For some people, especially those with major depression, depression medications may be an important part of the treatment plan. Milder forms of depression may be treated without depression drugs, also called antidepressants, but most experts agree that when depression is severe, a depression medication can help.
If you have depression and you and your doctor are considering a depression medication, you should know that most people taking an antidepressant experience at least one side effect and about 40 percent of people do not get relief from the first depression medication they try.
Depression Medications: Common Types
The theory behind using medication to fight depression is that depression is caused by a chemical imbalance in your brain. Low levels of brain chemicals called neurotransmitters may be responsible for some types of depression. Emotional and social factors also play a role in depression — it's important to remember that depression medication by itself is not a magic bullet.
Common classes of depression medications include:
- Selective serotonin reuptake inhibitors (SSRIs). These depression drugs work by making more of the brain chemical serotonin available to your brain. Serotonin is believed to influence your mood. These medications are the most frequently prescribed for depression because they have fewer side effects than older medications. Some of the drug names you may be familiar with are fluoxetine (Prozac), paroxetine (Paxil), and citalopram (Celexa). The most common side effects include sexual problems, headache, nausea, dry mouth, and difficulty sleeping.
- Atypical antidepressants. These depression drugs are similar to the SSRI drugs. In addition to serotonin, they may target other brain chemicals such as dopamine or norepinephrine, which may play a role in depression. Common drugs in this class are venlafaxine (Effexor), duloxetine (Cymbalta), and bupropion (Wellbutrin). Side effects are similar to the SSRI drugs and include fatigue, weight gain, sleepiness, and blurred vision.
- Tricyclic antidepressants. This is an older class of depression drugs. Like newer antidepressants, tricyclics work by increasing levels of brain chemicals, but nowadays they are not used as often since they have more side effects. These include dry mouth, blurred vision, urination difficulties, and constipation. Also, tricyclics can make you tired. If you have glaucoma, you should not take any tricyclic antidepressant.
- Monoamine oxidase inhibitors (MAOIs). Another older class of antidepressant drugs, MAOIs are also now infrequently used because of their potential side effects. These drugs work by blocking an enzyme called monoamine oxidase, which breaks down the brain chemicals serotonin and norepinephrine. People taking MAOIs can experience dangerous reactions if they eat certain foods, drink alcohol, or take over-the-counter cold medicines.
Depression Medications: The Government Warnings
In 2005, the U.S. Food and Drug Administration warned that the risk of suicidal thoughts or behavior may be increased for children and adolescents taking depression drugs. In 2007, the warning was expanded to include anyone under age 25 taking antidepressants. If you are taking an antidepressant, especially if you are under 25, let your doctor know if your depression seems to be getting worse or if you have any thoughts of hurting yourself.
If you and your doctor decide that you should try medication for your depression, know that it takes about six weeks for the depression medication to have its full effect. Never start or stop a depression medication without letting your doctor know. Suddenly stopping your medication can cause an unpleasant withdrawal reaction, so when the time is right your doctor will give you instructions for gradually reducing the dose before stopping the drug.
Although you need to be aware of their side effects and keep in close contact with your doctor, most people who need an antidepressant find one that works for them.