Depression Treatment From The American Medical Association
Q: How is depression treated?
Today, depression can be successfully treated with a variety of
antidepressant medications, various forms of psychotherapy, or some
combination of these or other treatments. Your doctor will choose the
best treatment plan for you or your loved one.
A:Antidepressant drugs are the main medications used to treat depressive
mood disorders. There are four types of antidepressants that work in
different ways to correct a chemical imbalance in the brain.
Nine out of 10 people who have depression can be helped by
antidepressant medication. However, which type of medication works
best varies from person to person. You may need to try several before
your doctor finds the best drug for you.
It is important to understand that, though these drugs are powerful in
the treatment of depression, they are not addictive. Antidepressants
do not provide an unnatural high and are not intended to change your
personality. When taken by a healthy, non-depressed person, they have
no noticeable effect.
Before taking an antidepressant, it is important to tell your doctor
about any other medications you may be taking and carefully follow his
or her instructions about diet, other drugs and alcohol.
The following four categories of antidepressant drugs differ in their
side effects, with the newer drugs usually causing fewer problems.
Side effects can include dry mouth, drowsiness, constipation,
headaches, nausea, nervousness and insomnia. If you have side effects
that last for more than a few weeks, tell your doctor. He or she may
be able to adjust the dose or prescribe a different drug.
Tricyclic antidepressants (TCAs). These drugs alter the balance in the
brain of the neurotransmitters (chemical messengers) norepinephrine
and serotonin. Some TCAs are imipramine, amitriptyline, desipramine
and nortriptyline.
Monoamine oxidase inhibitors (MAOIs). These drugs slow the breakdown
in the brain of the neurotransmitters (chemical messengers)
norepinephrine and serotonin, letting them assist brain cells in
sending messages for longer periods. When taking MAOIs, you must
follow a special diet to avoid problems; follow your doctor's advice
on which foods to avoid. A number of medications (including cold
pills) also must be avoided to prevent adverse interactions. MAOI
drugs include phenelzine and tranylcypromine.
Selective serotonin-reuptake inhibitors (SSRIs). These drugs work by
enhancing the neurotransmitter (chemical messenger) serotonin. By not
interfering with other chemical messengers, SSRIs treat depression
without causing the side effects often associated with TCAs and MAOIs.
SSRI drugs include citalopram, fluoxetine, fluvoxamine, paroxetine and
sertraline.
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