How do Antidepressants Work?

health wellness

Antidepressants are often prescribed to people suffering from depressive illness. Depressive illness is caused by a decrease of certain chemicals or neurotransmitters in the brain that are responsible for mood. Antidepressants stimulate chemical changes that increase the levels of these neurotransmitters. Three main neurotransmitters associated with mood are serotonin, norepinephrine and dopamine. Different antidepressant medications affect one or more of these neurotransmitters.

Neurotransmitters released from nerve cells in the brain only have a short time to relay their message to another cell before enzymes destroy them or they are taken back up by the cell. This process is referred to as reuptake. Once reuptake occurs, the neurotransmitter ceases to have any affect on the brain.

In people suffering from depressive illness fewer of these neurotransmitters are being produced. Therefore antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) delay the reuptake of one of these neurotransmitters, serotonin, thus raising levels in the brain. With more natural levels of serotonin in the brain, mood is elevated from the depressed state to a more normal state of mind. SSRIs are very popular because they seem to have the least side-effects among antidepressants. Additionally, side-effects tend to be mild to moderate and are transitory, usually disappearing after 1-3 weeks. Some brand names of SSRIs are Zoloft, Prozac, Paxil and Lexapro.

Tricyclic antidepressants (TCAs), work in the same manner but affect the uptake of all three neurotransmitters associated with mood: serotonin, norepinephrine and dopamine. However TCAs have more side-effects and can be dangerous if overdosed. TCAs are not recommended to patients with heart trouble. Some tricyclic antidepressant brand names are Allegron, Tryptizol, Anafranil and Ortrip.

Monoamine oxidase inhibitors (MAOIs), an older class of antidepressants, also increase levels of all three neurotransmitters by inhibiting an enzyme responsible for inactivating them. However, MAOIs also affected tyramine, a molecule inked to blood pressure. As a result anyone taking MAOIs must stick to a very strict diet that forbids a variety of common foods like cheeses, yogurt, certain meats, bananas, and many more foods. Failure to do so can lead to a hypertensive crisis and may result in death. MAOIs also interact with many medications and are no longer widely prescribed.

Although antidepressants are not addictive and can be taken in an ongoing regimen, they are normally prescribed for a 4-6 month period, with most people experiencing some benefit after 2-4 weeks of use, and full benefits at about 4 months. Patients are encouraged to seek other means of relief from their depression during this period, including exercise, a healthy diet, and in some cases "talk" therapy to work through any external cause for the depression.

Specific side-effects vary among the different groups of antidepressants and should be discussed with your physician. Antidepressant medications should not be mixed unless your doctor tells you to do so. In some cases depression can increase at the onset of taking an antidepressant until it has had a chance to work, and in rare cases this has reportedly been linked with suicide in those intolerant of these medications. However, for the vast majority of patients antidepressants have played an important role in relieving depressive illness and might also be prescribed to relieve anxiety, obsessive behavior, panic attacks and post-traumatic stress syndrome.

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12
- anon16504, there is plenty of evidence for the case of anti-depressants and other drugs used to treat mental disorders.

It has not been proven to be a casual relationship, i.e., a person with low levels of serotonin will have depression, but it is much more likely. Likewise, someone with a high level of dopamine does not automatically have schizophrenia. But schizophrenics do tend to have higher levels of dopamine.

Therefore, doctors prescribe drugs that change the way your body produces and absorbs chemicals, or neurotransmitters if you want the technical term, and although they are not effective in 100 percent of cases (no method of treating disorders is) it does help significantly. Like anon21493 says, taking medication combined with psychotherapy (or cognitive behavioural therapy) is the most effective way of treating, and living with disorders such as depression.

Anybody who is on anti-depressants, or any other medication, please do not stop taking it. It will help. It'll be a long journey, but with perseverance and treatment, it will be worth it.

- anon50821
11
I have been taking Zoloft for about a year now and it was not because I have depression. It is because I have high stress levels and with a condition I have, I pass out without my Zoloft. anon45133 Yes I had the same thing with it when I started it. It does get better but I would talk to your doctor about your dose. I had to increase mine to make sure I still felt well.
- anon50303
10
Anon21493, are you a scientist? A doctor? Personally, I think if somebody is "diagnosed with clinical depression" it's crap. Guys, I'm depressed, I'm depressed as hell for many, many reasons. But I refuse to go on anti-depressants, or anything like that. We do not need drugs to get through our struggle. Is it really any different than doing hardcore drugs? Like heroin? Or other kinds of hardcore drugs? Is it really any different than just smoking pot? A drug is a drug, and just because a scientist or a doctor recommends you take these drugs, doesn't mean it's best for you. I think the only way to get over things like depression, (And I say 'things like depression' because I'm not referring to issues when you are sick), is to do it with will power. Change your life and make it better yourself, and don't rely on drugs.
- anon46573
9
Hi there. I have recently started on Zoloft and quite worried because it is actually making me feel worse instead of better. Has this happened to anyone else? Is this normal? If so how long does it stay around for.
- anon45133
7
The doubtful anon sounds shockingly close to the official line of Scientology.
- anon34372
6
hey. i took xanax, paxil, abilify, lamictal, and seroquel.. abilify was horrible. lamictal i was allergic to. paxil didn't work. xanax was just fun. and seroquel was the best for me. i eventually didn't need them because i found my own happiness. i combined it with psychotherapy and i'm happy as can be. they do work, but i promise you you won't need them for the rest of your life. it's kind of like a crutch when you can't handle the depression.
- anon29690
5
I have no idea when this article was posted, but based I feel compelled to make a comment based on the comments, just in case someone who has been recently diagnosed with depression (or has had depression for a long time) reads the post of anon16504 and is frightened into not taking their medication.

First of all, hundreds of studies have clearly demonstrated that SSRIs are extremely beneficial for the treatment of depression. This has been clinically proven time and time again. Psychotherapy is also helpful, and in fact, the most effective way to treat depression is to COMBINE psychotherapy with antidepressants.

While it is true that the monoamine hypothesis of explaining depression (i.e. the depression is a result of low levels of norepinephrine and serotonin) is just that, a hypothesis, that does not mean that it is fabricated, and it does not mean that there is "no medical evidence that these chemical imbalances even exist." In fact, multiple studies have found that serotonin and norepinephrine are lower in patients with depression. And most importantly, these medications work!!! The brain is an extremely complex thing and to be completely sure of why and how depression (or any psychiatric disorder) occurs is a huge feat, one that scientists are diligently working on, but there is still much work to be done.

There are cases when depression is REACTIVE (meaning in response to something bad happening; i.e. "my grandmother and my dog died and I failed out of college") this depression may not be a result of a chemical imbalance, but depression that affects daily life for an extended period of time may be a result of this chemical imbalance.

In conclusion, these medications (namely SSRIs) are effective with minimal side effects and are prescribed based on scientific and medical evidence. It is certainly much more dangerous to NOT take medication if you are diagnosed with clinical depression. Please do not listen to Anon16504 if you have been diagnosed with depression. Instead, talk to your doctor, or a psychiatrist, or a scientist, or even a Biology teacher. Depression isn't a weakness or a character flaw, it is a chemical imbalance in the brain and it is very treatable. Thank you, and good luck

- anon21493
4
Is what anon16504 posted true? Is there really no medical evidence for the chemical imbalance theory? Do psychiatrists know this? Shouldn't it be illegal?
- curious217
3
Why do you tell people that antidepressants help correct chemical imbalances in the brain when there is no medical evidence that chemical imbalances even exist? No one knows what one would look like and research shows that an increase in the brain chemicals needed have little or no effect on depression. It is also true that some people with depression have high levels of seratonin and some people experiencing no symptoms of depression have incredibly low levels of seratonin. Is it true that psychiatrists and physicians do not actually know how or why the medication works?
- anon16504
2
hi i am taking anti depression for 3 years

can i become pregnant now?

please could u tell me as soon as possible

- anon6126
1
Hi there www, I have taken paxil for major depression for 13 yrs straight....I have never had another bout of depression again...is there anyone with similar results with ssri use?
- robot

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Written by R. Kayne
Last Modified: 01 November 2009

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