Medications Used in the Treatment of Depression

​Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They are highly effective and generally cause fewer side effects than the other antidepressants. SSRIs help to alleviate symptoms of depression by blocking the reabsorption or reuptake of serotonin in the brain. Serotonin is a naturally occurring neurotransmitter (chemical) that is used by brain cells to communicate. As SSRIs mainly affect the levels of serotonin and not levels of other neurotransmitters, they are referred to as “selective.”

Selective Serotonin Reuptake Inhibitors (Ssris) include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), fluvoxamine CR (Luvox CR), paroxetine (Paxil), paroxetine CR (Paxil CR), sertraline (Zoloft).
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Side effects of SSRIs may include nausea, vomiting, diarrhea, sexual dysfunction, headache, weight gain, anxiety, dizziness, dry mouth, and trouble sleeping.

Although SSRIs are relatively safe, there are some safety concerns regarding their use. Serotonin syndrome: Serotonin syndrome is a serious medical condition that can occur when medications that alter the concentration of serotonin in the brain are taken together. Symptoms of serotonin syndrome may include anxiety, restlessness, sweating, muscle spasms, shaking, fever, rapid heartbeat, vomiting, and diarrhea. Examples of medications that can cause serotonin syndrome include antidepressants, some pain relievers such as meperidine (Demerol) or tramadol(Ultram), St. John's wort, medicines used to treat migraine headaches called triptans, and some street drugs such as cocaine.

Significant Warning Signs for SSRI’S
Suicidal thoughts or behavior: All antidepressants may increase the risk of suicidal thoughts or behavior in children, adolescents, and young adults (18 to 24 years of age).
 
What Is Norepinephrine Used For?
Norepinephrine is indicated for blood pressure control in certain acute hypotensive pressure. Norepinephrine is also indicated as an adjunct in the treatment of cardiac arrest and profound hypotension. Norepinephrine is available under the following different brand names: Levarterenol, and Levophed.

What Are Tricyclic Antidepressants, And How Do They Work?
Tricyclic antidepressants (TCAs) are a class of antidepressant medications that share a similar chemical structure and biological effects. Scientists believe that patients with depression may have an imbalance in neurotransmitters, chemicals that nerves make and use to communicate with other nerves. Tricyclic antidepressants increase levels of norepinephrine and serotonin, two neurotransmitters, and block the action of acetylcholine, another neurotransmitter. Scientists believe that by restoring the balance in these neurotransmitters in the brain that tricyclic antidepressants alleviate depression. In addition to relieving depression, tricyclic antidepressants also cause sedation and somewhat block effects of histamine.

For What Conditions Are Tricyclic Antidepressants Used?
Tricyclic antidepressants are approved by the Food and Drug Administration (FDA) for treating several types of depression, obsessive compulsive disorder, and bedwetting. In addition, they are used for several off-label (non-FDA approved) uses such as:
panic disorder, bulimia, chronic (for example, migraine, tension headaches, diabetic neuropathy, and post herpetic neuralgia), phantom limb pain, chronic itching, and
premenstrual symptoms.

Note: Alcohol blocks the antidepressant action of tricyclic antidepressants but increases its sedative effect.


Thomas Kessler, LMFT, RAS
www.thomkesslertherapist.com
[email protected]