from depression, there is hope. So talk to your doctor to see what your options are before you feel even worse.

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